Fight Drug-Resistant Tuberculosis, NIAID's Research Agenda.

The World Health Organization (WHO) estimates that 500,000 people worldwide have rug-resistant TB-multidrug, MDR TB, while the frequently fatal XDR TB, extensively drug-resistant TB has been detected in 46 countries. Factors contributing to the rising tide of drug-resistant TB include

• Lack of routine testing to determine TB drug-sensitivity
• Incomplete treatment of people infected with TB-causing bacteria
• The epidemic of TB in HIV-infected people
• Limited TB research by pharmaceutical companies, resulting in few new anti-TB drugs or other interventions.

The National Institute of Allergy and Infectious Diseases, NIAID research agenda complements domestic and international efforts to prevent and control the spread of MDR and XDR TB. Whereas the WHO's STOP TB Partnership plan emphasizes increased surveillance and control and treatment efforts, the NIAID agenda focuses on biomedical research. The Institute also collaborates with the Centers for Disease Control and Prevention and other NIH Institutes and Centers on TB research efforts in the United States.

To prevent the further emergence and spread of MDR and XDR TB, the NIAID agenda identifies areas of biomedical research that are likely to contribute substantially to a global public health response. Building on existing efforts within the international network of TB research, NIAID's priorities include efforts to

• Develop and test reliable technologies to rapidly diagnose TB and to identify drug resistance
• Define the most effective use of existing TB therapies and other antibiotics available to treat drug-resistant TB and develop new drugs, particularly to treat MDR and XDR TB
• Better understand the basic biology of TB-causing bacteria and their interaction with the human host that underlie the development of drug-resistant TB
• Understand the epidemiology of drug-resistant TB
• Investigate the various manifestations of TB in adults, children and those with co-infections, including HIV/AIDS
• Conduct research to develop new vaccines and other preventive strategies.

The full NIAID research agenda for MDR and XDR TB is available at: http://www3.niaid.nih.gov/topics/tuberculosis/default.htm
tag: WHO, NIAID, MDR TB, XDR TB