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Addressing challenges along the 'access cascade' for new TB regimens

J Servello1, P de Colombani1, L Dall'Olio1

  • 1Centre for Multidisciplinary Research in Health Science, Universita' di Milano, Milan, Italy.

IJTLD Open
|March 18, 2026
PubMed

Insights

New tuberculosis (TB) treatments are advancing. This review proposes an

Area of Science:

  • Drug development and infectious diseases.
  • Global health policy and access to medicines.
  • Clinical trial consortia and regulatory affairs.

Background:

  • Multiple novel chemical entities are progressing through the tuberculosis (TB) drug development pipeline.
  • There is a critical need to ensure timely and equitable access to new TB treatments.
  • The UNITE4TB consortium is a global effort focused on developing new TB drugs and regimens.

Purpose of the Study:

  • To inform policy discussions on the adoption of new TB treatments.
  • To identify and address potential bottlenecks in accessing new TB regimens.
  • To propose actionable recommendations for stakeholders to facilitate equitable global access.

Main Methods:

  • Analysis of stakeholder engagement within the UNITE4TB consortium.
  • Review of outcomes from a UNITE4TB Annual Meeting 2024 session with diverse stakeholder representation.
  • Comprehensive literature review on TB drug access and policy.

Main Results:

  • A proposed 'access cascade' model outlining the stages from R&D to clinical care.
  • Identification of potential bottlenecks hindering equitable global access to new TB regimens.
  • Development of stakeholder-specific recommendations to overcome access barriers.

Conclusions:

  • Addressing bottlenecks in the access cascade is crucial for successful TB treatment adoption.
  • Collaborative action among pharmaceutical, clinical, research, regulatory, oversight, and advocacy groups is essential.
  • Proactive strategies are needed to ensure new TB regimens reach all populations equitably and rapidly.
Keywords:
UNITE4TBdrug pipelinetuberculosis

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