An ambitious Sustainable Development Goal has been put in place to end TB by 2030, which has led to research for new therapies to better manage and cure the disease.
Nevertheless, developments of new treatments are costly, in both time and money, so the repurposing of drugs approved for alternative indications is becoming a new avenue for more quickly identifying new potential therapies. Padayatchi et al (CAPRISA, Centre for the AIDS Programme of Research in South Africa, South Africa) and Mafukidze, Harausz & Furin (Harvard Medical School, USA) discuss the important roles of antimicrobial stewardship and update us on the progress of drug repurposing for TB respectively.
Varying patient populations pose additional complications for treatment. Pediatric populations bring their own set of specific treatment needs and safety concerns. Schaaf et al (Stellenbosch University, South Africa) discuss the adverse effects of oral second-line antituberbulosis drugs in children, and explain the importance of managing these for treatment adherence. Garcia-Prats et al (Stellenbosch University, South Africa) go on to discuss the safety and tolerability of second-line injectable antituberclosis drugs in children. Coinfection is also an important consideration in many TB patients, for example those with HIV. Due to a compromised immune system, TB poses a more serious health risk, when compared to those with a singular TB infection. In fact, TB is the main killer in patients with HIV, responsible for approximately 35% of deaths. Peloquin et al (University of Florida, Gainsville, USA) describe the pharmacological challenges of treating this opportunistic infection in HIV patients.
Despite these considerable challenges, WHO is working globally to address them and accelerate action to end TB altogether, whether this can be achieved by 2030, however, is yet to be seen.