Tuberculosis is a multifaceted problem that involves an interaction between a pathogen M. tuberculosis and the human host.  On top of this are overlays of poverty, politics and privation.  The PanACEA consortium has observed that, in the past individuals and small groups have pursued solutions piecemeal resulting in small steps of progress.   The limited resource was divided into small tranches that were insufficient to achieve a regulatory standard clinical trial.  The urgency of the tuberculosis emergency means that a different approach is needed.  If the problem is multi-facetted so must the solution.   If competition between researchers is impeding progress then it is necessary to develop a partnership based on collaboration where the greater goal of delivering a new treatment for tuberculosis overrides individual consideration.  The paradigm that has been applied to tuberculosis treatment development remains largely unchanged since the early days of the MRC trials in the middle of the last century so innovation had to be hardwired into everything that we did.   

Key questions needed to be asked:

  • How do we use new technology in the context of trials and how does it relate to older methods?
  • Can we shorten tuberculosis therapy by two months?
  • What is the optimum dose of rifampicin?
  • Can we develop a completely new compound?
  • Can we work with partners in Africa to develop capacity and create an interactive network of sites that can deliver trials to a regulatory standard?

These are the challenges that were set for PanACEA!