Platform for efficient and practical tuberculosis treatment trials: meeting report, 30 September-1 October 2024, Geneva

This meeting report summarizes discussions and recommendations from a WHO consultation held in Geneva on 30 September–1 October 2024 to explore the establishment of a platform for efficient and pragmatic tuberculosis (TB) treatment trials. Participants included representatives of national TB programmes from six high TB burden countries, clinical trial experts, regulators, funders, researchers and community representatives. The meeting reviewed current challenges in generating high-certainty evidence for TB treatment policies and examined opportunities to strengthen the global clinical trial ecosystem through streamlined, adaptive and multicountry randomized controlled trials. Discussions focused on aligning the initiative with WHO guidance on best practices for clinical trials and addressing regulatory, ethical and operational considerations for pragmatic TB research.

The report outlines priority research areas and proposed trial approaches, with particular emphasis on optimizing treatment regimens for drug-susceptible TB through shorter, safer and more person-centred therapies. Participants discussed candidate regimens, comparator treatments, inclusion of populations often underrepresented in clinical trials, and approaches to treatment stratification and outcome measurement. Additional discussions addressed financing mechanisms, community engagement, governance arrangements and coordination between countries and regulatory authorities. The meeting concluded with broad support for establishing an inclusive multicountry TB treatment trial platform to accelerate evidence generation and improve TB treatment outcomes globally.