Research

USAID’s investment in global TB control includes support for focused research in a number of areas critical for accelerating global DOTS expansion and improving DOTS program performance. A number of partners are currently funding research aimed at the development of new TB drugs and improved TB vaccines. To complement these investments, USAID works with its partners and focuses its support on the development, evaluation, and introduction of tools and approaches that are appropriate for use in low-resource countries, have the potential for significant public health impact, and have traditionally been under funded by the public and private sectors.

• Operational Research - New or improved tools to increase TB case detection are urgently needed, as lack of access to accurate and reliable diagnostic services precludes or delays identification and treatment of cases leading to poor patient outcomes and disease transmission. In addition, there is a critical need for investment in operational research aimed at developing new or improved approaches to increase access, quality and effectiveness of TB control services in both the public and private sectors.
  


• The development of new and improved diagnostics - USAID supports the development of new and improved diagnostics appropriate for use in developing and transitional countries that are accurate, rapid, affordable, uncomplicated, appropriate to developing and transitional countries, and functional in a variety of settings (including areas of high HIV prevalence). Examples of current investments include support for the development of a rapid, point-of-care test to detect active TB disease, efforts to strengthen clinical trial capacity for the evaluation of new diagnostics, and the development of improved methods for smear microscopy. To this end, USAID also invests in WHO’s TB Diagnostics Initiative to improve access to well-characterized reference materials for diagnostic tool development and to strengthen clinical trial capacity for the evaluation of new diagnostic tools.
  


• The development of new drug treatment regimens and new drugs - USAID also supports the development of new drug treatment regimens and new drugs that are easier to use, safer, lower in cost, and less labor intensive to administer. Current projects include research (clinical trials) on fixed-dose combinations of TB drugs, intermittent and shorter treatment regimens, and the use of newly approved antibiotics. These products have the potential to improve DOTS programs through decreased operational costs, lower overall health expenditures and improved patient adherence, leading to higher cure rates and fewer cases of drug resistance.
  


• Management and delivery of TB control interventions - Finally, USAID supports operations research to improve the management and delivery of TB control interventions. Examples of priority research areas include:
  1. approaches to improve access, quality and effectiveness of DOTS programs (including laboratory services);
  2. the development of effective strategies to address the HIV-TB co-epidemics;
  3. social, economic and behavior research related to issues such as stigma and poor nutritional status;
  4. health policy and systems research, including strategies to improve of public-private partnerships to ensure the harmonization of public-sector DOTS programs and the private sector, NGOs, and communities in TB control;
  5. approaches to combat the expansion of MDR TB; and
  6. communication strategies to improve program performance and demand for services.