By Sharon Atieno

Despite Tuberculosis (TB) being in existence for more than 200 years, it has only one vaccine, the Bacillus Calmette-Guérin (BCG) vaccine administered in infants and young children. In commemoration of 100 years of the vaccine’s existence, researchers and other stakeholders in the TB field have called for increased investment in the development of more vaccines.

Speaking during a virtual briefing, Dr. Suvanand Sahu, Deputy Executive Director of the Stop TB Partnership, noted that the vaccine protects against severe forms of TB, particularly in infants and young children but offers poor protection against other forms of TB, TB transmission and disease in adolescents and adults.

Globally, about 4000 people die daily as a result of TB, more than a quarter of the deaths occur in Africa.  One in four people who fell ill with TB in 2016 were Africans, accounting for about 2.5 million people, according to the World Health Organization.

At the United Nations High-Level Meeting (UNHLM) on TB in 2018, world leaders committed to delivering new TB vaccines but failed to deliver necessary investments.

Shortfalls remain in the funding of the disease, with only USD 17 million being invested in TB research in 2019 against a target of USD 550 million a year required to deliver a new vaccine by 2025.

“What the world has achieved in the past one year with the development of safe and effective vaccines for COVID-19 is astonishing and worth celebrating,” Dr. Sahu said.

“Now, it is the time to invest the same level of technology and funding in developing new vaccines for another airborne deadly infectious disease-TB-which has been around for a millennium and still kills up to 4,000 people every day, including about 700 children.”

Dr. Sahu observed that the COVID-19 pandemic has had profound negative impact on global TB response pushing back progress by up to 12 years.

“However, vaccines developed for COVID-19 at great speed provide hope that the slow moving TB vaccine development can be fast tracked with strong political commitment , adequate funding and faster research techniques,” he stated.

Welcoming the G7 countries 100 days commitment to tackle future pandemic Dr. Sahu noted that the commitment should be extended to existing pandemics such as TB. Further, he called on the world to provide sufficient financial resources and political will to allow for the delivery of a new effective, safe equitable and affordable TB vaccine by 2025.

According to Prof. David Lewinsohn, Chair of Stop TB Partnership’s Working Group on New TB Vaccine, the commitment seen in COVID-19 vaccine development should also be deployed in TB vaccine development. This includes willingness to purchase vaccine before knowing their efficacy and willingness to engage in parallel clinical development tracks.

He observed that there are currently 14 candidate TB vaccines in different stages of development, which reflect a diversity of different vaccines, including viral vaccinations, modified bacteria vaccinations and protein vaccinations.

“With multiple vaccine candidates preparing for late-stage efficacy trials and next-generation vaccines based on mRNA and other novel platforms on the way, there has never been a better time to invest in TB vaccine research and development,” said Prof. Lewinsohn.

Additionally, he said that there was also a need for greater capacity to evaluate and license vaccines to have equitable distribution.

According to Caroll Nawina, a TB survivor and advocate for policy change at national, regional and international levels, effective vaccines are critical to ending the TB epidemic.

“But having a vaccine is not enough if it is not affordable and accessible to all. The distribution of COVID-19 vaccines has clearly shown the inequalities and inequities of a system that favors the rich. We will not accept such a situation in TB, and we must ensure future TB vaccines reach those most in need,” she said.