Market-driven, value-based, advance commitment (MVAC): accelerating the development of a pathbreaking universal drug regimen to end TB.

### Summary box Tuberculosis (TB), an infectious disease primarily affecting poor and neglected populations, kills an estimated 1.6 million men, women and children each year).1 Our existing arsenal of tools is insufficient to address this enormous burden. Current treatment cycles are long and toxic, causing some patients to discontinue treatment, acquire drug resistance and spread a drug-resistant pathogen to others. Treating drug-resistant cases takes even longer, is more expensive and less effective. More extensive forms of drug resistance are developing and spreading quickly. On the current trajectory, the world will not achieve the Convergence 2035 targets for TB until 2074, almost 40 years later than originally projected (see figure 1). Figure 1 New cases of tuberculosis per 100 000 people. Source IHME. BRICS, Brazil, Russia, India,China and South Africa; HTA, health technology …