TB doesn't get the prioritization it needs

Tallinn, Estonia: Tuberculosis (TB) is considered a major public health issue by decision makers, yet commonly doesn't get the place of importance it needs as a health care priority. These are the preliminary results of a study presented at the Second Global Forum on TB Vaccines in Tallinn, Estonia, on Wednesday, 22 September 2010. Read more

The market research study provides an overview of national-level decision makers’ views on the introduction of new vaccines against TB. Undertaken in eight countries with high TB burdens, researchers conducted 86 one-on-one interviews (45-60 minutes) with senior Ministry of Health (MoH) civil servants responsible for vaccine introduction, MoH technical experts involved in delivering vaccines through the Expanded Programme on Immunization, senior Ministry of Finance (MoF) civil servants responsible for health budgets, senior public health clinicians, (children’s) health related NGOs, parliamentarians, and senior journalists. The study was conducted in China, India, South-Africa, Brazil, Russia, Mozambique, Cambodia and Romania.

The interviewees were presented with three hypothetical scenarios for new TB vaccines and asked questions about, among others, the likely demand and likelihood of rapid implementation. Overall, there was enthusiasm for (the use of) a new TB vaccine. "We still need to further analyze and break down the results, but generally they are encouraging," said Lew Barker, Senior Medical Advisor with the Aeras Global TB Vaccine Foundation. "What is striking is that the answers varied both within and between countries, ranging from positive to negative, and often with a wait and see attitude."

When the interviewees were initially asked about their country's major public healthcare priorities, none mentioned TB. Rather issues such as primary healthcare, mother and childcare, chronic diseases and HIV/AIDS topped the lists. "But if they were then asked about TB, the respondents immediately acknowledged it is a big problem that doesn't get the attention it deserves," Barker explained. "So TB is not at the top of their mind but it definitely is there on a lower level. It is a neglected disease - we already know that - that is one of the challenges the fight against TB has to face."

The results further showed a widespread dissatisfaction with the only currently available vaccine, Bacille Calmette Guérin (BCG). The vaccine is protective against severe forms of TB in children, but not effective enough against lung TB in adolescents and adults, the most common and most infective form of TB worldwide.

The market research study titled 'Barriers and Drivers for Introduction of New TB Vaccines' was done as part of a broader initiative of the Stop TB Partnership's Task Force on Economics and Product Profiles for New TB Vaccines. It will be published online later this year.

At the international conference in Tallinn, around 200 scientists, clinicians, manufacturers, NGOs and governmental institutions from around the world this week (September 21-24) review the progress made in vaccine development in the past decade and look forward to the challenges and opportunities ahead.

Babs Verblackt-CNS
(The author is a freelance journalist, a Fellow of CNS Writers' Bureau and Associate Communications at TuBerculosis Vaccine InitiativeTBVI

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