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Welcome to the Working Group on new TB Vaccines
On the occasion of the UNION World Conference, the 2009 update of the TB Vaccine Pipeline has now been made available
Approximately a third of the world's population is infected with Mycobacterium tuberculosis out of which roughly eight million come down with active TB every year, mainly in low-income countries. In Africa in particular a huge proportion of TB "carriers" are co-infected with HIV, which dramatically increases the likelihood of degenerating from latent into active TB. The current BCG vaccine prevents serious complications of disseminated TB in children, but is not very effective at preventing pulmonary TB, the most common and most infectious form of the disease. Efficient drug therapy exists, but the treatment is long and case detection rates are low, making the development of a better vaccine an important goal.
In 2009, at least six different TB vaccine candidates both live and subunit vaccines, have completed initial phase I clinical trials, three are currently in phase II trials. Most of the new vaccines will at least initially be given as booster doses on top of a priming BCG vaccination. A virus vectored booster vaccine candidate has recently entered an early efficacy ("phase IIb) trial and we should soon know if this vaccine provides an advantage over BCG. In an optimistic scenario, i.e. assuming that at least one of the first generation candidates successfully completes phase III (efficacy) evaluation, licensure of a new TB vaccines is anticipated around 2014-15. Until that time, extensive resources are needed to conduct reliable clinical trials in developing country settings. As with other vaccines targeting diseases of poverty, particular efforts in the areas of financing, production capacity logistics, etc, must be made to ensure that once a new TB vaccine is available it can be implemented rapidly and up to high coverage rates.
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