Good news in the battle against TB

ohannesburg, 31 October 2008: Eli Lilly Pharmaceuticals this week announced its first acquisition of compounds for further development into tuberculosis (TB) drug candidates. Forming part of The Lilly TB Drug Discovery Initiative, agreements were reached with two global research organizations namely Summit plc of Oxfordshire, UK, and the Microbial Chemistry Research Foundation (MCRF) of Tokyo for two compounds that have shown potential in initial testing.

The Lilly TB Drug Discovery Initiative is a not-for-profit public-private partnership with a mission to accelerate early-stage drug discovery by bringing together specialists from around the world for the systematic exploration of vast, private molecular libraries in search of new TB treatments. Headquartered in Seattle, The Lilly TB Drug Discovery Initiative includes representatives of government agencies, philanthropic organisations, pharmaceutical companies, universities and other research institutions. Its most important goal is filling the pipeline for future TB drugs. Top South African scientists are also engaged in this global initiative and plans are afoot for wider involvement of the local medical and scientific fraternities.

Created in June 2007, the Initiative's primary members are Eli Lilly and Company, the Infectious Disease Research Institute (IDRI), and the National Institute of Allergy and Infectious Diseases (NIAID), part of the U.S. National Institutes of Health (NIH). The access this public-private initiative has to proprietary chemical libraries of compounds is unique. It will bring together microbiologists, molecular biologists, synthetic chemists, medicinal chemists, pharmacologists, toxicologists, and process chemists to expedite the testing and optimizing of early-stage compounds to fill the pipeline for drug development.

“This initiative is part of Eli Lilly's relentless effort to address the most pressing healthcare problems facing all members of our community, including the impoverished and other vulnerable persons. Defeating tuberculosis is a national healthcare priority in South Africa and we are determined to make our contribution,” says Dr Zi Chapanduka, Medical, Regulatory and Corporate Affairs Director for Lilly South Africa.

Dr Chapanduka adds “We in South Africa find ourselves in the hapless position of having an especially high background incidence of TB, compounded by a high number of people living with HIV/AIDS. To add insult to injury, we have one of the highest burdens of both multidrug-resistant (MDR) and extensively drug resistant (XDR) TB in the world”.

Over the past year, The Lilly TB Drug Discovery Initiative has organised operations and labs and identified compounds for the first round of work. Screening will soon be done to identify compounds with the highest potential for subsequent development into successful antibiotics.

In addition to screening activities, the Initiative will study the potential of the newly acquired compounds from MCRF and Summit plc:

MCRF has discovered CPZEN-45, an early stage clinical candidate which may have a new mechanism of action against TB, and also shows efficacy against multidrug-resistant and extensively drug resistant TB infected mice without any detectable side effect so far examined.
Summit plc's compounds also show significant potential as a new class of antibiotics for treatment of TB and will be further explored by the Initiative.

Globally, more than 1.5 million people die each year from TB, most of them in low income countries. In 2006, at least 1.7 million people died of TB. With a TB incidence of over 700 cases per 100 000 population, South Africa has a TB epidemic by World Health Organisation (WHO) definitions. The WHO defines an incidence of 200 TB cases per 100 000 population as an epidemic. Furthermore, South Africa has one of the highest recorded incidences of both MDR and XDR-TB.

To fight the new strains, new drugs with more muscle are needed and, while a number of drugs are in later stages of clinical trial, this initiative is needed to fill the early-stages pipeline. New drugs are needed because it is considered a matter of time before emergence of strains resistant to all available TB drugs becomes a problem.

“There has been criticism from some quarters that multinational pharmaceutical companies have scant interest in diseases affecting the poorer citizens of our planet. Lilly aims to address this criticism by putting resources behind sustainable initiatives to fight tuberculosis in all its forms. This is the basis for the not-for-profit Lilly TB Drug Discovery Initiative,” explains Dr Chapanduka.