As we observe World TB Day on March 24, the World Health Organization (WHO) reminds us of the commitment made with the “End TB” strategy: to reduce tuberculosis incidence by 80%, tuberculosis deaths by 90% and to eliminate catastrophic costs that burdens TB-affected families, by 2030.
We call on country leaders, stakeholders and partners to join the strategy to increase the number of people reported as diagnosed and treated, and to reach at least 30 million people with TB preventive services between 2018 and 2022.
This challenge makes the STriTuVaD project, of which IDRI is a member, particularly suitable in addressing the 2019 World TB Day’s theme “It’s time.” It’s time to act on the urgency to scale up access to prevention and treatment, especially in countries, like India, where tuberculosis isn’t just a health issue. “The social and economic impacts are devastating, including poverty, stigma and discrimination,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “We need to accelerate our efforts to make TB history.” Improving how we test new immunotherapeutic approaches could be a huge step in that direction.
In particular, the STriTuVaD project has the ambitious goal of bringing radically innovative in silico methods in the evaluation process of new vaccines. This may have a dramatic impact in terms of a faster and cost-effective development of new therapies to fight this deadly disease.
In almost any industrial sector where there are safety concerns, before a product is tested in the field, it is analysed with dozens of computer simulations, aimed to highlight if that product will work as expected under a variety of conditions. The only exception is the medical field where, until recently, the only way to assess the safety and the efficacy of new therapies was to test them on animals or on humans in clinical trials.
Beside the ethical implications of such experimentation, this trial and error approach based on very expensive clinical trials is a major factor in the high cost of new drugs. These prices are becoming so high that people in lower income countries can rarely afford them. In countries where universal healthcare is provided, the drug expenditure is becoming so high that the free access to healthcare is being questioned. In silico trials, or the possibility to test any new drug first in a computer simulation, could dramatically reduce such costs, opening the door to more effective but also more affordable TB therapies. We also expect in silico trials to considerably shorten the time required for a new drug to reach the market.
Before we adopt these innovative in silico methods, we need to demonstrate convincingly that their predictions are accurate and reliable. That’s why it is crucial that all the stakeholders answer the challenge as posed by one of our partners in the STriTuVaD project, Prof. Viceconti from University of Bologna: “We invite all related institutions and organizations to set a long-term goal: similar safety studies with 50% less animals used and 50% less costs within a 10 year period, a conservative objective if in silico trials approaches are adopted.”