1. TBD-UK: The UK response in the discovery and development of new TB drugs. Dr Geoff Coxon Deputy Leader & Director of Medicinal Chemistry, TBD-UK APPG-TB New Tools meeting HoC 23 rd June 2011 www.tbd-uk.org.uk

2. Why are we here today? We all know the facts and figures about TB New tools urgently required:  Rapid, robust, reliable & accurate diagnostics  Vaccines  Key Biomarkers  New drugs

3. Why new TB drugs? Treatment takes 6 to 9 months Contributes to low compliance, resistance and relapse Co-infection with HIV/AIDS is limits the use of current drugs No new drugs since the 1960s! New drugs urgently needed to reduce treatment time, combat resistance and be compatible with HIV/AIDS sufferers

4. Broad spectrum antibiotics Drug regime for drug susceptible TB The Challenge !

5. State of the current development pipeline Long & Very complex with high rates of attrition Highly multi disciplinary Very expensive - £100s millions No commercial market to sustain the development pipeline Current strategy: TB Alliance is the “Global Coordinator” working with partners in academia and pharmaceutical industry UK can increase its’ established role within this strategy

6. State of the current Global development pipeline Early Stage Discovery Basic Science Identification of new “actives” Numerous projects in UK and globally from academia and pharmaceutical industry At least 30 known projects to discover new actives Exploratory Development Pre-clinical Clinical At least 6 known projects 8 projects at Phase I and II Full Development 3 projects including REMox-TB (UCL & St Andrews) at Phase III None at launch & phase IV (since 1960s) Start Finish Progressing BUT grossly insufficient

7. The UK perspective: TB Drug discovery UK (TBD-UK) Funded for 2 years in 2009 by the Medical Research Council UK wide consortia of academic and industrial partners involved in TB drug discovery and development research Goal: To engage the UK in coordinated research and maximise it’s contribution to global efforts to facilitate drug development and provide new drugs at the clinic

8. TBD-UK: What has been achieved so far? New class of anti-TB agent identified (others now integrated into TBD-UK) New basic science breakthrough discoveries in drug targets IMI-EU framework 7 pre-DICT consortia formed to support “models” Working TBD-UK blueprint created to guide all UK research Significant UK outreach with 40+ researchers engaged in collaboration International outreach via website www.tbd-uk.org.uk

10. TBD-UK: Conclusion & Future direction UK science ready to integrate with DFID & BIS policy to make real impact Development of public private partnerships is a key factor Dialogue with pharmaceutical industry, MRC, NGOs, Charities and DFID essential to move forward and maximise UK potential APPG-TB round table meeting with all parties should be the next step to achieve our common goals in finding new TB drugs