The National Institute of Allergy and Infectious Diseases (NIAID), a component of the National Institutes of Health (NIH), today released its NIAID Research Agenda for Multidrug-Resistant (MDR) and Extensively Drug-Resistant (XDR) Tuberculosis (TB). While focusing on MDR/XDR TB, many of the research priorities identified in this document also relate to drug-sensitive tuberculosis. The research priorities identified in the agenda build on a foundation of ongoing NIAID-supported TB research, which currently comprises more than 300 research projects worldwide.

Diagnosing, treating and controlling the spread of TB has become increasingly complicated because of the HIV/AIDS co-epidemic and the emergence of MDR and XDR TB, which threatens to set TB control efforts back to the pre-antibiotic era. According to NIAID Director Anthony S. Fauci, M.D., NIAID developed this TB research agenda to address MDR/XDR TB with appropriate urgency, while reaffirming the Institute’s commitment to a robust program of research focused on all aspects of TB. NIAID is well prepared to foster the development of new TB diagnostics, drugs and vaccines, but given the realities of MDR/XDR TB, the research agenda outlines those areas that need additional attention to enable public health officials to more effectively combat all forms of tuberculosis, he says. He notes that the agenda is a Web-based “living document” that can be updated as scientific and public health needs and opportunities evolve.

NIAID collaborated with other government and non-government experts to prepare the MDR/XDR TB research agenda. In addition to its review by TB specialists in academia, advocacy groups, international organizations and other government agencies, the draft agenda was presented to the National Advisory Allergy and Infectious Diseases Council, NIAID’s main scientific advisory body.

The research agenda specifically describes six critical areas where additional investigation is needed to close gaps in our understanding of MDR/XDR TB and to improve the clinical management of people with TB:

• Finding new TB diagnostic tools
• Improving therapy for all forms of TB, including MDR/XDR TB
• Understanding basic biology and immunology of TB
• Studying MDR/XDR TB epidemiology
• Enhancing the clinical management of MDR/XDR TB in people with or without HIV/AIDS
• Improving TB prevention strategies, including vaccines