Tuberculosis, a highly infectious respiratory disease, continues to haunt humanity as it claims over a million lives annually. Despite efforts to improve diagnosis and treatment, TB remains a global health crisis, particularly in low- and middle-income countries. However, there is hope on the horizon as new breakthroughs in medical research are shedding light on a path forward for tackling this deadly disease. In this article, we will explore the latest advancements in TB treatment and prevention, and how they can help humanity fight back against this preventable tragedy.
Tuberculosis (TB) is a major global health challenge, with 10 million people infected each year and 1.5 to 1.6 million people dying from the disease annually. Developing effective vaccines and treatments to combat TB has proven to be a difficult and costly endeavor, with little financial incentive for pharmaceutical companies due to its classification as a “poor man’s disease”. However, one vaccinologist, Helen McShane, has spent her career developing vaccines for TB, and has recently found a new way to accelerate the testing of potential vaccines: human challenge trials.
Human challenge trials involve purposefully infecting healthy volunteers with a specific pathogen to evaluate the efficacy of a vaccine or treatment. However, due to the potential risks involved with exposing individuals to a potentially deadly infection, conducting such trials has been ethically questionable in the past. McShane’s solution has been to use Bacille Calmette-Guérin (BCG), a vaccine designed to protect infants from TB infection in the brain, to test other potential vaccines in human challenge trials. While BCG protects infants to some extent, it does not offer adequate protection against the lung infection that is most common and contagious.
McShane explains that to create a more effective vaccine, researchers need to “de-risk” vaccine development for pharmaceutical companies, and human challenge trials are one way to do that by providing quick answers. Testing vaccines on vaccinated individuals and then purposefully infecting them with BCG would enable rapid evaluation of vaccine effectiveness, compared with traditional trials that require thousands of people and years of testing.
However, exposing people to the mycobacterium tuberculosis, even when attenuated by BCG, is still an ethically fraught proposition. TB is difficult to treat, often requiring months of antibiotics, and can remain undetected in the body for years. For an ethical challenge trial, it is important to have enough willing volunteers, a safe and ethical way to conduct research and a way to measure the number of infected individuals.
By using BCG, McShane labs can measure the pathogen loads and outcomes of any potential vaccine or trial, without exposing the volunteers to the dangers of TB itself. BCG, which is made with a weakened form of Mycobacterium bovis, a close relative of TB that infects cows, is already safely produced, readily available, and cheap. Therefore, the testing of other vaccines using BCG can be conducted more safely and cheaply, providing pharmaceutical companies with the necessary data to develop a usable vaccine at a lower cost than traditional testing.
A successful human challenge trial that utilizes BCG instead of TB would be a significant breakthrough. Researchers and scientists would be able to create a more effective vaccine with greater ease, potentially saving millions of lives globally. While TB remains a major public health threat, this new approach could help increase the effectiveness of vaccines and treatments, particularly in low- and middle-income countries where the disease burden and death toll is highest.
As we conclude, it is clear that Tuberculosis remains a global health crisis, affecting millions of people around the world every year. But with recent scientific advancements and promising new treatments on the horizon, there is hope that we can finally begin to turn the tide against this deadly disease. By increasing awareness, investing in research, and continuing to work together as a global community, we can take bold steps towards eradicating Tuberculosis once and for all. Let us continue to fight this battle with all the resources at our disposal, to ensure that future generations can live in a world free from the fear of TB.
