Building and managing a complex drug discovery consortium: insights from the tuberculosis drug accelerator.

Developing tuberculosis drug regimens requires coordinated discovery of multiple, mechanistically distinct agents, which challenge traditional single-asset models. The Tuberculosis Drug Accelerator (TBDA) was established as a multi-organizational consortium to enable collaborative discovery across academia, industry and research institutions. Over more than a decade, the TBDA has demonstrated how such collaborations can align incentives, manage uncertainty and maintain portfolio discipline. This manuscript examines the operational and governance mechanisms that enable sustained collaboration. Although shaped by a global health context, this model can inform collaborative drug discovery efforts in other research settings requiring coordinated, multi-institutional approaches.