Fourth Global Forum on TB Vaccines
Nearly 300 experts in tuberculosis (TB) and TB vaccine development from 32 countries around the world gathered in Shanghai in April for the Fourth Global Forum on TB Vaccines to discuss the latest efforts and advances in TB vaccine development. The Forum, which was held April 21-24, is convened approximately every other year by the Stop TB Partnership’s Working Group on New Vaccines.
In her keynote address, Glenda Gray, President of the South African Medical Research Council, stressed the need for South Africa and other countries with high levels of TB to better address the R&D needs for TB vaccines. “We need to create a sustainable R&D structure in Africa,” said Gray. “We need to make sure that governments are spending adequately so we can address these issues. Currently less than 10 percent of the funding for R&D comes from local money. And the current efforts aimed at treating African diseases depend on organizations outside of Africa. This cannot continue.”
The Opening Session also included several presentations from TB experts in China who spoke about the country’s TB burden and its commitment to improving diagnosis and treatment, as well as research and development for new tools, including vaccines. Speakers included representatives from the World Health Organization, the Chinese Center for Disease Control and Prevention, the Chinese Anti-Tuberculosis Association and the Bill and Melinda Gates Foundation China Office, and the China Office of the U.S. National Institute of Allergy and Infectious Diseases.
The Forum provided updates on the latest efforts in TB vaccine development, including progress of clinical candidates, research related to epidemiology, biomarkers and correlates, and new approaches to animal models. Researchers also discussed strategies to diversify the global pipeline of TB vaccines under development, as well as the importance of international collaboration in both research and advocacy.
A key area of discussion focused on seeking to better understand the complex means by which M. tuberculosis, the bacteria that cause TB, evade the immune system, and on research to develop novel vaccine candidates that can trigger unique immune responses that the bacteria have not evolved the capacity to avoid. Several strategies to achieve this were discussed at the Forum, including the potential for using a novel cytomegalovirus (CMV) vector to deliver M.tuberculosis antigens in a way that could stimulate an active immune response close to the site of initial infection in the lung, rather than in lymph nodes.
Researchers from the London School of Hygiene & Tropical Medicine presented preliminary findings from epidemiological modelling indicating that the elderly are likely to become major contributors to new TB cases in China, suggesting the importance of including this demographic in planning for vaccine development and dissemination in this country. Preliminary results predict that the elderly (those aged 65 years and above) contribution to TB transmission in China may increase from 18 percent to 53 percent, and their burden of new TB disease may increase from 13 percent to 71 percent of all cases between 1990 and 2050. According to the researchers, this increase is a result of China’s success in bringing down TB transmission since 1990, in combination with the increasing size of the elderly population who were likely infected with the bacterium that causes TB in the years before 1990 when transmission in China was still very high.Several presentations from the Forum will be available at the Forum’s website in the coming days. A report on outcomes from the Forum is planned for publication later this year.
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