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Volume 10, Number 11—November 2004
ICEID Session Summaries

HIV, Tuberculosis, and Malaria Antimicrobial Resistance1

J. Todd Weber*Comments to Author  and Gail Cassell†
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Eli Lilly and Company, Indianapolis, Indiana, USA

Suggested citation for this article

Increasing drug resistance among many infections of public health importance has created an urgent need for new and effective antimicrobial agents. However, existing economic incentives for research and development appear to be insufficient to meet the anticipated need for new antimicrobial drugs. U.S. Food and Drug Administration approval of new antibacterial agents has decreased by 56% in the past 20 years (1998–2002 vs. 1983–1987), and only 6 of 506 drugs disclosed in the developmental programs of the largest pharmaceutical and biotechnology companies are new antibacterial agents (1). Infectious diseases of worldwide importance such as tuberculosis and malaria are affected by the same problems, and antiretroviral drugs are not used effectively in developing nations because of the lack of economic incentives.

The Global Alliance for TB Drug Development is a public-private partnership; its goal is to help develop new, faster acting, and affordable tuberculosis medicines. The partnership intends to accelerate research and development and ensure affordability of the drugs developed, given that the need is greatest in resource-poor countries with high rates of tuberculosis. The Green Light committee reviews applications to the World Health Organization and its international partners for directly observed therapy short course (DOTS)-plus pilot projects in low- and middle-income countries, projects that modify typical DOTS strategy in light of issues (such as the use of second-line drugs) specific to areas with a high prevalence of multidrug-resistant tuberculosis.

The Medicines for Malaria Venture manages a portfolio of projects that are conducted by academic and pharmaceutical partners. Criteria for products to treat uncomplicated malaria include efficacy against drug-resistant strains, cure within 3 days, low propensity to generate rapid resistance, safety in children <6 years old and pregnant women, appropriate formulations and packaging, and low cost.

The Accelerating Access Initiative, a joint project of UNAIDS, other international organizations, and several HIV-drug–producing pharmaceutical companies, has developed what it calls a common approach to accelerating access to HIV/AIDS care and treatment in developing countries. The approach calls for political will and commitment of governments; strengthened national healthcare capacity; safe, secure, and efficient distribution systems; involvement of all sectors of society; substantial additional funding from national and international sources; and continued investment in research and development by the pharmaceutical industry.



  1. Spellberg  B, Power  J, Brass  EP, Miller  LG, Edwards  JE Jr. Trends in antimicrobial drug development: implications for the future. Clin Infect Dis. 2004;38:127986. DOIPubMedGoogle Scholar


Suggested citation for this article: Weber JT, Cassell G. HIV, tuberculosis, and malaria antimicrobial resistance. Emerg Infect Dis [serial on the Internet]. 2004 Nov [date cited].

DOI: 10.3201/eid1011.040797_07

1Presented at the International Conference on Emerging Infectious Diseases, Atlanta, Georgia, February 29 – March 3, 2004, by Gail Cassell, Eli Lilly and Company; J. Carl Craft, Medicines for Malaria Venture; and Jeffrey Sturchio, Merck & Co., Inc.

Table of Contents – Volume 10, Number 11—November 2004

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Please use the form below to submit correspondence to the authors or contact them at the following address:

Todd Weber, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop C12, Atlanta, GA 30333, USA; fax: 404-639-4197

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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.