The Indian Council of Medical Research (ICMR) has won the Stop TB Kochon Prize for excellence in TB research and development. The $65,000 Prize is awarded annually by Stop TB Partnership to individuals and/or organizations that have made a significant contribution to combating TB. The ICMR emerged the winner from amongst 18 nominations.

The 2017 Kochon Prize was awarded to the Indian Council of Medical Research (ICMR) today in New Delhi for building a tradition of excellence in TB research and development. The $65,000 Prize is awarded annually by Stop TB Partnership to individuals and/or organizations that have made a significant contribution to combating TB. The ICMR emerged the winner from amongst 18 nominations.

“The 2017 Kochon Prize is specifically about contributions to TB research. Since ICMR and several of its research groups — NIRT, JALMA and India TB Research Consortium — are engaged in TB research, and some of them for a very long time, it made sense to nominate ICMR for this Prize this year. I nominated ICMR for the large body of research over many decades,” says Prof. Madhukar Pai, a TB expert from McGill University, Montreal, Canada who nominated ICMR for the award.

“TB research can no longer depend on U.S., UK or other rich countries. They are all cutting back on global health. Countries most affected by TB must step up, show leadership, and invest in TB control as well as research. So, I am delighted that this year’s Stop TB Kochon Prize to ICMR recognises decades of ground-breaking TB research by India, which shaped the global DOTS strategy. The award is richly deserved, and timely, as India has raised its ambition and political commitment,” Prof. Pai says in an email to me.

“ICMR deserves the recognition. TB research itself needs recognition. We can’t end TB without research,” says Dr. Soumya Swaminathan, Deputy Director General at the World Health Organisation. She is a TB researcher and former Director of NIRT before becoming the Director-General of ICMR.

“The Prize sends a strong message that investing in research is critically important to end TB epidemic. The recognition comes at a crucial time when the Indian government is increasing its commitment to end TB. The award will improve the profile of ICMR, bring more awareness and  funding for research and attract more people to take up research on TB,” says Dr. Swaminathan.

NIRT’s contributions

“Since its inception in 1956, Chennai’s National Institute of Research in Tuberculosis (NIRT) [which was formerly known as the Tuberculosis Chemotherapy Centre and later as Tuberculosis Research Centre (TRC)] has undertaken several trials that had had impact internationally,” says Dr. Swaminathan.

TRC started with the landmark Madras Classic trial 1956 to compare the outcomes of domiciliary chemotherapy with treatment in sanatorium. The first of its kind trial showed that the cure rate was the same when treatment was offered at home and in sanatorium.  The BCG vaccine trial by TRC, the largest ever to be conducted, followed-up 350,000 volunteers for 15 years. “The trial was conducted to the highest standards. Such a large trial has never been replicated anywhere else,” says Dr. Swaminathan.

TRC was also involved in path-breaking studies such as the necessity of direct observation of treatment, studying the feasibility of detecting TB using sputum smear microscopy at the PHC level thus enabling quicker detection of TB cases. It also studied the effectiveness of intermittent short-course chemotherapy. “These findings laid the foundation of directly observed treatment, short course (DOTS), which has been adopted by nearly 150 countries worldwide, Prof. Pai writes in Nature.

TRC has also conducted more than 50 drug combination and duration trails for both pulmonary and extra-pulmonary TB, and undertaken pharmacokinetic studies for dosing. It has developed new diagnostics, and tested and validated diagnostics developed elsewhere.

India TB Research Consortium

The India TB Research Consortium is addressing the need for increased investment by India and other TB high-burden countries. In a few months, trails using the two new TB drug (Bedaquiline and delamanid) combinations for MDR-TB and XDR-TB will get under way. The trails will be combining two existing drugs and the two new drugs to reduce the duration of treatment from the current 24-30 months to 6-9 months.

Another trial to be carried out at multiple sites in India will test the effectiveness of adding the already approved diabetes drug metformin to standard anti-TB regimen for drug-sensitive TB. With the ethics committee approval already in, the trial is expected to start very soon.

Published in The Hindu on March 13, 2018