We welcome your Editorial plea ('Orphan giant' Nature 459, 1034; 2009) for stronger advocacy for tackling tuberculosis (TB), a shared global strategy and increased commitment to research and innovation. The emerging threat of drug-resistant TB in Europe, highlighted in a recent report from the European Academies Science Advisory Council (EASAC; http://www.easac.eu) could be an opportunity to bring European Union (EU) public-health objectives to bear on a shared global strategy.
EASAC was formed by the national science academies of EU member states to provide advice to policy-makers. Its report indicates that the EU has failed so far to respond adequately to the global TB threat, despite now being on the frontline for infection control. There is still an opportunity for strategic leadership: the EU is in a good position to draw on its considerable strengths in science, to develop effective coordinated public-health capabilities and to contribute to solving the problem on a global scale.
The report recommends, for example, that the EU should improve its procedures for collecting, reporting and using its own TB-surveillance data. To help understand the molecular determinants of virulence and resistance, standardized characterization of pathogen strains and their drug sensitivity should be linked into user databases of genetic and clinical information. Better EU funding models for research and innovation should eventually generate new health-care products and services.
The domestic public-health objectives for the EU can be directly aligned with global policy requirements. For example, policy-makers worldwide need to extend the 'advanced market commitment' — under which governments and other sponsors pay in advance for development of vaccines — to cover TB diagnostics, drugs and vaccines. However, to avoid repetition of previous problems caused by lack of coordination among multiple initiatives, there must also be more effective interaction among EU institutions, intergovernmental and non-governmental organizations.
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