World Health Organization (WHO) Director-General, Dr. Tedros Adhanom Ghebreyesus,  has urged the development of a new tuberculosis (TB) vaccine to end the global epidemic. He used the ongoing COVID-19 pandemic as a benchmark as the world searches for a life-saving alternative. 

Ghebreyesus aired his concerns during the Global Forum on TB Vaccines yesterday, an event which is being convened virtually in Toulouse, France from 22 to 24 February 2022. The forum is the world’s largest gathering of stakeholders striving to develop new vaccines to prevent TB through research and innovative approaches. 

Currently, the Bacille Calmette-Guérin (BCG) vaccine is given to newborn babies to stimulate the infant’s immune system to build antibodies. First administered in 1921, its effectiveness in adults remains uneven. This is evident given that South Africa has the fifth-highest burden of TB in the world.

Power of vaccines

“The COVID-19 pandemic has taken a heavy toll on people with TB and the services on which they rely. The pandemic has also demonstrated the incredible power of vaccines to save lives. An effective and safe vaccine against all forms of TBs is our best shot of ending this global epidemic,” said Ghebreyesus.

The National Institute for Communicable Diseases (NICD), stated that TB is spread from person to person through the air. When people with TB cough, sneeze or spit, they propel germs into the air and a person needs to inhale only a few of these to become infected.

Every year, at least 10 million people contract  TB, despite it being a preventable and curable disease. A total of 1.5 million die from the disease each year, making it the world’s top infectious killer. It’s also the leading cause of death among people with HIV and a major contributor to antimicrobial resistance.

Stumbling blocks

Ghebreyeus said funding for TB vaccines research remains a stumbling block towards finding a new vaccine.

“WHO is coordinating a health and economic impact assessment and a road map to prepare the best way for licenses. However, public funding for TB vaccine research remains inadequate and industry engagements are low owing to lack of market incentives,” he stated. 

But, Ghebreyesus remains hopeful that a solution can be found using COVID-19 as an example.

“There are solutions. The pandemic has demonstrated the value of a multi-platform portfolio of vaccine candidates, including mRNA and viral-vector technologies. This approach could transform vaccine development efforts for other diseases including TB,” stated Ghebreyesus.

He added that three other ingredients are essential. “First, public-private partnerships for bringing expertise together and funding from various sources to tackle major scientific challenges. Secondly, strong political leadership backed by substantial financial resources can shorten the time to availability of vaccines. And thirdly, equitable access must be considered early, with need prioritised above the ability to pay. Together we can end TB.” 

Dr Makuta Sharma (@WHOSEARO) highlights a few points that are needed for timely access for new #TBvaccines

📊 Population modeling
🌍 Vulnerability mapping
💵 Money
🛑 Addressing TB stigma

— Global Forum on TB Vaccines (@GlobForumTBVax) February 22, 2022

BCG’s failure

Carol Nawina Nyirenda, a TB activist from Zambia, shared WHO’s sentiments.

“Tuberculosis was among the first diseases for which humanity developed a vaccine, commonly known as the BCG. At the time, it contributed to decreased mortality in children and showed a certain level of protective effects. However, due to its inability to protect adults and adolescents, it is no longer an answer to end TB by 2030,” she said. 

“We need a new vaccine, and we need it urgently. According to the current modelling, we will be able to end TB by 2030 if the vaccine becomes available by 2025. And for that to happen, we need to fast-track clinical trials. We did that with COVID-19, why can’t we do it with TB vaccines?,” she asked.

“Cause for optimism”

Dr. Anthony Fauci, director of the US National Institute of Allergy and Infectious Disease (NIAD), said there was finally “cause for optimism” in the quest for a TB vaccine.

“There have been significant research advances and there is cause for optimism,” said Fauci. But, he also expressed concern in light of how TB treatment took a serious knock during COVID-19, and warned: “incremental changes alone are not sufficient and not acceptable”.

Fauci added: “Diagnoses have decreased and not because people are getting less TB, but because they are not being diagnosed with TB due to the interruption of services. – Health-e News