Can a Spoonful of Pepsi Help the Medicine Go Down?

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PepsiCo is using its expertise to help make medication more palatable for children.

The giant food and beverage company, whose original soda was concocted by a pharmacist using sugar, lemon oil and nutmeg, is returning to its roots by deploying its vast research and development operation to improve the taste of tuberculosis drugs.

Tuberculosis medications are produced in pills meant for adults, and are often difficult for children to swallow. “The drugs are not formulated for them, and they’re unpleasant,” said Dr. Richard Chiasson, a professor of medicine, epidemiology and international health at Johns Hopkins University in Baltimore. Parents are advised to crush the pills and mix them into foods like applesauce, peanut butter or ice cream to mask the vile taste, but that often simply turns children off applesauce, peanut butter and ice cream, he said.

“Getting kids through treatment for TB is a nightmare,” Dr. Chiasson said.

“Not only are we hoping this will improve the drugs we already have, the other thing is what it will do to set the tone for newer drugs that are coming online,” said Dr. Mel Spigelman, chief executive of the TB Alliance, the nonprofit group with which Pepsi is working.

About 10.4 million people each year contract tuberculosis, and 1.8 million of them die, or roughly 5,000 each day, making it one of the world’s 10 deadliest diseases.

But only recently have public health officials woken up to the prevalence of tuberculosis among children, and even now, they say their figures on youngsters with the disease are more guesstimate than estimate.

“Over the last 60 years, the timeline of when TB cases were counted, the number of cases in children has been vastly underrepresented,” Dr. Chiasson said.

“In the last several years, we’ve begun to recognize that there are at least twice as many cases of TB in kids as was previously reported.”

Dr. Chiasson said that because young children don’t always have the characteristic cough that spreads the bacteria that causes tuberculosis, the medical community had assumed the disease wasn’t as widespread among them as it now believes it is.

In its most recent report on tuberculosis, the World Health Organization estimated that roughly one million children each year come down with the disease, most in Africa and India but also in parts of what was the Soviet Union and Latin America. About 200,000 of them will die, Dr. Spigelman said.

Last year, the alliance, together with Unitaid, the World Health Organization and UNICEF, introduced a fruit-flavored syrup containing three of the drugs used to fight simple tuberculosis. It took six years and $16 million to bring those medications to market, said Dr. Mario Raviglione, director of the global tuberculosis program at the World Health Organization.

“The adherence issue in TB is a major one even among adults because the treatment is long, anywhere from six months to 18 or 24 months, and the drugs have some bad side effects, so anything that means people stay on the treatment longer is a good thing,” Dr. Raviglione said.

Pepsi has one of the more unusual research and development operations in the food and beverage business. Its leader, Mehmood Khan, is a physician and scientist who previously worked at Takeda Pharmaceuticals, and he has brought that expertise to bear in reducing sugar, enhancing flavor and generally improving the nutritional quality of the company’s products.

One of the first innovations to come out of Dr. Khan’s lab was Trop50, an orange juice product with half the calories of orange juice. More recently, the lab’s work was responsible for one of the company’s most successful products in the last decade, Mountain Dew Kickstart, a 60-calorie version of the soda with flavors like Pineapple Orange Mango and Fruit Punch.

Trop50 and Kickstart are sweetened with stevia, a natural sweetener that has been difficult to use because the initial sweetness it delivers tends to quickly turn bitter. Kickstart, which was introduced in 2013, is on track to generate $400 million in sales this year, Dr. Khan said.

“Nobody has copied that product or Trop50 because they can’t,” said Dr. Khan, vice chairman and chief scientific officer at PepsiCo. “We have know-how in our lab that no one else has, and we can leverage that to make these drugs taste better.”

The idea of tapping into PepsiCo’s expertise came from Rajneesh Taneja, senior director of pharmaceutical product development at the alliance and himself a survivor of drug-resistant TB — and a veteran of Pepsi’s R & D lab. Dr. Khan said it took almost no time to get Indra Nooyi, PepsiCo’s chief executive, to sign off on a partnership.

“This is a no-brainer,” he said.

PepsiCo will be working to improve the flavor and sensory perception of 17 drugs used in treating tuberculosis. The company is donating to the alliance its time, expertise and any intellectual property associated with the flavors and sensory innovations it comes up with to make the drugs more palatable.

Ties between soda and food companies and medical organizations have been under scrutiny of late, but Dr. Spiegelman said he was not concerned that the alliance’s organization with Pepsi would corrupt its mission.

“I have to admit that when we went more public about this internally, some of our people raised the issue of this being a company that’s selling sugar to kids and making people fat and did we really want to be associated with that,” Dr. Spigelman said. “But as I weighed the option of being politically correct versus really doing something that will help save lives, to me the decision was really simple.”