because the potential profits in selling a drug to poor people don’t justify the risk and expense of R&D the way afflictions of wealthy countries, like cancer and diabetes, do.
Birt was quick to challenge my assertion about TB being a disease of the developing world, though. In the age of jet travel, an attorney from Atlanta can get infected with an extensively drug-resistant form of TB and can get on a plane and go to Europe and back, potentially infecting others—and causing public health authorities to get seriously worried. Seattle has also had its share of notorious TB cases, including a diagnosis in 2001 of former Mariners shortstop Carlos Guillen during the September stretch run of the memorable 116-win season.
So just like any infectious bug, TB can cross borders pretty fast and cause trouble in our neighborhood. Then again, there’s a reason that the American public has forgotten about TB. The incidence rate in Washington state reached an all-time low of 3.5 cases per 100,000 people in 2008, according to the Washington state Department of Health.
Since Xconomy is focused on innovative new solutions, I asked Birt and the summit’s project director, Claire Topal, to point to some of the most intriguing TB treatments emerging in the pharmaceutical industry pipeline. One that popped to mind was TMC207, in development by Johnson & Johnson. This drug, which recently showed promising results in a mid-stage clinical trial, is thought to have potential because it’s highly potent against drug resistant strains of TB, researchers say.
And just on the other side of the building from Xconomy’s Seattle office, there’s another intriguing effort underway. It’s the Lilly TB Drug Discovery Initiative, a program sponsored by Eli Lilly at the Infectious Disease Research Institute. This is a small group of scientists who formerly worked together at Bothell, WA-based Icos, who received $9 million of donated equipment for high-speed screening of drug candidates. Lilly has opened up access to its library of 500,000 small-molecule chemical compounds to be screened as TB drug candidates, and Lilly donated $6 million in cash over the next five years to do the work.
The work is still at an early stage, although “there has been a lot of progress,” says Steve Reed, the founder and head of research and development at IDRI. One drug candidate donated from a research group in Japan has shown particular promise in fighting multidrug resistant TB in mice, he says, and scientists are working to optimize the compound for use in humans, he says. The goal will be to come up with a number of drugs like this that can be potent single agents on their own, which would simplify the course of treatment and give doctors a number of tools to throw at the bug.
“You want to have an arsenal,” Reed says.
Reed plans to attend the Pacific Health Summit. I asked him what he hopes to accomplish. “Networking,” he says. “It’s important to initiate new collaborations, and bring visibility and funding. I hope more pharmaceutical companies get more interested.”
