New TB Vaccines: A Reality In The Next Decade

Often thought to be a disease of the past, tuberculosis still kills around 1.7 million people per year. Worldwide, more than 9 million people become infected every year. Although TB mostly affects poor people in developing countries, it is prevalent in all continents, especially in Asia, Africa and Europe.Along with great human suffering the disease has serious financial consequences and hampers economic growth. Multidrug-resistant TB (MDR-TB) that does not respond to the standard treatments using first-line drugs, is present in virtually all countries in the world. There were an estimated 440,000 new MDR-TB cases in 2008 with three countries accounting for over 50% of all cases globally: China, India and the Russian Federation.

Extensively drug-resistant TB (XDR-TB) occurs when resistance to second-line drugs develops. It is extremely difficult to treat and cases have been confirmed in more than 58 countries.

In 2010, the largest WHO MDR-TB survey reported the highest rates ever of MDR-TB, with peaks of up to 28% of new TB cases in some settings in the former Soviet Union.

“Why do we need vaccines to control tuberculosis? We have to deal with cases where drugs do not or
hardly work. And we have the problem of HIV/TB co-infection.” To Michel Greco, chair of the Stop TB Partnership Working Group on New TB Vaccines, the story is very clear: “Drugs are important, but we have to go to the root of the matter, with new vaccines.”

For WHO and the Stop TB Partnership, recognition for the importance of new vaccines seems to have increased. Currently, only one vaccine against tuberculosis is available. The BCG vaccine protects children against severe forms of the disease but offers very limited protection against pulmonary TB in adults and adolescents. Safer and more effective vaccines could save millions of lives.

John Bowis, a member of Council of Trustees of TBVI (TuBerculosis Vaccine Initiative), wants politicians and decision makers to understand that the disease is still a threat nowadays. “I believe that one should bring these things to life by talking about real people. Having worked in health, I have seen TB on the march. It’s come back with a bang and it is worse because of drug resistance.”

“There are many health issues that I feel strongly about,” says the former politician. “I’m mostly drawn to unresolved issues and to diseases with a stigma. TB is one of those and there is a great need for new vaccines.”

The 2010 annual report of TBVI gives an overview of the highlights, challenges and milestones that TBVI came across in 2010. It is confident that a new and effective tuberculosis vaccine can be available within a decade. However the delivery of these life-saving vaccines requires both political will and innovative funding.

TB vaccine research is moving forward steadily, and new TB vaccines could very well be realized within the next decade.  Developing new tuberculosis vaccines is scientifically challenging, but the progress that has been made over the past ten years is tremendous.  Researchers within TBVI’s network are reportedly progressing towards new, safer and more effective vaccines against tuberculosis. The year 2010 has been a remarkable year for the TB vaccine world, as several vaccine candidates advanced to a subsequent phase in their development. Out of TBVI’s portfolio, several vaccine candidates have advanced to a subsequent phase in their development. Worldwide, there are now twelve vaccine candidates in clinical trials.

“A breakthrough that nobody would have thought of 20 years ago,” said Prof. Kaufmann, chair of the TBVI’s research project NEWTBVAC.

Now the challenge is of finding the capacity and the resources to execute the clinical trials and to make new vaccines available for those who need them most. In order to bridge the calculated critical financing gap of 560 million euros, needed to bring the most advanced vaccines out of its portfolio to the market, TBVI has proposed an innovative funding model. In this plan, European governments are asked to provide guarantees to make it possible for TBVI to finance clinical trials through a loan. The loan can then be repaid through the sales of marketed vaccines.

This way  “New vaccines can be developed at no cost for the tax-payer and with minimal risk for state budgets,” explains TBVI’s vice president Joris Vandeputte.

Looking at the current status of TB vaccine research, TBVI is confident that a new, more effective, safe vaccine can be delivered within a decade. Still, in order to quickly deliver live-saving vaccines, we need to continue and strengthen collaboration between all different actors. Researchers can provide solutions for the growing threat of tuberculosis. Now is the time for politicians, industries and private funders to make this possible.

Although the ‘TB vaccine pipeline’ looks more promising than ever, yet there is need to continue innovating the discovery work in the laboratories. Investments in new technologies will have to be made to develop vaccines that also protect latently-infected people from getting tuberculosis, and vaccines that block infection and transmission. The search for biomarkers, which are necessary to monitor the effectiveness of new vaccines, should continue. While clinical trials are progressing, it is becoming more and more important to find the right assays to predict the protection rate of a vaccine candidate.

“Tuberculosis is not only a human disaster, it is also an enormous drain on the global economy,” said Mr Onno Ruding, chair of TBVI’s Governance Board. “Creating new vaccines is a long-term process. If we stop investing now, we will run all previous investment to waste.”


Published in:
Citizen News Service (CNS), India/Thailand
Health, Thailand
Wikio News, Africa
Elites TV News, California, USA
World Care Council, UK