Wall Street Journal - October 27, 2004
Marilyn Chase, Staff Reporter of The Wall Street Journal

Tuberculosis, the world's second-biggest killer, after AIDS, infects one-third of the world's population. It causes nine million new cases of active disease and kills two million people a year.

TB also acts in lethal synergy with HIV , the AIDS virus, doubly infecting many patients, weakening their immune systems and hastening death.

The alliance, a not-for-profit public-private partnership with offices in New York, Brussels and Cape Town, South Africa, is expected to announce today that it has signed a letter of intent with the Novartis Institute for Tropical Diseases to codevelop a new TB drug family.

The lead compound in the family, PA-824, will enter Phase I safety studies in healthy volunteers next year. Later the group hopes to launch studies of drug efficacy in Africa, Latin America or the Far East.

PA-824, licensed by the alliance from Chiron Corp., differs from existing treatments by killing both fast-growing and slow-growing strains of TB bacteria. In lab tests, it shows promise against TB strains that are resistant to multiple drugs. Such resistant strains are on the rise.

Paul Herrling, head of corporate research for Novartis and chairman of the Novartis Institute for Tropical Diseases, said that if successful, PA-824 could be ready for use in six years, but added that any other new drugs related to it could take 11 or 12 years to develop. "The drug discovery effort is really not a quickie," said Prof. Herrling. "It takes sustained efforts."

Novartis has pledged to make treatments available without profit to poor patients in developing countries.

Many drugs in the TB tool kit are decades old, and treatment time is long. Curing simple TB takes six to nine months; for drug-resistant strains, it's one to two years.

Alliance President Maria Freire said that the team hopes to make one new compound a year in the PA-824 family, also known as nitroimidazopyrans.

"Promising compounds such as this need to be nurtured," said Peter Small, a tuberculosis expert with the Bill and Melinda Gates Foundation of Seattle, which helps fund the TB Alliance. "Drug resistance is emerging in every country against a disease that is killing someone every 15 seconds, and the new-drug pipeline is little more than a trickle."

Separately, on the eve of a world conference on lung health beginning Oct. 28 in Paris, the humanitarian organization Doctors Without Borders warned that TB is spiraling out of control in many parts of the world.

Write to Marilyn Chase at marilyn.chase@wsj.com
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