PUSH, PULL, POOL: Accelerating Innovation and Access to Medicines for Tuberculosis

Tuberculosis (TB) mainly affects low- and middle- income countries with 95% of cases occurring there. 1.3 million people were killed by the disease in 2012 and there were 8.6 million new cases requiring treatment. With the advent of new diagnostics like GeneXpert the confirmed numbers of multidrug-resistant (MDR) TB cases are rising and programmes are unable to cope - 16,000 patients diagnosed with MDR-TB in 2012 did not receive treatment.  And about 80% of those estimated to have MDR-TB are not even diagnosed.

MDR-TB treatment is particularly difficult, because it is long—two years of treatment including eight months of daily injections and a total of more than 14,600 pills to swallow—and because many of the medicines used have toxic side effects such as deafness, psychosis and severe nausea. Moreover, the success rate is unacceptably low with only 48% of patients being cured, and costs can be very high. For 9% of global cases with extremely drug-resistant TB (XDR-TB) treatment is even longer, more expensive and the success rate is even lower at only 13%.

The aim of the ‘3P Project’ is to rapidly deliver affordable, effective new regimens for TB through an open collaborative approach to conducting drug development and through novel approaches to financing and coordinating R&D.  The 3P Project implements three mechanisms to facilitate the necessary and appropriate R&D for TB regimens:
•    push funding to finance R&D activities upfront (i.e. through grants)
•    pull funding to incentivise R&D activities through the promise of financial rewards on the achievement of certain R&D objectives (i.e. through milestone prizes)
•    pooling of intellectual property (IP) to ensure open collaborative research and fair licensing for competitive production of the final products
TB demo project extended version For Web_12032014.pdf
Page updated: 7 November 2013
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