A pragmatic solution would be to support the formation of national bodies for setting research agendas, including key national stakeholders and researchers engaged in the country, which inform global funding priorities and play a role in evaluating research proposals in terms of applicability and potential impact on tuberculosis in high burden settings. © 2020 BioMed Central Ltd unless otherwise stated. The funding allocated to operational research was, however, much lower than all other research areas, representing only 4 % of the 2014 target at $80 million. RC and HF contributed to writing the manuscript and all authors provided critical input. New Brunswick: Rutgers University Press; 1988. While most researchers cited priority research questions that were linked to their own work, those working on development of new drugs, vaccines and diagnostics recognized the importance of research to ensure that new tools can be accessed by tuberculosis patients in resource limited settings. While the barriers to managing tuberculosis are numerous, including its association with poverty and the generation of drug resistance owing to inadequacies in health systems, these challenges are well defined; the balance between generating new knowledge and identifying strategies to implement proven solutions is thus being questioned. Resource limitations did not allow us to expand the scope of our interviews to include researchers and policymakers in high tuberculosis burden countries; such a study would allow an important additional comparison of research priorities in international versus national institutions. A Medical Research Council investigation. endstream endobj startxref Global Plan to End TB Paradigm Shift 2016–2020. 2009;87(6):405–84. A support obtained from these organizations gave … We use cookies to help provide and enhance our service and tailor content and ads. http://tb.lshtm.ac.uk/about-us/members/. Tuberculosis Research and Treatment is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to all aspects of tuberculosis, from the immunological basis of disease to translational and clinical research. Finally, we compare researchers’ priority areas to the global funding agendas and activities. Hesseling AC, Cotton MF, Marais BJ, Gie RP, Schaaf HS, Beyers N, Fine PE, Abrams EJ, Godfrey-Faussett P, Kuhn L. BCG and HIV reconsidered: moving the research agenda forward. 13 The research subgroup of the working group on MDR tuberculosis produced a document in which they investigated the scale-up of programmatic … In order to reflect upon, and learn from, our recent research activities and priorities, we look at the past 5 years of tuberculosis research funding and discuss two critical gaps in funding and in knowledge owing to essential topics being left off the research priority agenda. We must also recognize that some funding streams may encourage researchers to restrict their activities to discrete silos, separating applied or implementation research from ‘hypothesis driven’ biomedical studies. We extracted, from text and tables in these articles, research topics that the authors identified as being important. 2011;15 Suppl 2:S30–6. The role of social protection and social determinants in tuberculosis is another area that researchers directed attention towards; indeed, there is a danger that neglecting to tackle socioeconomic determinants of tuberculosis may justify criticisms about failing to learn lessons from the massive reduction in tuberculosis incidence in much of Europe, which was achieved without drugs, vaccines or technologically-advanced diagnostics [19]. The authors declare that they have no competing interests. Finally, we combined the quantitative and qualitative data into a single table (Table 1) to compare researchers’ priority topics with the global funding agendas and activities, highlighting key gaps. The total annual funding goal for 2014, in US dollars, was identified in the report for individual research areas according to the classification used by the authors (drugs, basic science, vaccines, diagnostics, operational research). Part of 1828 0 obj <>stream Although many of the priority research questions identified by researchers fell within the Global Plan categories, our analysis highlights important areas that are not explicitly mentioned in the current plan. Marshall G. Streptomycin in the treatment of pulmonary tuberculosis. Improvements can be made to ensure the process is more rigorous and transparent, and to use existing research or systematic reviews more often. At $56 billion, the Stop TB Partnership’s forecasted total cost represented a three-fold increase in annual investment in tuberculosis control compared with the first Global Plan for 2001–2005 [16]. 1810 0 obj <> endobj The top priority areas were drug development (28 articles), diagnosis and diagnostic tests (27), epidemiology (20), health services research (16), basic research (13), and vaccine development and use (13). Engaging local researchers would not only build research capacity and reduce costs from engaging primarily international teams, but also potentially aid dissemination and uptake of findings into policy. While an acknowledgement of the need for a change in approach is promising, the tuberculosis control community has been criticized for failing to act effectively on the basis of existing knowledge and for constantly looking for ‘new’ solutions. There appears to be some disconnect between funding priorities, researchers’ agendas and global disease control strategies. Fauci AS, Group NTW. Rasanathan K, Sivasankara Kurup A, Jaramillo E, Lönnroth K. The social determinants of health: key to global tuberculosis control. 1949;1:382–6. The Global Plan to Stop TB 2011–2015: transforming the fight towards elimination of tuberculosis. Int J Tuberc Lung Dis. The interviews were conducted at the annual TB Centre meeting under the supervision of a PhD student at LSHTM, and were recorded with respondents’ permission. We gratefully acknowledge Katherine Horton’s support in collating information from the LSHTM TB Centre member consultation exercise.

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