The global pharmaceutical industry has only 22 compounds in development for treating tuberculosis (TB), according to Pharmaprojects, a UK-based database company which tracks pharmaceutical R & D.

'This is a startlingly low figure for a disease with such a heavy global burden', says Pharmaprojects, especially when compared with the R & D activity focused on developed world diseases. For instance, pharmaceutical companies are developing almost 400 new therapies for treating cancer, including 70 for lung cancer.

TB has always been a major health threat, with one third of the world's population infected with Mycobacterium tuberculosis and a TB-related death every 15 seconds, but the rise of multidrug-resistant TB (MDR-TB) is creating an even greater problem. This has led the World Health Organisation to warn recently that R & D into new TB drugs is 'urgently required'.

Money is the main factor impeding drug development. TB is primarily a disease associated with poverty, whether in the developing or developed world, and it is estimated that only 5 per cent of TB sufferers can afford treatment. The market for TB drugs is currently valued at only $450 million (£251m), which would make it difficult for pharmaceutical companies to recoup their R & D investment.

The way forward may be through private-public partnerships, such as the Global Alliance for TB Drug Development or the Aeras Global TB Vaccine Foundation, in which pharmaceutical company expertise and public-sector funding come together.

Already the TB Alliance has 10 compounds in its pipeline, including one about to enter clinical trials, while Aeras recently received $82.9 million (£46m) from the Bill and Melinda Gates Foundation.

Jon Evans