Hemera Technologies via Getty images.
We Need To Inject Some Funding Into Tuberculosis Research.
This week Australia, along with the rest of the world, marks World Immunisation Week. As a father of four young daughters, I am grateful to have access to effective vaccines to protect them from serious diseases. However, some vaccines work better than others.
One of the most common vaccines that has significant limitations is the Bacille Calmette-Guérin (BCG) vaccine for tuberculosis (TB). It has been used for almost 100 years and while it partially protects young children from severe forms of childhood TB, it isn’t effective at protecting children and adults against the most common form of the disease, which is TB of the lungs.
The limitations of the BCG vaccine show why new tools are needed against an ancient disease such as TB. The lack of modern drugs, faster diagnostics, and a new vaccine that is more broadly effective are three reasons why the TB epidemic continues to take so many lives around the world — even more than HIV/AIDS.
In 2014, TB caused 9.6 million new illnesses and 1.5 million deaths, according to the World Health Organisation (WHO). This makes TB the single deadliest infectious agent in the world, causing tremendous suffering to individuals and families.
In most cases, TB is curable — if the disease is appropriately diagnosed and treated. But that doesn’t always happen. Treatment regimens can be difficult for patients, taking six months or more and sometimes causing debilitating side effects. In addition, the emergence of drug resistant strains of TB means even longer treatment times, much higher costs to treat, and even more troubling side effects.
Multidrug-resistant (MDR) TB, which is resistant to at least the two most powerful, first-line medications, and extensively drug resistant (XDR) TB, which is resistant to nearly all TB medications, represent an emerging threat around the world.
TB is not a distant threat to Australia. The WHO’s Western Pacific Region had 52,000 cases of MDR-TB in 2014. Our neighbours in Papua New Guinea are facing one of the highest TB rates in the world, with more than 30,000 new cases in 2014. They have also been newly added to WHO’s list of high-burden MDR-TB countries. Here in Australia, one hospital in Western Sydney has recorded some of the highest levels of TB in recent years, indicating an increase of TB acquired right here at home.
That is why the world must increase investment in research and development for the improved treatments, diagnostics, and vaccines required to get the job done.
The critical role of vaccines in eliminating infectious disease must not be ignored. We have eradicated small pox from the world, and yellow fever and polio are almost gone. Vaccines played a crucial role in eliminating these deadly epidemics. The right vaccine could do the same for TB.
Our current BCG vaccine only partially protects infants and young children from severe TB and it doesn’t adequately protect teens and adults, who are most at risk for developing and spreading TB. Teens and adults are driving the epidemic and we desperately need a vaccine that works for them.
Vaccines take time and financial support to develop — requiring a long-term commitment, a long-term investment, and a long-term vision. The short-term efforts to increase diagnosis rates and access to treatment are important and will undoubtedly save lives, but will not be enough to end the epidemic.
But while the WHO and many public health experts recognise the need for new and more effective tools to fight TB, research and development for the new tools we need remains woefully underfunded.
According to Policy Cures, an Australia-based NGO that provides information about funding levels for research and development for diseases of the developing world, only 20 percent of the limited funds for TB R&D are devoted to vaccine development. That is simply not enough.
Australia has a proud record in vaccine development. The rotavirus vaccine for children was the culmination of over four decades of research in Australia, following the discovery of rotavirus by a team led by Professor Ruth Bishop in 1973 in Melbourne. Similarly, Professor Ian Frazer and his team at the University of Queensland discovered how to make the basis of the human papilloma virus (HPV) vaccine.
Australian and international researchers now need more funds to address TB in the same way.
The funding needed to research and develop a TB vaccine is a small fraction compared to the financial burden caused by TB. The WHO calculates that the TB epidemic costs the world US$8 billion per year. Compare that to the small fraction of that the Stop TB Partnership estimates is needed for developing a new TB vaccine.
Someone dies every 21 seconds from TB. We must invest in the new tools we need to end this deadly epidemic that continues to cause so much suffering around the world.