PAN-TB, Project to Accelerate New Treatments for Tuberculosis

The Problem
The current treatment regimen for the most common form of tuberculosis (TB) requires taking multiple drugs for about six months under clinical supervision. Patients with drug-resistant TB face even longer and more complex treatments.
The Solution
The PAN-TB partners work together to develop novel treatments for TB that are shorter in duration, better-tolerated, and simpler to use.

Overview

PAN-TB was created to address the prevalence of tuberculosis and challenges to current treatments. Tuberculosis is a serious and persistent infectious disease, and one of the leading causes of death worldwide. The COVID-19 pandemic has significantly disrupted the global TB response by overburdening health systems and compromising disease control capacity. In 2020, 1.5 million people died from TB, marking the first increase in TB mortality in a decade. The discovery of novel therapeutics came to a standstill.

Role of the FNIH

The Foundation for the National Institutes of Health (FNIH) is the lead project manager of the PAN-TB collaboration. Since June 2021, the FNIH has provided project management for the PAN-TB governance bodies: the Sponsorship Board and the Steering Committee, as well as multiple working groups, and focused scientific series. The FNIH documents governance decisions, supports internal and external communications, and organizes the project’s virtual or in-person convenings and governance meetings when appropriate.

Challenges to Current TB Treatments

The current regimen to treat drug-susceptible TB, the most common form of TB, requires patients to take multiple drugs for six or more months under clinical monitoring. Since patients with a drug-resistant form of TB cannot use this regimen, they often face longer, more complex treatment courses and frequently endure significant side effects.

The length of treatment can lead to adherence issues and a lack of follow-up. In addition, the drugs may be poorly tolerated and can cause undesirable interactions with other drugs, such as hormonal contraceptives and HIV antiretroviral therapy (ART). Consequently, the treatment success for TB has remained stagnant at approximately 85 percent globally.

Achieving Better Standards of Care

The PAN-TB collaboration is working to develop novel regimens that could transform TB care. A shorter and safer regimen that can treat TB irrespective of pre-existing drug resistance, and with reduced need for drug resistance testing, could provide a significant benefit to both patients and health systems.

The novel regimens would have an improved safety profile, require minor monitoring, be easy to administer (once daily), and be affordable for patients in lower- and middle-income countries (LMICs). The hope is that these attributes will lead to greater treatment adherence and improved treatment success among millions of TB patients, and perhaps also lead to reduced transmission of infection. With less time and patient support needed for treatment, more resources would be available for enhanced case finding, which should accelerate the decline in disease burden on the path to eliminating TB.

A New Model for Research

Traditionally, pharmaceutical companies rely on their own unique resources to drive innovation. The PAN-TB collaboration takes on a synergistic approach by joining together organizations to collectively drive this effort forward with funding, scientific knowledge, and the ability to reach advocates, patients, and healthcare professionals to help truly eradicate the disease. The success of this collaboration model could help fast-track other global health initiatives with a similar strategy.

Goals

  • Develop new drug regimens that could effectively treat both drug-susceptible and drug-resistant forms of TB in a shorter duration than current regimens
  • Expand TB trial capacity and streamline design and execution of some trials
  • Advance research through phase 2 clinical efficacy studies to identify promising regimens for further development
  • Decrease TB transmission rate and accelerate progress toward the global elimination of TB

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