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Totally Drug Resistant TB: The Role of New TB Vaccines. Videlis Nduba, MD, MPH Grace Kiringa, MD, MSc KEMRI/CDC Kisumu 8 th World Conference of Science Journalists Helsinki, Finland. Tuberculosis: A Global Epidemic. Estimated number of new cases, 2010.

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Totally drug resistant tb the role of new tb vaccines

Totally Drug Resistant TB: The Role of New TB Vaccines

Videlis Nduba, MD, MPH

Grace Kiringa, MD, MSc

KEMRI/CDC Kisumu

8th World Conference of Science Journalists

Helsinki, Finland


Tuberculosis a global epidemic
Tuberculosis: A Global Epidemic

Estimated number of new cases, 2010

  • Over 2 billion people or 1/3 of the world’s population is infected with TB

  • Nearly 2 million deaths per year

  • MDR/XDR-TB reported in more than 70 countries, cases rising

  • Emergence of TDR- TB

  • Cost of treating MDR can be as much as 200 times more expensive than drug sensitive TB

2


The need for new tb vaccines
The Need for New TB Vaccines

  • BCG developed 90 years ago, not improved upon since

    +Does reduce risk of severe pediatric TB disease

    -Wide use, but failure to reverse the growing global TB epidemic

    -Not known to protect against latent TB becoming active disease(DS, MDR, XDR or TDR)

    - Not recommended for use in infants infected with HIV

  • Studies show that a new TB vaccine – along with other new tools – is needed to meet global goals to eliminate TB


Potential Uses of a TB Vaccine

Block Initial Infection

Prevent Latent

Infection

Prevent Early Disease

Prevent Reactivation

Disease


The potential benefits of new tb vaccines
The Potential Benefits of New TB Vaccines

  • Safer and more effective including in people with HIV

  • Protect against drug resistant strains (MDR , XDR and TDR)

  • Economic benefits

    • cost savings to the health system

    • improves economic productivity

    • Interrupt the intergenerational poverty promoting cycle of disease

  • Essential to global elimination efforts

5


A vaccine that prevents adolescents and adults from developing infectious TB would be the single greatest advance in the fight against the disease

Active Disease

Covered by existing vaccine

Latent

No coverage or impact from existing vaccine

Pre-infection

Infants

Adolescents

Adults

HIV+ All Ages

  • Target vast, unmet need for new, more effective TB prevention in multiple populations

  • Potential replacement and/or boost for widely used BCG:

    • 180 countries recommend BCG

    • 100M+ doses per year

6


Predicted Impact of 50% Effective developing infectious TB would be the single greatest advance in the fight against the disease New TB vaccine

D. Young, C. Dye, Cell, Vol 124, Issue 4 (2006)


Tb vaccine access and availability
TB Vaccine - Access and Availability developing infectious TB would be the single greatest advance in the fight against the disease

  • Future access considered at every stage of vaccine development

  • Manufacturing

    • Guarantee by partners for sufficient production and affordable prices, or technology transfer

    • Manufactured by Aeras with partners in developing world

    • Aeras will not consider vaccine candidates that will be costly to manufacture on a large scale

  • Pricing

    • Dual pricing for affordable distribution in resource-poor countries

    • Aeras provides at cost

  • Distribution

    • Developing world governments

    • International organizations (GAVI, UNICEF)

    • Developing world partners


Questions for discussion
Questions for Discussion developing infectious TB would be the single greatest advance in the fight against the disease

  • What are the impediments to development of a more effective TB vaccine to curb the epidemic

  • What are the prospects like for a new TB vaccine in the next 5 years?

  • How are developing countries engaged in the fight against TB


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