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Kenya is expected to hugely benefit from a new global push to end tuberculosis by 2030.
Last week, world leaders at the United Nations General Assembly’s High-Level Meeting on Tuberculosis approved new targets for the next five years toward ending the TB epidemic.
The targets include licensing of at least one TB vaccine. This is likely to be the M72, which was partly tested by the Kenya Medical Research and found to be 50 per cent effective in adults.
The other targets include reaching 90 per cent of people with TB prevention and care services, using a WHO-recommended rapid test as the first method of diagnosing TB; providing social benefit packages to all people with TB; and closing funding gaps for TB implementation and research by 2027.
“For millennia, our ancestors have suffered and died with tuberculosis, without knowing what it was, what caused it, or how to stop it,” said Dr Tedros Adhanom Ghebreyesus, head of the World Health Organization.
“Today, we have knowledge and tools they could only have dreamed of. The political declaration countries approved today, and the targets they have set, are a commitment to use those tools, and develop new ones, to write the final chapter in the story of TB.”
BCG is currently the only licensed TB vaccine. While it provides moderate efficacy in preventing severe forms of TB in infants and young children, it does not adequately protect adolescents and adults, who account for the majority ( more than 90 per cent) of TB transmission globally.
The KEMRI is one of the centres testing the M72 adult TB vaccine Phase 3.
The vaccine is funded by the Bill and Melinda Gates Medical Research Institute (Gates MRI) and Wellcome Trust.
The M72 vaccine showed a 50 per cent efficacy in preventing pulmonary TB disease in a phase 2b trial.
The Gates Foundation recently noted that over 25 years, a vaccine with at least 50 per cent efficacy could prevent up to 76 million new TB cases and 8.5 million deaths. It will also avert the need for 42 million courses of antibiotic treatment, and prevent US$41.5 billion in TB-related catastrophic household costs, especially for the world’s poorest and most vulnerable people, according to the WHO.
“With TB cases and deaths on the rise, the need for new tools has never been more urgent,” said Bill Gates, co-chair of the Bill & Melinda Gates Foundation. “Greater investment in safe and effective TB vaccines alongside a suite of new diagnostics and treatments could transform TB care for millions of people, saving lives and lowering the burden of this devastating and costly disease.”
WHO Chief Scientist Jeremy Farrar recently told Devex he was hopeful of the M72.
“M72 is the most advanced, but no, it’s much broader than that. … I think the pipeline is stronger than it’s ever been in my professional career. But also whatever the results of the M72 vaccine, which we won’t know for three, four, five, whatever years, you will also learn a huge amount about TB, and that will inform the development of second generation vaccines,” he said.
The M72 vaccine candidate, is the most advanced of 17 TB vaccine candidates currently in the pipeline.
Kenya is among 30 high TB burden countries in the world. The Ministry of Health says about 139,000 people a year develop TB (35,000 of them being HIV-positive) and 21,600 people die from it.
By 2020, TB was the fourth largest cause of death in Kenya.
The new targets hope to change all that.
Taking stock of progress towards targets set in 2018 for a five-year period, WHO reported that while global efforts to combat TB have saved over 75 million lives since the year 2000, they fell short of reaching the targets, mainly due to severe disruptions to TB services caused by the Covid-19 pandemic and ongoing conflicts.
Only 34 million people of the intended 40 million people with TB were reached with treatment between 2018 and 2022. For TB preventive treatment, the situation was even more grim, with only 15.5 million of the 30 million people targeted to be reached with preventive treatment accessing it.
Funding for TB services in low- and middle-income countries fell from US $6.4 billion in 2018 to US $5.8 billion in 2022, representing a 50 per cent financing gap in implementing the required TB programmes, WHO said.
Annual funding for TB research ranged from US $0.9 billion to US $1.0 billion between 2018 and 2022, which is just half of the target set in 2018.
This has placed an even heavier burden on those affected, especially the most vulnerable. Today, TB remains one of the world’s top infectious killers: annually, more than 10 million people fall sick, and over 1 million lose their lives to this preventable and curable disease. Drug-resistant TB continues to be a major contributor to antimicrobial resistance with close to half a million people developing drug-resistant TB every year.
“Uniting around the TB response by world leaders, for a second time, provides an opportunity to accelerate action and strengthen health systems capable of not only addressing the TB epidemic, but also protecting the broader health and well‑being of communities, strengthening pandemic preparedness and building on lessons learnt during the COVID-19 pandemic,” said Dr Tereza Kasaeva, Director of the WHO Global TB Programme.
“Averting TB-related financial hardship and preventing the development of the disease in vulnerable groups will help diminish inequities within and between countries, contributing to the achievement of the Sustainable Development Goals.”
TB incidence and deaths have risen between 2020 and 2021 but coordinated efforts by countries, WHO and partners are resulting in a recovery of essential services.
In the lead-up to this historic meeting, Ghebreyesus, officially launched the TB vaccine accelerator council to facilitate the development, licensing and use of new TB vaccines.
The Council, supported by the WHO secretariat, will be led by a ministerial board, consisting of nine members who will serve on a rotating basis, for a term of two years.