New TB vaccines could save seven million lives by 2050

• New tuberculosis (TB) vaccines, which are expected to become available from 2029, could help save up to an estimated 7.3 million lives between 2030 and 2050, according to a new study published by Gavi, the Vaccine Alliance.

• It could unlock up to $135 billion in economic benefits across low and middle-income countries, according to new analysis on their potential impact. 

• According to the study, demand for the vaccines among low-income countries and middle-income countries could reach, on average, 86 million vaccination courses per year, with greater demand in the early years as high-burden countries seek to expand protection across multiple age groups in high-risk areas.

• Novel TB vaccines could be the next blockbuster immunisation tool. However they will only realise their potential if we are able to ensure sufficient, predictable and affordable supply for those countries with the highest disease burden.

What is Gavi?

• Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate more than half the world’s children against some of the world’s deadliest diseases. 

• The vaccine alliance brings together developing country and donor governments, the World Health Organisation, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Gates Foundation and other private sector partners. 

• Since its inception in 2000, Gavi has helped to immunise over 1.2 billion children. 

Roadmap to a powerful new tool

• Tuberculosis is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. It can spread when people who are sick with TB expel bacteria into the air – for example, by coughing.

• The year 2024 saw 10.7 million tuberculosis cases and 1.2 million tuberculosis deaths globally. The burden falls overwhelmingly on low and middle-income countries, with Gavi-supported countries accounting for an estimated 77 per cent of all deaths. 

• The one vaccine currently licensed, the Bacille Calmette-Guérin (BCG) vaccine, is over 100 years old, and while it is effective in protecting infants and young children against severe forms of the disease, its protection wanes, highlighting the need for new tools to prevent manifestation of the disease among adolescents and adults.

• New vaccines aim to fill that gap. 

• Designed to prevent infectious pulmonary TB disease among adolescents and adults, they would be a major addition in the fight against TB.

• Combined with other prevention measures, they could accelerate progress against one of the world's deadliest diseases.

• However, there is a series of risks that could hold back rapid rollout once licensure is secured. 

These include:

i) Policy risks, including the possibility that recommendations could be limited to the highest-risk groups because of gaps in evidence.

ii) Risks that could limit uptake by countries, such as inadequate global and domestic financing. 

iii) Supply risks, driven, for example, by this demand uncertainty holding back manufacturer capacity investments for late-stage candidates.

How to overcome these risks?

Gavi highlights three well-defined objectives that, drawing on its market-shaping and innovative financing expertise, it will pursue to help ensure new vaccines reach low-income and middle-income countries that need them the most, as fast and equitably as possible.

1) Ensure sufficient, timely, affordable and sustainable supply of novel TB vaccines to meet demand. 

2) Support widespread uptake that maximises health impact through routine immunisation and targeted catch-up campaigns. 

3) Encourage a competitive and geographically diverse pipeline of novel TB vaccine candidates, ensuring products meet country preferences.