The urgent need for a new tuberculosis (TB) vaccine is evident due to the high mortality rate caused by this infectious disease. Despite scientific advancements, the global response to TB has been insufficient, and the United Nations target to reduce TB deaths by 75% between 2015 and 2025 is now considered unattainable.
Currently, the Bacillus Calmette-Guérin (BCG) vaccine is the only available vaccine against TB, but it is not effective for the millions of adults and adolescents who contract the disease each year. However, there is hope with three promising vaccine candidates in Phase III trials: MTBVAC, M72/AS01E, and VPM1002. The success of these trials could be a turning point in the fight against TB, but it requires adequate funding and political will.
The potential rollout of new TB vaccines presents challenges in terms of equitable access and manufacturing capacity. Understanding the demand for TB vaccines is crucial to establish sufficient manufacturing capabilities to meet the needs of high-burden countries. This will require significant investment and time, as seen during the COVID-19 pandemic, which highlighted both rapid vaccine development and global vaccine distribution inequities.
To address these challenges, the World Health Organization (WHO) has established the TB Vaccine Accelerator Council. This initiative aims to ensure effective distribution of new TB vaccines, with a focus on equity in access. Gavi, the Vaccine Alliance, also recognizes the importance of TB vaccines and includes them in its Vaccine Investment Strategy to support availability in eligible countries.
While Gavi's support is a step forward, additional strategies are needed for middle-income countries (MICs) facing high TB burdens but not eligible for Gavi assistance. These strategies should focus on investing in vaccine delivery platforms and creating mechanisms for regional pooling of purchasing power to negotiate better prices. Policy solutions, such as sovereign debt forgiveness and relief, can enable MICs to invest more in health systems and vaccine delivery.
The fight against TB is not just a public health issue but also crucial for economic stability and social equity. The lessons learned from the COVID-19 pandemic must be applied to the TB response. The urgency for a new TB vaccine is clear, and with the right investments and commitment to equitable access, it is possible to save millions of lives and turn the tide against this long-standing pandemic.