Development of new antituberculosis drugs: Its relevance worldwide and in the Asia-Pacific region

: Tuberculosis (TB) remains a global health problem today. The development of new TB drugs is in line with WHO's Stop TB Strategy. The Global TB Drug Alliance was formed in 2000 to enhance TB drug development. Current drug therapy for active TB, TB/HIV coinfections, multidrug‐resistant TB and latent TB infection are far from satisfactory. New drugs with desirable characteristics are required. Ideally, drugs should be active against drug‐sensitive and drug‐resistant bacteria, and act on both dividing and nonreplicating persistent bacteria. More needs to be known about the biology of ‘persistent’ bacilli which may be important for development of drugs for shortening current treatment regimens and tackling the huge pool of latent infection. The TB drug development process has been very slow, and there are a number of hurdles in efficacy evaluation. Mathematical models have predicted that substantial benefits can be gained with the introduction of new, shorter treatment regimens. Nowadays, an increasing number of potential candidates are in the global TB drug development pipeline. Among these, seven relatively more important novel compounds are in various stages of clinical development, namely, gatifloxacin, moxifloxacin, TMC207, OPC‐67683, PA‐824, LL3858 and SQ109. In addition, there are other new compounds in the TB Alliance's portfolio in various stages of development, and many more in the projects of other workers worldwide. The stock‐taking exercise by the Working Group on New Drugs has provided many examples of such work. With the flourishing interest in this field, it is hoped that a new drug may become available rather soon.