Even as tuberculosis (TB) continues to threaten the lives and wellbeing of thousands of people each year in India and several other countries, India and the US will soon begin collaborative research on TB under the Indo-US vaccine action programme (VAP).

The main aim of this initiative is to build and enhance biomedical and clinical research capacity in India by establishing long term longitudinal cohorts of TB patients and their contacts (or other high TB risk patients) for studies using state of the art research tools. Similar cohorts may also be established in other high burden countries and in the future a collaborative global network of these cohorts might be utilized to undertake coordinated research to better understand similarities and differences in the TB epidemic in high burden countries and to facilitate a broad array of biomedical TB research.

According to senior officials in the Department of Biotechnology (DBT), there is an urgent need to start research in this area as TB continues to threaten the lives and well being of thousands of people each year. With the rapid increase in drug resistant TB, this is an urgent issue. Understanding the dynamic nature of TB in high burden countries is critical for the development of drugs, vaccines and diagnostics that will have their greatest impact in these settings, and requires a combination of biomedical (basic science) and clinical research.

Using biomedical research tools to study TB patients and their contacts over a longer period of time in a longitudinal cohort will increase global understanding of the differences in the trajectory of the TB epidemic in India. It will also provide an understanding of how these differences are related to emerging co-infections (e.g., HIV) and co-morbidities (e.g., diabetes, other immune compromising conditions), among other factors.

Biomedical science provides the knowledge that underlies the development of new drugs, vaccines and diagnostics, and leads to clinical tools to help understand the differences and commonalities of TB in various regions throughout India.

Officials also said that TB is a strategically important epidemic. Emerging forms of TB that are multi-drug-resistant (MDR) and extensively drug-resistant (XDR) add urgency to the need for a greatly expanded programme of global research to better understand and confront this disease. Clinically oriented biomedical research is a critical component of global efforts to better understand the TB epidemic and to develop improved tools that can rapidly be made available to countries, health care providers and ultimately patients. For this, collaborations between epidemiologists and clinical and basic researchers have to be strengthened to maximize TB research capability in countries where TB is a serious health concern.