Workshop on Medical innovation prizes as a mechanism

to promote innovation and access

Prize for TB low-cost point of

care rapid diagnostic test
Pierre Chirac

Médecins Sans Frontières, Paris, France

Campaign for Access to Essential Medicines
 TB : a global threat...
for poor people
• The most frequent infectious disease
worlwide
• Strong link with poverty
• Mycobacterium tuberculosis usually affects
the lungs but not only
• Active pulmonary smear positive TB very
infectious
• All form of TB are deadly if lefted untreated
 TB : one of the big killers with
AIDS and malaria
• Every year TB kills around 2 million people and
9 million develop the disease

• TB is the leading killer of people with HIV/AIDS

• Almost half a million new cases of multi-drug

resistance (MDR) TB are seen every year

• Cases of extensively drug-resistant (XDR) TB are

increasingly being detected (global threat)
 TB : a neglected disease

• Inadequacy of tools to diagnose and treat

TB
• Inadequate pipeline for the future
• Lack of basic biological understanding
 TB : a neglected disease (2)

• Lack of funding and capacity as well as regulatory

barriers
• Treatment of TB should be dramatically shortened
and simplified
 TB : a neglected disease (3)

• Strong link TB/HIV

• Dramatic surge of multi-drug resistant TB
(MDR-TB)
• Urgent need for a range of new diagnostic
tools for various test indications
 MSF and TB

• In areas of chronic conflict or politically

instable contexts

• In 2006, around 29,000 patients in 40

countries around the world.
 MSF and TB (2)

• Growing number of patients infected with

MDR-TB
• Rapid spread of TB among people living
with HIV/AIDS.
• Lack of reliable, rapid ways to diagnose TB
 TB diagnostic

• Microscope cheap but only detects around

half of all TB cases
• Culture too slow
• Improvements to culture remain logistically
difficult
• More modern methods are too
sophisticated
 TB diagnostic (2)
• In MDR-TB, further tests are necessary
• Drug resistance can be more rapidly
detected by new molecular tests but can’t
be done in the remote areas
 TB and R&D needs

• New diagnostic tools that are simple, reliable, and

adapted for use in remote, resource-poor settings
• More potent drugs to shorten the length of
treatment
• Drugs that do not negatively interact with AIDS
drugs
• Effective vaccine to protect against the disease
 MSF assessment of pipeline

• Huge resource gap in TB R&D

• Governments and public agencies must take a
leadership role
• IGWG could provide the necessary framework for
action
• Scientists, doctors, public health specialists,
laboratory technicians, and FIND should share
information and resources
• Field needs should guide product development
•  
 MSF NY

• The TB community must engage in the

IGWG process
• participants of the New York symposium
support current discussion at the WHO for a
treaty on essential health R&D
 MSF NY
Participants call upon governments,
intergovernmental agencies, researchers,
drug and diagnostic developers,
nongovernmental organizations, and
funders to take action in five key areas.
• 3. Support new approaches to R&D
• 4. Commit to global TB R&D leadership
• 5. Increase funding for TB R&D activities
 MSF and TB next

• Promote an open source/open access model

innovation for TB and neglected diseases:
a) case study on how to stimulate and fund TB
drugs and diagnostics R&D
b) feed outcomes of the expert meeting into the
IGWG
 TB diagnostic test :
a good case for a prize
• Many examples of prizes that have been offered to
stimulate or recognize research, treatment, prevention
and care of tuberculosis from 1887 to 2007
• InnoCentive Tuberculosis Prize for PA-824 (2007)
for a “Safe and Economical Synthetic Route for PA-824,
a candidate drug for tuberculosis.” Funded by the
Rockefeller Foundation ($20,000)
• low-cost point of care rapid diagnostic test : the next TB
prize ?