Is it time TB vaccines were improved?

Is it time TB vaccines were improved?
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A new study commissioned by the World Health Organization (WHO) has predicted high health and economic returns from investment in new TB vaccines.

According to the study, if the production of all TB vaccines met WHO’s preferred product characteristics, TB incidence and mortality would be significantly reduced, antimicrobial stewardship and health equity would be improved, and economic growth would be stimulated. TB vaccines for adolescents and adults are projected to have more significant immediate impacts than one for infants.

The study has been featured in the report An investment case for new tuberculosis TB vaccines.

TB vaccines are outdated

TB is one of the world’s most deadly infectious diseases. In 2021, 1.6 million people died from the disease and 10.6 million people became seriously ill. No new TB vaccine has been licensed since Bacille Calmette–Guérin (BCG) was created over 100 years ago, despite being categorised as an urgent global health challenge.

There are currently at least 16 vaccine candidates in clinical development. However, the full development of these candidates and the creation of more new candidates has been challenging due to inadequate funding.

“Investments in safe and effective TB vaccines can protect millions of people from falling ill and dying from TB – a preventable and curable disease, as well as help, combat the antimicrobial resistance crisis”, said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme.

“There are clear economic benefits as well, with the report highlighting that TB vaccines are highly cost-effective in countries with a high TB burden and can be cost-saving. For every US$ 1 invested in the full set of interventions for the adolescent and adult vaccine scenario, we expect US$ 7 in health and economic benefits to be returned to the economy over 25 years,” continued Dr Kasaeva.

The benefits of an improved vaccine

The report presents evidence showing how a more effective vaccine could deliver a higher impact. A TB vaccine for adolescents and adults that provides 50% effective protection against the disease could prevent 37.2-76 million people from falling ill. According to the researchers, this protection would help avoid 4.6–8.5 million deaths between 2025 and 2050.

Comparatively, a vaccine that is 75% effective could stop an estimated 54-110 million people from becoming ill with TB and 6.7–12.3 million TB-related deaths over the same period.

Improved vaccine efficacy would have several economic benefits as well. A 50% effective vaccine could save US$ 36.6–41.5 billion in TB-related household expenditure. This would avert two-thirds of costs incurred by people in the lowest wealth quintile. The improved vaccine could lead to gains in gross domestic product of US$ 1.6 trillion between 2025 and 2080.

The report concludes that urgent and increased investment in the research and development of new vaccines, alongside the rapid introduction and scaling up of use, once available, will deliver maximum public health and economic benefits.


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