Breakthroughs Blog: Tuberculosis

In 2023, tuberculosis (TB) retook the spot as the world’s leading infectious disease killer from COVID-19, claiming the lives of around 1.25 million people that year. Insufficient and inadequate tools and treatments and growing drug resistance have challenged global efforts to bring the TB epidemic to an end. In 2023, approximately 8.2 million people were newly diagnosed with TB, the highest number recorded since the World Health Organization (WHO) began global TB monitoring in 1995. At the same time, global funding for TB diagnostic, treatment, and prevention services fell in 2023 and globally, TB research remains greatly underfunded, with only 24 percent of the $5 billion annual target reached in 2023. Scientists hope that the tide can be turned as new technologies and innovations advance to market—but to achieve that, more investment is urgently needed to boost resources and reverse setbacks. In recognition of World TB Day, test your knowledge of innovations to end TB with GHTC’s quiz: 

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. A team of Brazilian researchers has developed a simple test that can detect exposure to any of the four strains of dengue virus, as well as the Zika virus, as dengue cases continue to rise to a concerning degree in the region. The test was first validated with blood samples from mice experimentally infected with the viruses and then with hundreds of blood samples donated by people during the 2015-2017 Brazilian Zika epidemic. It uses technology that can be easily adapted for use in automated systems and rapid point-of-care tests and could serve as a key tool in the case of a Zika outbreak, allowing health care providers to test the immunity of at-risk groups while accounting for the possibility of cross-reactivity with antibodies produced after infection by dengue.Last week, IAVI and Biofabri announced that the first doses of tuberculosis (TB) vaccine candidate MTBVAC have been administered in a critical large-scale Phase 2b trial testing the safety and efficacy of MTBVAC to prevent active TB lung disease in adolescents and adults. While there is a vaccine for TB, it is more than 100 years old and has limited efficacy in preventing pulmonary TB, the most common form in adults. A new vaccine could be a game changer in the global fight against this leading infectious disease. MTBVAC is also a single-shot vaccine, making it easier to administer in low-resource and remote settings, and the partners developing it are committed to ensuring that, if proven successful in further trials, there will be a sufficient, affordable supply in the places where it is most needed.The Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X) last week announced a $2 million award to Immunethep to develop a vaccine against invasive strains of Escherichia coli. The funding will support work on a conjugate peptide-based vaccine candidate designed to induce immunity to E coli, which can cause serious, life-threatening infections that are becoming harder to treat with the rising prevalence of antimicrobial resistance. There are currently no vaccines for E coli. The candidate has demonstrated efficacy against E coli, as well as four other priority bacterial pathogens in animal models, and, if it continues to prove successful, could be a key tool for preventing serious bacterial infections in vulnerable populations.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. A prospective cohort study of patients with drug-resistant tuberculosis (TB) found that the six-month, all-oral BPaL (bedaquiline, pretomanid, and linezolid)-based regimens recommended by the World Health Organization were safe and highly effective, providing critical data from real-world settings with a high burden of drug-resistant TB to support global guidelines recommending their use. The results were comparable to previous Phase 3 clinical trials testing the regimens. Further research is needed to test the regimens among other key populations, including children and people with severe forms of extrapulmonary TB.A recently published analysis found that the 2023 global supply of seasonal influenza vaccines has been stable since 2019, suggesting that production capacity was sustained through the COVID-19 pandemic. Monitoring seasonal vaccine production capacity is important for estimating the capacity to manufacture vaccines in the case of an outbreak of pandemic influenza because pandemic influenza vaccines are produced primarily by the same or similar manufacturers, technology, and facilities as seasonal flu vaccines. The analysis found drastic disparities in production capacity between high-income and low- and middle-income countries and found that the majority of pandemic vaccines, in the case of a novel flu pandemic in the near future, would be egg-based. The author noted that advancing novel influenza vaccines, including mRNA vaccines, could greatly improve global production capacity and pandemic preparedness in the face of pandemic influenza, given they would be faster to produce than egg-based vaccines.A team of researchers has engineered an improved paper-based device for collecting and transporting blood samples of HIV patients. In low-resource settings with limited clinical and laboratory facilities, paper-based devices have become one way that HIV patients can collect their blood to be shipped and analyzed in distant laboratories. The new device has wax-printed patterns that create precise channels and collection spots, ensuring that it consistently collects the same volume of blood and thereby reducing the chances of inaccurate readings. A clinical pilot found that the device more accurately measured the extent of HIV infection compared to the industry gold standard and was also better at detecting drug-resistant viral mutations, enabling physicians to make better care decisions.

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. A new study explores the novel use of artificial intelligence (AI) to screen for antimicrobial compound candidates that could be developed into new tuberculosis (TB) drug treatments, as the rise of drug-resistant strains of TB underscores the urgent need for new drug candidates. While discovering new TB drug candidates through traditional laboratory methods is laborious and time-consuming, sensitive machine learning is better and faster at helping interpret complicated images of the Mycobacterium tuberculosis bacterium, accelerating TB research capabilities and helping identify optimal candidate compounds for drug development.A COVID-19 nasal vaccine will enter a Phase 1 clinical trial conducted by the National Institute of Allergy and Infectious Diseases in the United States this spring. While COVID-19 cases have fallen dramatically since the height of the pandemic, the virus continues to circulate and cause severe illness and death. The nasal vaccine is designed to induce strong immunity in the nose and upper respiratory tract where the virus enters the body, aiming to not only reduce serious illness and death but also to stop transmission in the first place, which cannot be achieved through COVID-19 vaccines that are injected into the body. If proven successful, the technology could also be adopted for other common respiratory viruses, including seasonal influenza, avian flu, and respiratory syncytial virus.Uganda recently launched a trial of IAVI’s experimental vaccine targeting the Sudan virus, which causes Ebola disease, following the identification of an outbreak in the country that has, so far, killed one person and infected two others. There are no currently approved vaccines for Sudan virus, although there is a vaccine for the Zaire strain of Ebola, highlighting the urgent need to generate data about vaccine candidates in the pipeline when outbreaks arise. Ugandan health authorities and research teams have rapidly jumped into action to prepare for the trial—2,160 doses of the trial vaccine and treatments arrived in Uganda’s capital, Kampala, over the weekend.