With third-highest TB burden, South Africa is critical player in search for vaccine

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The following is a guest post by  Jim Connolly,  president and CEO of Aeras, a nonprofit product development partnership dedicated to the development of tuberculosis vaccines. Aeras is located in Rockville, MD and operates an office in Cape Town, South Africa. 

By Jim Connolly

Recently I had the privilege of visiting our colleagues and partners in South Africa to see first-hand the contributions that South African researchers are making to tuberculosis vaccine research and development. As someone who has spent a career in the pharmaceutical industry, I was impressed by the extensive research and clinical trial infrastructure in South Africa. People across the country are determined to take action to help find an ultimate, long-term solution to TB in their communities that will impact the disease burden worldwide. From government officials implementing TB programs; to TB vaccine researchers with expertise in basic research, immunology and clinical research; to individuals who volunteer for clinical trials to test new vaccines – the people I met radiated a spirit of optimism and hope that this disease can be conquered.

Research Nurse Julia Amsterdam examines an infant who is participating in a TB vaccine clinical trial. “I just want to see that someday South Africa is TB free or there is a very small percentage of people with TB,” she said. “It’s obvious that the BCG, the vaccine that we are currently using, is inadequate because all the babies in South Africa get the BCG vaccination at birth, and some still get TB when they’re in contact with people that have TB.”

South Africa has the third highest TB burden in the world, with an incidence that has increased by 400 percent over the past 15 years. As one of the world’s preeminent emerging economies, South Africa has developed medical infrastructure and fostered a favorable research environment. The South African government has prioritized its response to tuberculosis. The Department of Health recently launched a new 5-year TB and HIVNational Strategic Plan with a long-term goal of eliminating TB and HIV infections, deaths, stigma and discrimination. The strategy recognizes the important role vaccines will play in achieving these goals.

South Africa is a critical player in global TB vaccine development. Researchers and institutions have partnered with Aeras and others to build and augment research capacity and infrastructure. Leading academic research organizations including the South African Tuberculosis Vaccine Initiative (SATVI) and the Center for Infectious Disease Research Institute (CIDRI) at the University of Cape Town, the Children’s Infectious Diseases Clinical Research Unit (KID-CRU) at Stellenbosch University, the Perinatal HIV Research Unit (PHRU) located in Soweto at the Chris Hani Baragwanath Hospital, and the Aurum Institute have joined with my organization to conduct TB vaccine clinical trials.

While in South Africa, I visited two partner clinical trial field sites. In Khayelitsha, a township with high rates of poverty and HIV, CIDRI is evaluating a TB vaccine candidate for safety and efficacy among people living with HIV. In Worcester, an area outside of Cape Town that has high rates of TB, SATVI has conducted clinical trials of six vaccine candidates, including a Phase IIb proof-of-concept trial of MVA85A, which enrolled 2,797 infants, making it the largest TB vaccine trial to date. This is an impressive accomplishment that required commitment to sustained community outreach efforts and perseverance in the face of the setbacks inherent in an ambitious and complex endeavor involving so many people over a period of years. The results of this first efficacy trial will be available early next year.

TB vaccine development is a daunting task, but we are confident that we will succeed in developing a new tool to protect people from TB. My trip to South Africa reiterated what I already knew: This is an urgent problem that cannot wait, and South African researchers are true leaders in the field. I am confident that, together, we will find a long-term solution to ultimately defeat the ancient scourge of tuberculosis.








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