Tuberculosis: Why do we need a new vaccine? | capital Cities

For over a hundred years, immunization programs have used the same vaccine, BCG. The authorities call for investment in new technologies

The creation of the BCG vaccine (Bacille Calmette-Guérin) in 1921 remains a major milestone for science. It was responsible for dramatically reducing the incidence of the two deadliest forms of tuberculosis in young children. But since then, research aimed at developing new disease prevention strategies has stagnated in time.

For more than a century, immunization programs around the world have used the same vaccine and international authorities have drawn attention to the fact that BCG does not adequately protect all age groups. Last year, the World Health Organization recorded, for the first time in more than a decade, an increase in deaths from the disease.

“The only vaccine against tuberculosis that has been developed so far, is more than 100 years old and does not provide adequate protection for adolescents and adults, who represent most cases of transmission of the disease,” WHO Director-General Tedros Adhanom Ghebreyesus pointed out at a press conference held in March 24th.

It is estimated that approximately 10 million people become infected with the bacteria each year, especially in low-income countries. In 2021, about 1.6 million patients died after infection. The risk is higher for individuals with weakened immune systems, such as those with diabetes, smokers, people with HIV or those who are malnourished.

Tuberculosis is a bacterial disease that mainly affects the lungs, but it can also affect the bones, kidneys, and meninges — the membranes that surround the brain. For these cases, BCG is not effective.

Isabela Palalay, director of the Brazilian Society of Immunization (SBIM), explains: The aim of BCG is to reduce the risk of miliary tuberculosis and meningitis occurring in childhood, which warrants indication for children less than 5 years of age. However, the disease can also appear in other forms.

“TB is a serious public health problem. Fortunately, we have BCG, but we need a vaccine that can really reduce or eliminate the disease,” says SBIM Director.

Ongoing studies

In a recent interview with ReutersMicrosoft co-founder and philanthropist Bill Gates said a lack of funding could delay testing of an experimental late-stage tuberculosis vaccine. It is estimated that the tests will cost between US$700 million and US$800 million, about R$4 billion.

“Failing to fund these treatments, which are impeding full-speed progress on vaccine trials, is a huge mistake,” Gates said Monday (3/4).

The Bill and Melinda Gates Foundation, one of the largest funders of tuberculosis studies, is supporting the development of the M72/AS01. Originally developed by GSK and the non-profit organization Aeras, the project is being led by the Bill & Melinda Gates Institute for Medical Research.

The businessman said a plan for Phase 3 immunization testing will be announced later this year, but asked governments and other philanthropists to be ready to help fund the tests. “While we are a great financier, we also need partners,” Gates said.

investment

The World Health Organization has proposed the creation of a “TB Vaccine Acceleration Board” to facilitate the development, licensing and use of new TB vaccines.

In September, world leaders will gather in New York, United States, for the United Nations General Assembly’s second high-level meeting on tuberculosis. The WHO leader hopes the meeting will be a turning point in the fight against the disease, as the authorities make real and lasting investment commitments.

“Eliminating TB is not the job of WHO, governments or health systems alone. It will require greater action and accountability from all governments, agencies, donors, researchers, the private sector and civil society,” Ghebreyesus said.

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