E-MED:L'UE s'engage à accroître la recherche contre la tuberculose
L'UE s'engage à accroître son aide à la recherche contre la tuberculose
BRUXELLES, 24 mars (AFP) - 13h57 - L'Union européenne s'engage à accroître
son aide à la recherche contre la tuberculose au cours des trois prochaines
années, a indiqué la Commission européenne à l'occasion de la Journée
mondiale de la tuberculose lundi.
L'UE a dépensé 28 millions d'euros au cours des quatre dernières années pour
lutter contre la tuberculose, dont 15 millions ont été consacrés à la
recherche sur les vaccins et 13 millions aux nouveaux médicaments, a
souligné l'exécutif européen dans un communiqué. [cf ci-dessous]
Dans le cadre de son actuel programme de recherche 2003-2006, l'UE s'engage
pour un montant "significativement plus important", annonce la Commission.
La tuberculose tue deux millions de personnes par an, dont 98% dans les pays
en développement, souligne Bruxelles.
La journée mondiale contre le tuberculose (Halte à la tuberculose, Stop TB)
est une initiative mondiale, parrainée par l'Organisation mondiale de la
santé (OMS), regroupant plus de 250 partenaires -- Etats membres de l'OMS,
sociétés savantes, organisations non gouvernementales (ONG), donateurs et
Ses objectifs sont de diagnostiquer d'ici à 2005 70% des cas de tuberculose
infectieuse et guérir 85% d'entre eux.
World Tuberculosis Day: EU-funded research in the fight against Tuberculosis
DN: MEMO/03/66 Date: 24/03/2003
Brussels, 24 March 2003
World Tuberculosis Day: EU-funded research in the fight against
Today is World Tuberculosis (TB) Day. The global impact of TB is
devastating, especially in developing countries where poverty and the
prevalence of HIV lower resistance and encourage further transmission.
Tuberculosis causes about 2 million deaths a year, about 98% in developing
countries. The EU has channelled ?28 million into TB drug and vaccine
research in the last four years, within the 5th EU research framework
programme, and will be committing significantly more during the course of
the current research framework programme (2003-2006).
With the rise in drug-resistant strains of the disease, TB could once again
become a major threat to Europe, as well as continuing to take a heavy toll
in the developing world. Prevention through vaccination could be the most
effective intervention. The availability of the complete genome sequence of
Mycobacterium tuberculosis offers new opportunities for the development of
an effective vaccine against tuberculosis and for the rational development
of new drugs. Both are urgently needed, and it is in this area that the
European Commission is waging the battle to beat the disease.
In the Fifth Research Framework Programme (1998-2002) the EU has allocated
?15 million to vaccine research. The largest single project is the TB
Vaccine Cluster (TBVac) that has brought together major public and private
research organisations striving to develop new vaccines. With complementary
expertise in genomics, genetics, immunology, structural biology and
vaccinology, TBVac has successfully established a joint academic-industrial
consortium capable of taking tuberculosis vaccine candidates from the
laboratory bench to phase I clinical trials.
The cluster project is co-ordinated from the Institute Pasteur in Paris, and
involves 38 leading European research groups from 12 different countries,
including 2 major pharmaceutical companies (Aventis-Pasteur and
GlaxoSmithKline). Within this European framework, a variety of new vaccine
candidates have been produced and tested in preclinical studies, with
several achieving high levels of protection.
In addition to this cluster project, the EU has been supporting
complementary TB vaccine projects.
Two EU-funded projects are exploring the possibilities of intranasal or oral
vaccination as an alternative to intradermal injection. A further two
projects are conducting studies in Africa, where TB is endemic. One of these
will test, in African volunteers, two candidate TB vaccines that have just
entered clinical trials in the UK - apparently the first to have reached
this stage of development anywhere in the world.
Several more promising candidates should follow. Clinical trials are costly
and time-consuming but essential and the EU has made a strong commitment to
supporting them through the sixth framework programme in particular through
the European Developing Countries Clinical Trials Programme (EDCTP)
With the aim of continuing the effort to integrate European efforts in
developing a TB vaccine, research proposals have been invited for projects
to develop TB vaccines up to and including the early clinical trial phase.
Subsequent clinical development (phase II and III clinical trials) will be
eligible for support through the EDCTP, and there will be an increased
emphasis on collaborating with countries where the vaccine is most needed,
Development of new drugs
In the Fifth Framework Programme, the EU awarded ?13 million to TB drug
research. In addition to supporting projects that lay the foundations for
rational and novel drug design, funding has been awarded to projects
studying the development of drug resistance, and projects to develop faster
and more reliable methods of detecting TB infection and the presence of
In the latter, promising advances have been made towards the development of
a low-cost marketable kit and two new methods for the rapid, low-cost
detection of drug resistant strains have been developed and published, based
on studies in Latin America. As with the vaccine work, the EU plans to
follow-up these past and ongoing efforts with calls for FP6 project
proposals, and for bringing the most promising drugs and diagnostics through
to clinical application in the places where they are most needed.
Poverty-related diseases in the Sixth Framework programme
Approximately ?400 million have been allocated to combat TB, malaria, and
HIV/AIDS during the course of the Sixth Framework Programme (2002-2006).
This is a significant increase compared to FP5, and it reflects the prospect
of bringing the results of promising preclinical studies through clinical
The Sixth FP on poverty-related diseases is focused on two components:
to develop vaccines, drugs and microbicides for HIV/AIDS, malaria and
tuberculosis through basic science up
to pre-clinical and early human testing (phase I clinical trials) using the
new funding instruments (network of excellence and integrated projects)
which allow a better integration of research efforts across Europe.
to develop new clinical interventions against HIV/AIDS, malaria and TB
through a long-term partnership between Europe and developing countries.
One of the main goals of the "European and Developing Countries Clinical
Trials Partnership" (EDCTP), based on art.169(1) of the EU Treaty, is to
support phase II and phase III clinical trials of promising products in,
with and for developing countries. Such large-scale trials have to be
conducted in the diseases-endemic countries under local clinical and social
conditions, in order to obtain relevant results for the benefit of the
population. The EDCTP is a response to better co-ordinate and increase the
impact and efficacy of national research programmes in this area.
EU research efforts to combat poverty-linked diseases:
The EDCPT initiative:
Tuberculosis (TB) claims more than 2 million human lives every year.
Approximately a third of the world's inhabitants are already infected with
the tuberculosis mycobacterium, and roughly every second a new infection
occurs. Although most healthy people survive infection without succumbing
immediately to disease, the mycobacterium persists in their lungs and can
With today's knowledge and technology a more effective vaccine against TB is
a realistic goal to aim for. Genomic sequences are now available for two
human strains of Mycobacterium tuberculosis, and several other related
mycobacterial species, while techniques have been developed which allow the
manipulation of these genomes in the laboratory. In addition, our
understanding of protective immune responses and our ability to follow them
with various tests has advanced significantly.
The challenge is to use this information and these tools to develop a
vaccine that is significantly more effective than BCG, the currently
available vaccine that was developed over 70 years ago at the Pasteur
Institute in Paris. BCG is a live attenuated vaccine that was derived from a
strain of bovine tuberculosis. It has lost the ability to cause disease but
can provoke an immune response that is at least partially protective again
the human form of TB. BCG works best in infants and young children who have
not been exposed to mycobacteria, and does help save lives in developing
countries. However its efficacy is inadequate and a better vaccine is
On this front, it is also realistic to hope for progress, as a combination
of comparative, functional and structural genomics can be employed in the
rational design of drugs that kill TB without harming the patient.
Antibiotics able to cure TB exist already, and helped drive this disease
from Europe 50 years ago, but new drugs are needed to combat multi-resistant
strains of TB that are on the increase, especially in Russia, the
newly-independent States and Eastern Europe. Although even multi-drug
resistant strains remain treatable at present, the course of drugs required
is much longer, significantly more expensive and more toxic to patients.
TBVac project results
Overall the vaccine cluster project has helped to standardise and
co-ordinate preclinical TB studies while encompassing several different
approaches, generating significant new knowledge, and aiding the development
of a number of promising vaccine candidates. Promising results have been
achieved by the project with several different types of vaccine, including
protein antigen vaccines, viral vector subunit vaccines, and recombinant BCG
vaccines. Another element of the cluster project has been the study of
non-protein TB antigens and the response they provoke.
Certain non-protein antigens stimulate immediate responses, known as "innate
immune responses", which affect the type of more long-lasting specific
immunity that targets protein
(1) Article 169 of the Treaty of Amsterdam allows the Community to make
provision for participation in research and development programmes
undertaken by several Member States
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