Collaboration and funding are some of the major requirements
for delivering new, more effective and safer vaccines against tuberculosis (TB). This was a much-heard statement during the annual research meeting of the TuBerculosis Vaccine Initiative (TBVI).
'Challenging' would be an understatement when it comes to
describing the WHO's latest plan for eliminating tuberculosis. Challenging. But
certainly not impossible. In fact, TBVI's research partners, many of whom came
together in Switzerland
in early February 2011, are carefully optimistic about the past year's advances
in vaccine research.
Dr Christian Lienhardt, who heads the Research Movement of
the Stop TB Partnership painted a clear picture. Tuberculosis research lacks
money on every level. Lienhardt happily noted that funding specifically for TB
vaccine research has increased in the past two years but much more support is
needed. In that light, it is a great breakthrough that the European Parliament
accepted a resolution to support the research and development of tuberculosis
vaccines. An overwhelming majority of the parliament recently voted
tuberculosis vaccine research onto the agenda of the European Commission,
calling upon the commission to explore new funding channels.
Successfully developing a new vaccine seems closer than ever
before. A broad collection of candidate vaccines is currently being researched
and several of those have now reached various stages of clinical trials. This
collection of candidates is called the vaccine pipeline and researchers present
at the research gathering in Switzerland
were very positive about its content. Lienhardt referred to the pipeline as
'robust' and challenged researchers and other partners to maintain it.
New vaccines are crucial in the fight against tuberculosis.
Research shows that the introduction of a new vaccine could reduce the number
of new TB cases by ninety percent within thirty to forty years. This makes the
development of vaccines an essential part of the Stop TB strategy. Hard work
over the past decade is starting to pay off with some promising results but the
process of developing, testing and licensing new vaccines is a complicated and
lengthy one. In order to battle tuberculosis, several different vaccines will
be needed; so-called 'priming' vaccines that can be given to newborns and
'boosting' vaccines to be used for infants, adolescents and adults. Vaccines
should not only prevent people from initial infection, they also have to
prevent people with a latent infection from developing active tuberculosis. In
addition to this, vaccines have to be safe for HIV-infected people.
The process of bringing a candidate vaccine from initial
discovery to licensed vaccine involves different phases of testing and trying.
Many candidates will not survive this process and trials are expensive enough
to only allow the very best candidates to enter. Therefore dozens of candidate
vaccines are needed. Currently, TBVI supports a portfolio of 39 candidates that
are in different phases of development and testing. The organization is hopeful
that two of those candidates could make it to the market by 2020 and another
two around 2025. Worldwide, there are about ten candidates in various stages of
clinical trials and about 50 more in development.
Funding is key in this process, however the TBVI research
gathering brought up another major requirement for success; collaboration.
Group efforts and partnerships are valued important by researchers. WHO's Uli
Fruth is nothing less then excited about what is happening at this front:
"During this meeting, I was delighted to see a plethora of collaborations
that the consortium has stimulated amongst the partners, which in the absence
of the TBVI structure would probably not have happened."
The goal of eliminating TB by 2050 is particularly ambitious
but the introduction of new vaccines would certainly be a great step forward.
Looking at current research progress and the candidate vaccines available, this
should be possible. For this to happen though, ongoing attention, a considerable
amount of funding and collaboration of research are fundamental.