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World TB Day: “It’s time” to improve access to treatment

Updated: Mar 29, 2019

On the occasion of World Tuberculosis Day on March 24, the World Health Organization (WHO) reminds the commitment made with the 'End TB Strategy': to reduce TB incidence by 80%, TB deaths by 90% and to eliminate catastrophic costs that burdens TB-affected families, by 2030.

The call is on country leaders, stakeholders and partners to join the strategy to increase the number of people reported as diagnosed and treated, and to reach at least 30 million people with TB preventive services between 2018 and 2022.

This is why the challenge and target set by the STriTuVaD consortium is very relevant to address on the World TB Day 2019’s theme 'It’s time'; it’s time to improve access to treatment. For this, there is an urgent toned to scale up access to prevention and treatment, especially in those countries, like India, where tuberculosis is not just a health issue, but a health burden for the people and the States:

“The social and economic impacts are devastating, including poverty, stigma and discrimination - says Dr Tedros Adhanom Ghebreyesus, WHO Director-General – we need to accelerate our efforts to make TB history". Joining forces worldwide to improve the testing of new drugs, would be a huge step in that direction.

In particular, the STriTuVaD project, co-funded by the European Commission under its framework programme 'Horizon 2020' and by the Department of BioTechnology of the Indian Government and consisting of European and international partners, has the ambitious goal of bringing radically innovative in silico methods in the evaluation process of new vaccines: this may have a dramatic impact in terms of a faster and cost-effective development of new therapies to fight this deadly disease.

In almost any industrial sector where there are safety concerns, before a product is tested in the field, it is analysed with dozens of computer simulations, aimed at highlighting if that product will work as expected under a variety of conditions. The only exception is the medical field, where until recently the only way to assess the safety and the efficacy of new therapies was to test them on animals or on humans in clinical trials.

Beside the ethical implications of such experimentation, this trial and error approach based on very expensive clinical trials is a major factor in the high cost of new drugs. The costs are becoming so high that people in lower income countries can rarely afford them, and in countries where universal healthcare is provided the drugs expenditure is becoming so high that the free access to healthcare is being questioned. In Silico Trials, or the possibility to test first in a computer simulation any new drug, could dramatically reduce such costs, opening the door to more effective but also more affordable TB therapies. We also expect In Silico Trials to shorten considerably the time required for a new drug to reach the market.

Before we adopt these innovative in silico methods, we need to demonstrate convincingly that their predictions are accurate and reliable. This is why it is crucial that all the stakeholders involved in TB vaccine development, consider pro-actively the challenge posed by one of the partners in the STriTuVaD project, Prof Viceconti from University of Bologna, in a recent declaration to the press: “We invite all related institutions and organizations to set a long-term goal to achieve similar safety studies with 50% less animals used and 50% less costs within a 10 year period" to which he added that this was a conservative objective if In Silico Trials approaches are adopted”.

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