Thanks for your comment. Just a sidenote to your point: I think it’s a curious element of TB history that we’ve known about the dangers of drug-resistant strains since at least the 1950s, not just as a potential future threat but right away in real world practice; the reason streptomycin is combined with other powerful antibiotics (e.g. isoniazid and others) as part of standard TB treatment is because that’s the only way to completely clear all bacilli. I wrote a bit about this in my piece for Metaculus: https://www.metaculus.com/notebooks/12130/from-reduction-to-elimination-replicating-the-successes-of-historical-tuberculosis-control/
I agree, I would also choose other interventions over manufacture of rifapentine in Europe, though I am not sure it’s likely to happen without incentives for Sanofi. As helpful as it might be in countries like Moldova, Estonia, etc., I think the preceding cause areas would have a far greater impact (they’re listed in order of my best guess at their value).
I added this mainly because I wanted to include a variety of options. Open Philanthropy may opt for a less effective but more tractable option, for example. It also shows just how many possible avenues there are to contribute to TB efforts.
Thanks for your comment. Just a sidenote to your point: I think it’s a curious element of TB history that we’ve known about the dangers of drug-resistant strains since at least the 1950s, not just as a potential future threat but right away in real world practice; the reason streptomycin is combined with other powerful antibiotics (e.g. isoniazid and others) as part of standard TB treatment is because that’s the only way to completely clear all bacilli. I wrote a bit about this in my piece for Metaculus: https://www.metaculus.com/notebooks/12130/from-reduction-to-elimination-replicating-the-successes-of-historical-tuberculosis-control/
I haven’t looked into projections of MDR-TB specifically, but this would definitely be a worthwhile line of inquiry. Interestingly, a quick search shows some advocacy for combined TB and AMR control efforts in LMICs: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5840628/
https://lshtm.ac.uk/newsevents/news/2020/where-and-how-does-tb-fit-amr-agenda
I agree, I would also choose other interventions over manufacture of rifapentine in Europe, though I am not sure it’s likely to happen without incentives for Sanofi. As helpful as it might be in countries like Moldova, Estonia, etc., I think the preceding cause areas would have a far greater impact (they’re listed in order of my best guess at their value).
I added this mainly because I wanted to include a variety of options. Open Philanthropy may opt for a less effective but more tractable option, for example. It also shows just how many possible avenues there are to contribute to TB efforts.