New vaccine strategy to advance solutions for tuberculosis

Against a backdrop of growing concern about the impact of tuberculosis on children, top scientific experts today published a global plan of action for developing the vaccines that are seen as critical to eliminating the disease.  Published today in a special issue of the journal, Tuberculosis , the strategic blueprint for the TB vaccine field, represents consensus reached by the TB vaccine community.

“The TB Vaccine Blueprint provides an enormous opportunity to coordinate efforts to halt the spread of this devastating disease,” said Dr. Aaron Motsoaledi, the Minister of Health of South Africa, a country that has played a vital role in ongoing clinical trials for TB vaccines. “Governments have an important role to play, and guided by this common strategy we will do our part to make a vaccine a reality.”

New, more effective vaccines will be decisive in the fight against TB. More than 10 million children have been orphaned by the disease, which is rapidly becoming resistant to available treatment options.  In addition to great human suffering, the disease causes significant financial and economic damage costing the global economy an estimated hundreds of billions of dollars a year.

“To develop a new TB vaccine that will be fully effective, researchers, donors and other partners will need to collaborate and coordinate their efforts as they address tough research questions,” said Dr. Lucica Ditiu, Executive Secretary of the Stop TB Partnership. “We cannot allow ourselves to be overwhelmed by either the costs or the obstacles. It is time to be bold and dare to do more in TB, especially in supporting the development of a new vaccine."

To address the many challenges posed by TB, ideal vaccine regimens must protect babies at birth from childhood TB, and prevent infection with the organism in older children and adults. A vaccine also is needed to protect people with latent TB who have not yet developed signs of disease. The only currently existing vaccine is limited in its ability to impact the global TB epidemic. Known as Bacille Calmette-Guérin (BCG), it protects children from severe forms of TB in the first years of life, but it endangers babies who have been infected with HIV by their mothers, and doesn’t protect the largest group of people infected with TB—adolescents and adults.

Creating more effective, safe vaccines against TB is a task that no one country or organisation can do alone. The blueprint, titled ‘Tuberculosis Vaccines: A Strategic Blueprint for the Next Decade’ emphasizes that effective vaccines will remain out of reach unless the world scales up efforts to solve the scientific puzzles now hindering development of vaccines.  Authors call for researchers, scientists, clinicians, advocates in endemic communities, vaccine manufacturers, and governments around the world to work together on creative new approaches from initial research in the laboratory to clinical trials in the field to global introduction.

“The new blueprint represents the best thinking of the field,” said Dr. Jelle Thole, director of the TuBerculosis Vaccine Initiative (TBVI) and co-editor of the blueprint with Dr. Michael J. Brennan, senior advisor for scientific and global affairs at Aeras. “It makes clear that the next 10 years will be vital in moving forward the global search for a dramatically improved vaccine against tuberculosis.”

TB vaccine research over the past decade has made advances that would have been unimaginable a decade ago. Between 2000 and 2010, scientists in the public and private sectors were able to move an unprecedented 15 vaccine candidates into clinical trials in a quest to see which scientific approaches held the most promise. Still there is much work to be done and now, more than ever, there is a need for intensified global collaboration, leadership, partnership and commitment.

“We began 10 years ago with an empty clinical pipeline, and we have made astounding progress,” said Aeras’ Brennan. “But we have to persevere. Given the trends we are seeing globally, failure to develop effective new vaccines for this disease puts everyone at risk.”

About the Blueprint:
Tuberculosis Vaccines: A Strategic Blueprint for the Next Decade was produced under the auspices of the Stop TB Partnership Working Group on New Vaccines (www.stoptb.org) with support from the World Health Organization (www.who.int), Bill & Melinda Gates Foundation (www.gatesfoundation.org), Aeras (www.aeras.org), TuBerculosis Vaccine Initiative (www.tbvi.eu), the EC FP 7 framework programme (ec.europa.eu/research/fp7/) and the US National Institutes of Health, National Institute of Allergy and Infectious Diseases (www.niaid.nih.gov/). The complete blueprint, including relevant opinion editorials, was published in the journal Tuberculosis (Brennan, MJ and Thole, J, Vol. 92, Supplement 1, ppS1-S35, March 2012) and is available at www.tuberculosisjournal.com.