The technological innovation and tuberculosis elimination: a Technology Foresight study.

In the present study, tuberculosis specialists were surveyed to rate the most effective strategies to eliminate TB as a public health problem by 2050. Then were investigated the most promising emerging technologies for the prevention, diagnosis and treatment of tuberculosis (TB) expected to reach the market by 2035. This Technology Foresight study was specifically carried out by means of a web survey closed questionnaire, which was sent to 29,988 TB specialists worldwide. Of these, 2,657 answers were obtained and analysed. Respondents had demonstrated a high level of academic training (PhD), more than 10 years of professional experience, and a great diversity of both areas of knowledge and geographic reach. In the view of experts, the strategies with the greatest potential impact on epidemic TB were a) shorter time between diagnosis and start of treatment of DS and MDR-TB; b) strengthening tuberculosis control actions in the most vulnerable populations; c) shorter and less expensive regimens for drug resistant MDR/XDR-TB. Regarding the strategies with the highest potential for eliminating TB, our data suggests that the biomedical paradigm is the strongest among the specialists. The most promising technologies expected to reach the market by 2035 selected by the specialists were: (1) new drugs of known chemical classes or new chemical classes; (2) new point-of-care diagnostic tests for DS-TB, drug resistant or multidrug resistant (MDR/XDR)-TB and TB Infection (TBI). We contribute by discussing the most promising technologies and strategies for the elimination of TB in light of social determinants of health models and forecasting studies. We conclude by suggesting that the expected emerging technologies ongoing development will not suffice to end TB by 2050.