TB a difficult bugger

This is according to Prof Greg Hussey, Deputy Dean of Research at the University of Cape Town’€™s Health Sciences faculty and someone who has been working in the TB field for many years.

Hussey said there was a huge challenge in finding ways to test potential vaccines. ‘€œIt is easy to develop a vaccine, but how do you assess the efficacy of the this product, how do you test it,’€ he asked.

Hussey, who established the South African Tuberculosis Vaccine Initiative (SATVI), which is now overseeing the testing of a number of vaccine candidates at the site in Worcester, said there was a critical need for more money to be invested in testing candidate vaccines.

He also criticised South Africa for investing very little money in research, especially in the people needed to carry out the research. ‘€œWe are not going to be making the vaccine here in South Africa, but we are going to have to test it and in order to do so we need to invest in human capital,’€ he said.

Responding to cynics who believed it was imperative to keep searching for a TB vaccine, but that it would be in vain, Hussey said: ‘€œThey are wrong.’€

‘€œWe are going to find one, for everything there has to be a solution. There has been complacency in terms of TB for many years because we were winning the battle, but that was before HIV appeared.

‘€œHIV has now made TB a problem in the north as well, lending some urgency, but we need to solve this problem soon,’€ said Hussey.

In South Africa, between 50 and 70% of people with TB also have HIV, with TB the biggest killer.

Dr Hassan Mahomed is a colleague of Hussey and co-director of SATVI. He confirms that worldwide there are 14 new vaccines that have been tested in humans in clinical trials.

One of the most promising vaccines to enter efficacy trials (efficacy trials follow safety trials) is University of Oxford’€™s Aeras 485/ MVA 85A which will be tested on infants at the Worcester site by SATVI.

It is a historic trial as it is the first efficacy trial of a new vaccine in infants since the BCG vaccine was introduced almost a 100 years ago.

There will be a trial arm as well as a placebo arm with infants followed up until April next year.

Mahomed said the Worcester site was established in a relatively ‘€œresearch-naïve’€ community and scientists could draw on a community of about 350 000 residents in the Boland area.

The rate of TB (per population) was also higher in this area than in Cape Town.

All the infants must have had a BCG vaccine within 24 hours of birth to enter the trial and the trial vaccine is then administered as a booster within four to six months.

Mahomed said historically big pharmaceutical companies did not view the development of a TB vaccine as a priority as it would not produce much profit.

‘€œThis is part of the reason why it has taking so long to develop a new vaccine, with pharma not prepared to fund the initial safety trials,’€ he said.

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