World TB Day 24 March 2026
Advancing the Fight Against Tuberculosis: Insights from H3D on World TB Day 2026
Each year on 24 March, World TB Day draws global attention to tuberculosis (TB), one of the world’s deadliest infectious diseases and the urgent need to accelerate efforts to end it. In 2026, scientists at the Drug Discovery and Development Centre (H3D) at the University of Cape Town reflect on the challenges and progress in TB drug discovery through a Q&A that unpacks the science behind developing new treatments.
Understanding the Drug Discovery Process
Drug discovery is a complex and time-intensive journey. It typically begins with the identification of “hits”, compounds that show potential activity against a biological target. These hits are discovered through either target-based or phenotypic screening approaches.
Once validated, scientists refine these compounds through iterative cycles of design, synthesis and testing to improve their effectiveness, safety and drug-like properties. This optimisation process can take between five to seven years and often involves significant challenges. Many programmes do not progress to the stage of identifying a viable drug candidate due to difficulties in balancing efficacy, safety and pharmacological properties.
TB Treatment Today: Progress and Limitations
Significant progress has been made in standardising TB treatment regimens, particularly for drug-sensitive TB. Current treatments typically involve a four-drug regimen taken over four to six months. However, treatment becomes more prolonged and complex in cases of drug-resistant TB or when patients have co-morbidities such as HIV.
In some instances, treatment duration can extend up to 18 months. While existing therapies have saved millions of lives, they are often associated with high pill burdens, long treatment durations and potential side effects. These challenges highlight the urgent need for improved treatment options.
A key global objective is the development of a universal, or “PAN-TB,” regimen capable of treating all forms of TB. This goal is guided by the World Health Organization’s Target Regimen Profile (TRP), which calls for shorter, safer and more effective treatments with reduced pill burdens.
H3D’s Approach to TB Drug Discovery
At H3D, TB drug discovery efforts are driven by collaboration and innovation. Working closely with partners such as the Gates Foundation-funded TB Drug Accelerator, researchers are focused on identifying novel drug candidates that could contribute to next-generation TB treatment regimens aligned with WHO targets.
A central strategy at H3D is to develop compounds with activity across multiple TB disease states. In addition, the team is prioritising candidates with properties suitable for long-acting injectable formulations, an approach that could significantly reduce dosing frequency and improve patient adherence.
Progress and Looking Ahead
H3D is currently advancing multiple TB drug discovery programmes at various stages of development. In its most advanced programme, a promising drug candidate has progressed to late-stage in vivo studies assessing safety and efficacy, an important milestone in the journey toward clinical development.
At the same time, researchers continue to address the high attrition rates typical of early-stage drug discovery by actively exploring new targets and screening approaches to identify additional hit compounds.
A Continued Commitment
As World TB Day reminds us, the fight against TB is far from over. Through sustained research, global collaboration and scientific innovation, institutions like H3D remain committed to developing better, faster and more accessible treatments, bringing us closer to a future free of tuberculosis.
