Every 24 March, we recognise World Tuberculosis Day.
The World Health Organization (WHO) chose 24 March for World Tuberculosis (TB) Day, because it was the day Dr Robert Koch announced the discovery of the bacterium that caused TB. This new understanding of the disease led the way to being able to diagnose and cure this awful disease.
Why do CELT Global Health care about TB?
TB has been one of the world’s most deadly diseases for generations. Despite being both preventable and treatable, the WHO reported that 1.23 million people died from TB in 2024. This makes it the leading cause of death from a single infectious agent; it also makes it a top 10 cause of death internationally. Despite being present in all countries and age groups, TB cases and deaths are disproportionate, with the majority being in low- and middle- income countries (LMICs). This suggests that measures to prevent and treat TB in these countries aren’t working as well as they could.
Latent TB infection is when a person has TB bacteria in their system without it having the effects of the full disease. TB preventative therapies work by treating latent TB infection, eradicating TB bacteria from the system, preventing it from causing more devastating disease.
What is LONGEVITY’s TB work?
TB preventative therapies often require many oral pills, and the full course must be taken for it to work properly. It can be hard to keep up with a pill regimen that has to be taken at certain times of the day for a long period of time, we call this a ‘pill burden’. Pill burdens can often lead to a lack of adherence to medication, leaving people susceptible to their latent TB infection becoming TB disease. We think this could be one of the key contributing factors to why TB is four times more prevalent in LMICs than their high-income counterparts.
Overseen by co-Directors Professor Andrew Owen and Professor Steve Rannard, the Centre of Excellence for Long-acting Therapeutics – Global Health (CELT Global Health) oversee the LONGEVITY project, which attempts to address this challenge.
The LONGEVITY project, led by Owen, represents a consortium of experts who believe that long-acting options of key TB preventatives would help eliminate the pill burden. By working with medicines that are already on the market, we’re starting with formulations we know are safe, trusted and already work. LONGEVITY expertise spans concept to preclinical and clinical evaluation, community engagement, policy and regulatory work, along with licencing. These areas working together are how we will make sure any LONGEVITY medication will be prioritised for patients in LMICs where TB (and the other project diseases, malaria and hepatitis C virus) are having the biggest impact. Receiving one administration of medication that lasts several weeks doesn’t place the same level of strain on patients and is easier to fit within busy lifestyles. This is particularly the case when patients are required to take medicines for a disease for which they don’t yet exhibit symptoms.
LONGEVITY’s patient and provider community engagement work was published last year and highlights that our solution aligns with what patients want and what providers believe will work. You can read more about it in this news piece we wrote.
Where is LONGEVITY’s TB work up to?
Last year, we used World TB Day to explain where we were up to with our two chosen medicines; rifapentine and isoniazid. You can read about it in our World TB Day 2025 blog.
This year we want you to hear from the team who will be running LONGEVITY’s TB clinical trials work. We spoke to Dr Marta Boffito, the Chief Investigator of the Chelsea and Westminster Hospital NHS Foundation Trust Research and Development (R&D) team.
Please enjoy Dr Marta Boffito’s words for World TB Day 2026
World TB Day makes me reflect on the responsibility that comes with exploring and advancing science around lifesaving drug development. In particular, the creation of simple and effective treatment and prevention tools for TB, which indeed remains one of the world’s deadliest infectious diseases.
We know that attention should be focussed on both active disease and the silent reservoir of latent tuberculosis infection (LTBI) to prevent TB developing in the next generations. TB is endemic worldwide, with over 80% of cases and deaths concentrated in low- and middle-income countries and an estimated one-quarter of the world’s population carries latent TB.
After completing my PhD in clinical pharmacology at the University of Liverpool, I have had the honour of continuing to collaborate with the Department on multiple life changing projects in infectious disease treatments. Over the past year, Chelsea and Westminster Hospital NHS Foundation Trust R&D Team and LONGEVITY have started to plan the delivery of a first in human Phase I study trial of a long-acting formulation of rifapentine for the management of LTBI.
Nowadays, current treatments for LTBI have shown high efficacy in adherent patients in reducing the risk of progression to active TB. The advances provided by shorter rifamycin-based regimens such as higher completion rates, superior safety profiles, and comparable or better effectiveness than traditional longer isoniazid intake are well described in modern guidelines. However, even with shorter-course options, adherence can be difficult, particularly in settings where access to healthcare is limited and TB-associated death rates are higher.
The availability of new TB prevention tools characterised by high efficacy which is independent from individual adherence would offer a powerful chance to change how TB is prevented and cured around the world. If long-acting rifapentine demonstrates to be safe and effective, the consequences are far-reaching, as we can start to imagine a future where people at risk of TB receive a single dose of treatment and are protected.
Rifapentine is already well-studied and what we are testing now is a long-acting formulation designed to maintain therapeutic drug concentrations in the blood ideally for up to a few weeks or even months, following a one off supervised intramuscular administration.
Although, as the Chief Investigator of this first-in-human study, I am very excited for this incredible development, I am aware that the road to implementation may still be long. Phase I trials are designed to demonstrate drug safety, tolerability and pharmacokinetics, and these early data will guide the next steps around drug dose optimisation and administration to people with LTBI.
It will be very exciting to work with healthy volunteers who have come forward to take part in this research project because they believe in this vital research initiative. They understand that preventing TB is one of the most powerful tools we have to save lives. Their generosity is what makes innovation possible.
If long-acting rifapentine works, as we very much hope, we can start imagining a future where all people (including children!) at risk of TB around the world can receive a single drug administration and be protected: this is not only about convenience, but also about equity.
Today, on World TB Day, I am reminded that TB elimination will come from patient-centred science strengthened by global partnerships that move discoveries from the laboratory to the communities, such as the one lead by the LONGEVITY group.
CELT Global Health and the LONGEVITY partners are determined to see the difficulties and deaths from TB in LMICs turn around. Patients from some of the hardest hit areas want long-acting options. Providers think they will eliminate some of the adherence issues. We’re working at regulatory and legislative levels to make sure that when these medications are ready, the infrastructure exists to get them to those most in need as soon as possible. The WHO want to reduce TB cases by 80% and deaths by 90% by 2030 and hopefully LONGEVITY will be part of what helps to get us all there.
The LONGEVITY project aims to simplify hepatitis C virus, malaria and tuberculosis treatment and preventative treatment to reduce the drug burden and the number of patients requiring complex therapies for active disease.
Find out more about the LONGEVITY project
The LONGEVITY Project is funded by global health agency Unitaid.
The project also involves critical partners and collaborators in the Clinton Health Access Initiative, Extentus Pharma Ltd, Johns Hopkins University, Medicines Patent Pool, Treatment Action Group and the University of Nebraska Medical Center.
