Over
the past 2000 years, tuberculosis (TB) has claimed more lives
than any other infectious disease. In 2020 alone, TB was responsible
for 1.5 million deaths worldwide, comparable to the 1.8 million deaths
caused by COVID-19. The World Health Organization has stated that
new TB drugs must be developed to end this pandemic. After decades
of neglect in this field, a renaissance era of TB drug discovery has
arrived, in which many novel candidates have entered clinical trials.
However, while hundreds of molecules are reported annually as promising
anti-TB agents, very few successfully progress to clinical development.
In this Perspective, we critically review those anti-TB compounds
published in the last 6 years that demonstrate good in vivo efficacy against Mycobacterium tuberculosis. Additionally,
we highlight the main challenges and strategies for developing new
TB drugs and the current global pipeline of drug candidates in clinical
studies to foment fresh research perspectives.