Over the past 12 years, gradual increases in the proportion of multi-drug-resistant tuberculosis (MDR-TB) cases in the United Kingdom has amounted to a significant upward trend, from 0.7% (25/3529) in 2001, to 1.6% (81/5,151) in 2012. The proportion of MDR-TB cases remained stable at 1.6% (81 cases).
The World Health Organization has stated that elimination of TB will depend on new diagnostics and more effective drugs and vaccines. Several international initiatives have generated a pipeline of potential new antimicrobials, and Bedaquiline is now available for MDR-TB.
As part of the UK's 2013 strategy to address antimicrobial resistance we are seeking to identify a sustainable model to incentivise research and development into new antibiotics, diagnostics and novel therapies, which balances conservation and commercial incentives to build support with international partners to deliver this model in practice.
The current vaccine, BCG, is generally safe, but has variable efficacy globally (0-80%). The introduction of new effective TB vaccines is an essential component of the global strategy to eliminate tuberculosis by 2050 (UN Millennium Goal 6C). There are a number of novel TB vaccine candidates under development which will need to be tested through a hierarchy of preclinical models of increasing complexity. Similar models are also being applied to the evaluation of new drugs.