In the first year of the COVID-19 pandemic, an infectious disease of epidemic proportions killed 1.5 million people across the world — but it wasn’t COVID. It was tuberculosis, a bacterial disease that claims more than a million lives annually despite the fact that an (only partially effective) TB vaccine has existed for nearly a century.
This past Sunday, March 24, was World TB Day, which every year commemorates the anniversary of when scientist Robert Koch announced that he had discovered the Mycobacterium tuberculosis bacteria that causes TB in 1882. Late March is therefore an ideal time to take stock of what progress has been made in fighting TB, which, until COVID-19, was the world’s deadliest infectious disease. This post includes an overview of that progress as well as resources and story ideas for reporting on TB.
TB vaccine development
The bacille Calmette-Guerin (BCG) vaccine against TB has been around since 1927, but it does not prevent primary infection. It protects infants and children against meningitis and disseminated TB, the spread of the bacterial infection throughout the rest of the body outside the lungs. (It’s not universally recommended in the U.S. since disseminated TB does not pose as big a threat in the U.S. as elsewhere in the world.)
The lack of a TB vaccine offering broader protection leaves teens and adults vulnerable to the lung infection that kills over a million people every year. In recent years, however, several candidates have reached late stage trials that hint at the possibility of a more effective vaccine soon.
Nearly $600 million was pledged to TB vaccine research in 2023 — about our times the amount spent on TB vaccines in the previous year — according to the 2023 Pipeline Report of the nonprofit Treatment Action Group (TAG). The lion’s share of that money is the $550 million that the Bill & Melinda Gates Foundation and the Wellcome Trust are putting toward launching a phase 3 trial of the investigational TB candidate M72/AS01E.
Several days before World TB Day this year, the Bill & Melinda Gates Medical Research Institute announced it had initiated the trial, which will include up to 20,000 participants at sites in seven African and Asian countries: South Africa, Zambia, Malawi, Mozambique, Kenya, Indonesia and Vietnam. In its phase 2b trial, the M72/AS01E vaccine was 50% effective at preventing adults infected with TB from advancing to active pulmonary tuberculosis over three years. While that does not sound impressive compared to the effectiveness seen from most approved vaccines, the WHO estimates that level of effectiveness could save 8.5 million lives and prevent 76 million new TB cases.
Meanwhile, other TB vaccines are making their way through the pipeline as well. According to TAG’s pipeline report, four other investigational vaccines are in or headed for phase 3 trials, including VPM1002 and MTBVAC.
Story ideas and resources
Reporters in the U.S. have historically overlooked reporting on TB because it affects far fewer Americans than others in the world. But any disease that infects an estimated 1.8 billion people — that’s more than one in five people on Earth — deserves attention, as this Johns Hopkins article argues. Consider the following topic areas for a place to start in exploring story ideas about TB:
- In late 2023, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) launched a large-scale effort to detect TB and prevent TB deaths in people living with HIV. How is that effort going?
- Check out the CDC’s personal stories of people with TB for ideas.
- One of the biggest threats to progress against TB is multidrug-resistant TB, but several new drugs and drug combinations are in development, including those discussed at the recent Conference on Retroviruses and Opportunistic Infections.
- TB is particularly a threat to people living with HIV, which already predominantly affects marginalized populations. What progress is being made to reduce this threat, specifically in those populations?
- The Treatment Action Group publishes an annual pipeline report on TB vaccines and another on TB therapeutics every year. The 2023 reports are here (vaccines) and here (treatments). These are short enough to skim.
- Contact any of the myriad TB organizations listed below and ask what stories the media isn’t telling and should be.
TB organizations and resources
- CDC annual resources for World TB Day.
- CDC’s Global TB Overview.
- National Tuberculosis Coalition of America.
- Stop TB USA.
- We Are TB, a survivors and advocates support organization.
- TB Elimination Alliance.
- Information on past World TB Days from Stop TB Partnership.
- Articles on TB at The Conversation.
- The Kaiser Family Foundation’s January 2024 report on the U.S. Government and Global Tuberculosis Efforts.
