Infectious disease experts from around the world gathered in Okinawa, Japan in mid-January for the second Nikkei Asian Infectious Diseases conference. Otsuka signaled its ongoing commitment to the fight against TB by again co-sponsoring the conference.
Asia, which accounts for more than two-thirds of the world's TB burden, clearly must be at the center of the goal to defeat TB globally. The introduction of a new drug for multidrug-resistant TB, as well as1new technologies to diagnose TB and its drug-resistant strains, are perceived as potential "game changers" in the fight against TB in the region.
However, one prominent specialist present noted that a badly designed MDR-TB program may actually cause more harm than having no program at all, citing the need for high-quality drug sensitivity testing and precise follow-up with patients.
This mixture of new optimism and renewed concern about TB prompted the event organizers to select TB as a key theme of the conference.
Hiroshi Ishikawa, Ph.D. (right) Fellow, Medicinal Chemistry at Otsuka, who was one of the key members of the Otsuka team that developed the drug delamanid, spoke with stirring passion at the conference about the scale of the challenge involved in creating a new TB drug. It included the study of over 14,000 compounds across two decades, something that a single chemist could not hope to accomplish in 100 years.
With an eye toward the future he noted that TB drug development will need to be simpler to reduce costs and facilitate broader access by patients.
Dr. Ishikawa also drew the attention of the audience to broader issues in the fight against TB. One is the need for improved diagnostics, especially kits that can rapidly measure TB bacilli susceptibility to drugs and biomarkers that can differentiate active from latent cases.
Max Yoshitake (left), Leader, Global TB Team was called on by one of the session moderators for his insights on issues such as latent TB, which is present in over 30% of the world's population. Mr. Yoshitake noted that one important challenge for Otsuka and others will be to shorten the duration of treatment to just a couple of months.
Overall, a sense of cautious optimism filled the conference room. This was suggested by the nearly 45% decline in the TB mortality from 1990 to 2013, partly due to the DOTS (Directly Observed Treat Short Course) and Stop TB strategies. Looking forward, new diagnostics and drugs to treat the most difficult forms of the disease also hold promise. But no one was ready to say that the victory over TB, a disease as old as humanity itself, is near at hand.