Tuberculosis (TB) disproportionately affects the poor and vulnerable, especially in developing countries. It can affect any part of the body, but in most cases it causes disabling lung damage, robbing people of their livelihoods and pushing them further into poverty because of the costs of health care-seeking and treatment. TB has caused more deaths in the last 200 years than any other infectious disease and yet receives only 1/6th of the funding that HIV research does. In 2013, an estimated 9.0 million people developed TB and 1.5 million died from the disease, 360 000 of whom were HIV-positive (WHO 2014). Drug resistant strains of tuberculosis are becoming more common worldwide and unless we find more effective ways to fight TB, there will be a return to the pre-antibiotic era, when there were no effective drugs for TB.
The STOP TB department of WHO has set an ambitious target to eliminate TB as a public health problem by 2050 and eliminate the catastrophic costs of TB by 2020.
To achieve these ambitious targets we need research to find:
- Ways of reducing the catastrophic costs caused by TB and care-seeking through engagement with universal health coverage and social protection.
- Improved diagnostic tests to detect the disease early and break chains of transmission.
- Shorter and more effective drug treatment combinations and new drugs especially for drug resistant tuberculosis.
- Improved understanding of how to treat TB and HIV together as people with HIV are more likely to suffer from TB.
- A more effective vaccine than BCG which does not provide complete protection from TB disease.
- Systematic and rigorous evaluation of the evidence to determine which new drugs and diagnostic approaches are effective.
- Research the optimal way to integrate new approaches to TB control in health systems which have limited funding and human resources and are struggling with many pressing health problems.
At LSTM our TB research spans the whole spectrum of this complex problem, working closely with partners in developing countries and taking a practical approach to find the best solutions which can be effectively applied in resource constrained countries, including those with the highest number of TB cases.
The International Multidisciplinary Programme to Address Lung Health and TB in Africa “IMPALA” is a four-year collaborative programme funded by the National Institute of Health Research under the first Global Health Research Programme call launched in 2016.
LSTM was successful in securing funding under this call to establish an Africa-focused NIHR Global Health Research Unit for lung health and tuberculosis (TB) that will generate new scientific knowledge and implementable solutions for these high burden, under-funded and under-researched health problems.