The initiatives by two top multinational drug companies in India last week should have taken many in the developing world by surprise. The companies Astra Zeneca and Eli Lilly have announced long term plans to tackle TB, a dreaded disease of the poor that kills 3 million people worldwide every year. India accounts for a good percentage of these deaths. Astra Zeneca's chief executive, Sir Tom McKillop, flew into Bangalore to open its 10 million dollar state of the art research facility dedicated to discovery of new TB drugs. The company committed another 30 million dollars during the next five years for finding a new TB molecule from this facility. The gesture deserves applause. India's top research-based companies Dr Reddy's and Ranbaxy are yet to think of TB and malaria as their new molecular research options. Astra's research venture is, probably, the first such project specifically into TB drug discovery in recent years. Drug MNCs have been abstaining from research for new molecules for TB and other tropical diseases for more than four decades. The only reason for this neglect is the fact that a new molecule for a poor man's diseases cannot be a blockbuster for MNCs to bring in billions of dollars.

Astra's project is quite ambitious. But how long it will take to get a new molecule from its facility is something to be seen considering the number of failures in the labs of even large MNCs in recent years. Emergence of Multi Drug Resistant TB is making the challenge of finding a new molecule for the disease even more difficult. Eli Lilly's announcement of its global plan with WHO to tackle MDR-TB in New Delhi, in this context, is significant. MDR-TB is emerging as a much more serious threat to humanity as the available drugs for treatment of TB are not working on such patients. And the number of MDR-TB cases is exploding as it can be spread to others just as normal TB. Nearly 4 lakh new cases of MDR-TB are detected in more than 100 countries each year. This is indeed a huge number. Lilly has committed 70 million dollars as its contribution to this global plan and promised to transfer technology to manufacture two antibiotics, capreomycin and cycloserine, for treatment MDR-TB to countries where the disease is most prevalent. Lilly's plan to establish a centre of excellence for training medical personnel in the treatment of MDR-TB and to have a comprehensive surveillance programme to monitor the resistance against antibiotics amongst the patients should bring some kind of control in this regard. As finding a new molecule is some years away, what is immediately required to contain the disease is a stringent surveillance system and strengthening of DOTS programme by qualified and trained medical personnel.