An urgent and massive expansion of clinical trials capacity is needed to carry out vital research to accelerate the development and evaluation of new TB drugs, say Unni Karunakara (MSF) and colleagues.

"Trials are urgently needed," they say, "to find regimens that are shorter, less toxic, and effective against multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDRTB)." Trials are also needed, they argue, to find new TB treatment regimens for children, for those with TB and HIV co-infection, and those with TB occurring outside the lungs (extra-pulmonary TB).

Unfortunately, say the authors, only about US $20-30 million was spent in 2005 around the world for TB clinical trials. The authors call for funding of at least US $300-500 million annually for a TB trials agenda.

Direct investment is also needed, they say, in the infrastructure required to conduct trials.

Citation: Schluger N, Karunakara U, Lienhardt C, Nyirenda T, Chaisson R (2007) Building clinical trials capacity for tuberculosis drugs in high-burden countries. PLoS Med 4(11): e302.
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