Tackling TB to reach MDG targets: The promise of new vaccines

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The following is a guest blog posting by Peg Willingham, the Senior Director of the Aeras Global TB Vaccine Foundation.

World leaders are meeting at the United Nations in New York this week to discuss the ambitious global poverty reduction agenda set forth in the Millennium Development Goals (MDGs).  With five years left in the timeline set out to halve global poverty through health, education and environmental programs, there is an urgent need to address issues that cut across the MDGs, such as tuberculosis, a devastating disease of poverty that continues to kill nearly 2 million men, women and children every year.  New tools to fight TB are urgently needed and momentum in TB vaccine research provides an opportunity for optimism.

Simultaneous to the MDG Summit in New York, TB vaccine researchers and stakeholders from around the world  are meeting in Tallinn, Estonia for the 2nd Global Forum on TB Vaccines to assess a decade of progress in the search for more effective TB vaccines and to chart a path forward to sustain the momentum over the next decade.  Developing these new weapons against TB is critical; no infectious disease has ever been eliminated without vaccines.  Yet this important fight has been hampered by the lack of funding for a disease that is too often overlooked by policymakers.

Despite gains in the delivery of available treatments, the TB epidemic is growing more complex and difficult to control due to drug resistant forms of TB, including multi-drug resistant (MDR) and extensively drug-resistant (XDR) TB, and the deadly relationship between TB and HIV. TB is the leading cause of death among people living with HIV/AIDS in Africa and is a major cause of death for women of childbearing age.  In 2008 more than half a million people infected with HIV died from TB.  TB affects people in the most productive period of their lives, impacting national economies and health systems, and contributing to the cycle of poverty.

The currently available TB vaccine – Bacille Calmette Guerin (BCG) – was developed in 1921 and has not been improved upon since.  Its ability to prevent TB is limited and unreliable and it is not safe for infants with HIV.

The TB vaccine field has moved into a pivotal new era.  Since the first Global Forum held in 2001, the portfolio of prospective new vaccines has expanded markedly.  Twelve TB vaccine candidates have entered clinical trials and nine are currently undergoing testing in Africa, Europe and North America.  A tenth is expected to enter trials later this year.

After 10 years developing a strong pipeline and bringing novel vaccine candidates from the laboratories to clinical trials, scientists and researchers are collaborating with a broad range of stakeholders to apply lessons from the rollout of other public health products to focus and plan for future access and adoption of new TB vaccines. 

The 2nd Global Forum on TB Vaccines will be a scientific meeting with much discussion about the challenges in developing vaccines against a bacterium with no clear biomarkers and correlates of protection.  But set in a capital of Eastern Europe, where in some parts TB patients are 10 times more likely to have multi-drug resistant TB (MDR-TB) than in the rest of the world, issues of global prioritization of TB and the need to raise greater awareness will also be on the agenda. 

Despite its devastating impact, people who suffer from TB garner far less attention and resources that they deserve. Policymakers and opinion leaders must recognize TB as a growing global threat and marshal significantly greater resources to support vaccine research and the ambitious plan to save millions of lives with them.

To learn more about the deliberations at the 2nd Global Forum on TB Vaccines visit http://www.tbvaccine2010.org/Agenda.html and on Twitter follow #TBVAX2010. Stay tuned to ScienceSpeaks later this week for information on outcomes from the Global Forum on TB Vaccines.

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