Lab assistant pours liquid in a P3 level tuberculosis laboratory in 2010

Scientists say we are at a promising moment in TB research globally.Credit: Denis Balibouse/Reuters

Global spending on tuberculosis research hit a high in 2017, according to a report released on 3 December1.

Investment reached US$772 million, up from $726 million in 2016, says the report, from the activist organization Treatment Action Group (TAG) in New York City.

The report, which tracked funding since 2005, shows that investment has gone up and down over the years, with a general upward trend.

The 2017 total is the most spent on research into tuberculosis (TB) in a year, according to the data, but it still falls short of the $2 billion a year that the TB research community says is needed to end the disease by 2030 (see ‘Tuberculosis funding shortfall’). That target is one of the United Nations’ Sustainable Development Goals and part of the World Health Organization Global Plan to End TB.

The rise in funding comes at a time when the disease remains prevalent but science is generating new hope. “We’re at an incredibly promising moment in TB research globally,” says Mike Frick, TB project co-director for TAG.

Source: Treatment Action Group

Around 25% of the world’s population — 1.8 billion people — is infected with TB, the World Health Organization estimates. In 2017 alone, some 10 million people fell ill with the disease, and 1.6 million died.

TB is treated with antibiotics, but health officials say that new treatments are urgently needed for children, as are better and shorter treatments for drug-resistant strains of TB and improved drugs for people living with both HIV and TB.

These treatments might be on the horizon. “Our understanding of the basic biology of TB has also advanced considerably thanks to investments in TB basic science,” says Frick.

For example, Frick notes that last year saw promising results from a vaccine trial and from trials of drugs intended to tackle drug-resistant TB and prevent the disease in people with HIV. And there has been progress in the development of simple tools to diagnose TB, including one that uses a urine dipstick, he says.

Poor market interest

Most of the $46-million increase in 2017 was driven by funding from the public sector. The US government was the largest investor, putting in $312 million. Unitaid, an global initiative that raises money for innovations in health diagnoses and treatments, nearly doubled its investment from $15 million in 2016 to $29 million in 2017.

Private-sector funding has risen slightly, but is at its lowest level since 2009. “We continued to see low funding from private industry, which collectively has spent less than $100 million on TB research each year since 2013,” Frick says.

This shows that there is a need for innovative ways of financing to reach the necessary funding levels. “We need to make sure that a commitment to provide more money for research comes with a commitment to doing research differently — moving beyond the market-based system that hasn’t worked for TB,” he says.

More funding could lead to improved vaccination, diagnosis and treatments, says Adrie Steyn, a molecular geneticist at the Africa Health Research Institute in Durban, South Africa.

Christoph Grundner, a biologist at the Center for Infectious Disease Research at the University of Washington in Seattle, agrees. “TB research is still vastly underfunded,” he says. “A lot of really good and promising TB research is not being done or is done too slowly just because of lack of funding.” He thinks that the public sector should step in to plug the gap.

An earlier version of the TAG report was released in September to inform the first ever high-level meeting of the UN on TB, where UN member states committed to closing the $1.3-billion annual gap in funding.