An estimated two billion people around the world and two million in India suffer from tuberculosis. There is treatment but there is no single drug as yet; and for over 40 years, doctors across the world have been prescribing the same combination of four drugs. Worse, the bacterium has started showing drug resistance.
Currently India is a key site for the hunt for a new drug to combat TB. AstraZeneca Plc through its Bangalore-based research subsidiary, is among the handful of companies across the world pursuing this challenge. As part of its research on drugs for infectious diseases for the developing world, the Anglo-Swedish pharma major has invested $ 40 million (nearly Rs 180 crore) in its India research hub, AstraZeneca Research India (AZRI).
The Bangalore -based AZRI is one of its 11 R&D centres located across the world. Its focus is to find a drug that can be more efficacious than the existing treatments, of shorter duration, affordable and functional against latent disease and resistance organisms. The research is based on the pathogen Mycobacterium tuberculosis.
The existing regimen is for four drugs (rifampicin, isoniazid, ethambutol and pyrazinamide) prescribed over six months - a regime which is effective but difficult for patients to keep up.
The AZRI team's focus is to eradicate the microbe from specific locations and reduce the treatment time. If it succeeds in its mission, the TB treatment time would be cut to under four months or 65 per cent of the present duration; this alone should bring down the cost of treatment by 30 per cent for every patient.
The benefits will also reach of the current WHO (World Health Organisation ) DOTS (Directly Observed Treatment Short-Course) programme from the existing 25 per cent to 50 per cent worldwide.
The aim is also to ensure that the new drug will have minimum side-effects and also be compatible to HIV Mycobacterium tuberculosis cases.
The parent AstraZeneca Plc is a global prescription pharma major engaged in research, development, manufacturing and marketing. Its core products are for gastrointestinal, cardiovascular, neuroscience, respiratory, oncology and infectious diseases.
It has invested in a modern AZRI laboratory built at an initial investment of $11 million and an annual dose of around $ 5 million. In 2005, the parent company again invested around $12 million in a Process R&D Lab - which is now expected to be come operational in November 2006.
Nearly 90 scientists hired from renowned research centres and universities are on the TB drug job at Bangalore. They interact closely with the AstraZeneca's infection research centre in Boston (US) and with external academic leaders. They employ bioinformatics-driven intracellular identification of novel pathways and have access to new technologies like high throughput screening and compound libraries. The company plans to expand its scientific team to include international experts.
The other AZ arm in the country, AstraZeneca Pharma India - which is the manufacture and marketing arm - also has a supporting role in the TB mission. It has launched a nationwide awareness campaign called 'Stop spitting, stop TB' where its sales force distributes posters and leaflets developed in local languages to clinics, hospitals and nursing homes.
AZPI deals with cardiovascular, oncology, critical care, CNS (local anaesthesia), maternal healthcare and respiratory therapy areas.
At a global level, the AZ tuberculosis project supports the Red Cross TB community programmes in Turkmenistan and Kyrgyzstan. It supports the TB control and management project run by the African Medical and Research Foundation (AMREF) to create an awareness on the symptoms, testing, treatment and training of local health workers of the TB treatment programme, DOTS. It also works with Red Cross/Red Crescent to tackle TB at a local level in the countries where the disease is rampant.