For the first time in nearly 40 years, there are several new and improved medications to treat tuberculosis (TB) and multidrug resistant TB that are successfully moving through clinical trials. To help improve access to these medicines globally, we have set out to improve the synthetic process for most of the medicines that comprise two potential new TB regimens and will describe our efforts to improve access to the TB drugs Pretomanid, Bedaquiline, Sutezolid, and TBI-223 by applying our techno-economically driven synthetic design and optimization strategies. The synthetic improvements are focused on optimizing for cost and manufacturability, rather than applying a more traditional academic approach of focusing on publication impact and novelty. These improvements to the overall TB regimen may improve access to the overall regimen by removing key cost-drivers, supply constraints, or manufacturing bottlenecks that plagued the previously disclosed routes.

Increasing access to the next generation of life-saving tuberculosis medications through techno-economically guided synthetic process improvements

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