Tuberculosis Preventive Treatment: Key Research Areas and the Clinical Pipeline for New Treatments

Abstract

An estimated one-fourth of the world’s population is infected with Mycobacterium tuberculosis, of which 5–10% will develop tuberculosis (TB) disease during their lifetime. TB preventive treatment is a scalable intervention to protect infected individuals with substantial risk of developing TB disease, offering benefits both to the individual and to population-level health. Recognizing this, political commitments and investments in recent years have focused attention on research and innovation on TB preventive treatment. This chapter summarizes recent achievements and research needs to improve the successful delivery of TB preventive treatment to maximize benefits to at-risk populations. Gaps in epidemiology, health economics and implementation research are described to guide the generation of future evidence in support of country efforts to scale up treatment. Finally, recent advances and challenges to the clinical development of more effective, safer and shorter treatment options are summarized, from which valuable contribution to TB elimination are expected over the coming years.