Time to Seize the Momentum on TB Vaccine Development

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Extensive groundwork is being laid out for a new TB vaccine in clinical sites and research institutions across Africa—lab capacity and field sites are being set up, health professionals are being trained, epidemiological studies are underway. David Bryden discussed the impressive work underway in South Africa in an earlier blog posting.  But all these efforts will be for naught if funding for Phase III trials of new vaccine candidates doesn’t materialize.

At a Congressional briefing today, three African researchers detailed the progress made and challenges ahead in the search for a new, more effective TB vaccine to replace the 90-year-old BGC vaccine now being used in the developing world. BGC offers some protection against severe forms of TB most often contracted by children, but it is not very effective against adult pulmonary TB. Additionally, it may case BCG disease in infants who are HIV positive.

The search for a new vaccine has taken on increased urgency in the context of the HIV epidemic, which has reignited TB across the developing world, said the panelists at today’s briefing, co-sponsored by Aeras and the Global Health Council.

Dr. Harriet Mayanja-Kizza, a physician and researcher at Makerere University College of Health Sciences in Kampala, described the twin HIV and TB epidemics in Uganda and said efforts to begin TB vaccine studies there began at the end of 2007. That work includes insuring the necessary infrastructure is in place and doing extensive epidemiological studies and it has had many other benefits, including general health system strengthening, training of nurses and community leaders, and identifying village scouts who can identify TB in children.

But funding for TB vaccine studies is at risk and “future support from the US government is crucial to us,” she said. “We want to keep our babies healthy and happy and with your support, we know we can do it.”

A second physician-scientist, Dr. Sizulu Moyo, a clinical researcher with the South African Tuberculosis Vaccine Initiative in Cape Town, said a new vaccine would also help protect against the growing threat of multidrug-resistant TB and extensively drug-resistant TB.

“We need a vaccine to stop the pandemic,” Moyo said, adding that an effective vaccine would also have significant side benefits, such as reducing the toll TB takes on the health care systems and national economies of poor countries.

“There’s a lot of momentum” in Africa right now to find a more effective TB vaccine, Moyo said, noting that Phase I and Phase II trials are underway. But critical funding for Phase III trials, which would cost an estimated $160 million, is in doubt. If the funding for that final critical phase is not available, “all that momentum will be lost.”

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