Taking Aim at Global Pandemics Using 21st Century Tools

Author: Nina Isoherranen, PhD on February 07, 2020


On the last day of 1927, a 30-year-old mother died after two years of consumption that followed the birth of her third child. A year and a half earlier, her younger brother had passed away similarly, and four years earlier another one of her teenage brothers had died. Despite close care from family, both slowly wasted away over a period of one to two years. Letters from the family tell the painful story of how tuberculosis (TB), one of the oldest diseases that has affected humankind, slowly takes away teenagers and young adults, many of whom leave behind small children.

This story took place in northern Europe, and the young mother was my great grandmother. During the 90 years that followed, my grandmother grieved the loss of her mom from the deadly disease that is believed to have killed one in seven people in the US and Europe in that time. While TB has since been controlled in Europe by the Bacille Calmette Guerin vaccination and by the invention of streptomycin and other TB treatments, this story could well describe a family tragedy in 2020 in a low income country in which older adolescents and younger adults are still most severely affected by TB. 

In the November 2019 issue of Clinical and Translational Science,  Heaton and Barrett describe the 21st century efforts by the Bill & Melinda Gates Medical Research Institute to bring affordable cures and novel drug combinations to the armamentarium of TB treatments in those countries most affected by the pandemic. Their article describes how the TB drug accelerator formed in 2012 has successfully identified novel candidates and mechanisms of action for development of a much-needed new TB drug treatment combination. The strategy that they describe employs cutting-edge technologies, model-based drug design, and quantitative sciences incorporated with adaptive trial designs and biomarker analysis to develop an effective TB drug regimen As stated by the authors, reaching the Sustainable Development goal of reducing TB mortality by 90% by 2030 appears closer with the use of state-of-the-art technologies. With the nearly 2 million deaths caused by TB each year, saving these lives will have a profound effect on the parents and children of TB-infected individuals.

Moreover, there is no doubt that this research will lead to scientific discoveries that may help us finally understand how and why the TB vaccine works and whether boosting the vaccine is useful. Bringing the approaches of 21st century drug discovery and development to treating infectious diseases around the world offers great hope. We will likely find cures for ancient diseases such as TB, which has long infected humans, and discover capabilities for advanced responses to emerging public health crises and novel emerging infections such as today’s coronavirus.

Image by Heaton and Barrett. Clin. Trans. Sci https://ascpt.onlinelibrary.wiley.com/doi/epdf/10.1111/cts.12718. Published 2019. Clinical and Translational Science published by Wiley Periodicals, Inc. on behalf of the American Society for Clinical Pharmacology and Therapeutics.

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