Reflections on UNITE4TB’s Ambitious Journey: An Interview with Project Lead, Derek Sloan

This year, you took over as project lead of the UNITE4TB Consortium. Can you briefly introduce yourself to our readers? 

I am a consultant physician specializing in infectious diseases and general (internal) medicine. I coordinate UNITE4TB for Radboudumc, hold an academic position at the University of St Andrews, and work directly with patients in Scotland. I’ve previously worked as a doctor and clinical researcher in Kenya, South Africa, Malawi, and England. Beyond TB-focused work, I have participated in humanitarian healthcare responses to Ebola in Sierra Leone and diphtheria among the displaced Rohingya population in Bangladesh. As such, my background is quite varied, with experience working in complex environments.

How has the experience been so far in managing this large multi-stakeholder project?

The UNITE4TB experience so far has been rewarding but also challenging. The consortium is made up of a phenomenal number of talented people from world-leading institutions, and we have an unprecedented opportunity to make a difference to the care available to TB-affected people worldwide. The team’s energy and determination are inspiring and reinforce our shared commitment to make this happen. The learning curve for me has been steep as the scale of the project is vast, and the range of stakeholders very broad. Maintaining a strong collective team spirit and sense of unity is crucial to our achievement. 
 

UNITE4TB is approaching the mid-term mark. What have been the key challenges and achievements of the project to date? 

Since its launch in 2021, despite the challenges of the Covid-19 pandemic, the consortium has built a global network of scientific partnerships and clinical research sites. Thanks to the leadership of colleagues at LMU University Hospital in Munich, and the research teams in Tanzania and South Africa, we already have one fully recruited clinical trial with the DECISION study. And thanks to the leadership of colleagues of the Medical Research Council team at UCL in London, and research teams around the world, the PARADIGM4TB trial is also really picking up pace. This is a significant achievement, as a multi-arm platform trial of this complexity has never been undertaken in TB before. It shows that we are not only studying novel drugs and new treatments, but we are also trying to completely change how antibiotic trials for TB are run.

Of course, there are always challenges. Getting PARADIGM4TB off the ground presented some hurdles, especially with regard to the ethical and regulatory requirements. Coordinating a steady supply of study medications on time is a major logistical undertaking, and making sure all guidelines and regulations are followed for drug procurement in the European Union is a challenge still being resolved. Overall though, I am enormously impressed by the positive attitude and initiative taken across the consortium to ensure we keep moving forward. I feel very optimistic that we will succeed in reaching our goals.  

Looking ahead to 2025, what will be the key focus for UNITE4B?

I expect 2025 will be a very busy year for the consortium. So far, recruitment for PARADIGM4TB has been based in Africa. Next year, I look forward to greater involvement from sites in Asia, Europe, and South America. Additionally, our pharmacology, biomarker, and artificial intelligence teams will intensify their work as more samples and data become available. The early phase clinical trials program, led by our partners at TASK and GSK, will also pick up steam. 

Part of the aim of UNITE4TB is to streamline the different stages of drug and regimen development to accelerate the journey from early-phase studies to large-scale evaluation and clinic delivery. In 2025, we will strive to have all parts of the machine running in unison. The year ahead will be an important one for the project. We have a big responsibility to use the resources entrusted to us to deliver hope to millions of people affected by TB each year. By working hard and, importantly, working together, we have a good chance of making a meaningful impact.