"Governments don't support TB research and development enough. We have to empower communities with more knowledge on TB issues to move governments to do something," Lucy Ghati, Community Representative to the Stop TB Partnership's Working Group on New TB Vaccines and Program Officer of the National Empowerment Network of People Living with HIV and AIDS in Kenya remarked at a press briefing on the state of TB vaccine development. "Without being pushed governments won't do anything," she added. "But we need new commodities to address TB and HIV: new diagnostics, better drugs and – if we want to have a long term solution – new vaccines."
The current diagnostics, drugs and vaccine against TB are outdated and not efficient enough. Peg Willingham, Senior Director External Affairs at the Aeras Global TB Vaccine Foundation, presented the example of TB vaccines in a separate media meeting held to brief journalists on key issues on the conference agenda. BCG, the only currently available vaccine against TB, is partly effective against severe forms of childhood TB but fails to prevent the most prevalent form, pulmonary tuberculosis in adults. Researchers around the world are working to develop new, more effective and safe vaccines, which will be affordable and available worldwide.
"It is important that the community is involved in the research. Therefore, our clinical trial research partners in the countries where we test new vaccines do a lot of community outreach," Willingham explains in an interview with CNS, citing different ways to engage and inform people such as through radio programs, outreach to schools, and comic books.
It is also essential to consider the perspectives of the decision makers at national levels who will play the leadership role in rolling out future new vaccines. "We want to make sure that what we are doing is what countries want," Willingham said. Aeras works to involve communities at all levels of society, as demonstrated by a recent market study done among national-level decision makers in high TB burden countries. The study, still in preliminary form, showed that TB is considered a significant health problem that does not get the attention it deserves.
"It would be a kind of a virtuous circle if people from the community said new vaccines are something they want," said Willingham, explaining that community engagement helps build demand for vaccine research and development, and it fosters clinical trial recruitment. Local involvement and demand is essential to building government support for research.
An added challenge to building demand for vaccines is that prevention is often overlooked. As Willingham explained, vaccines administered in childhood that have worked in preventing illness are quickly forgotten. The cause and effect relationship of vaccines and the disease they prevent are not immediate, as with medication that quickly provides relief.
Stigma surrounding people with TB and the lack of advocates willing to add their voices to public calls for new TB vaccines also contributes to the lack of awareness about the inadequacies of BCG and the need to improve or replace it.
"People are always surprised to hear still two million people die of TB every year," Willingham says. "More people need tell to their personal stories and provide the face of people with TB. We have to figure out a way to reduce that stigma, figure out how to get people to feel safe and brave to speak up because otherwise people will keep dying quietly, behind closed doors, and it will never get any better."
Joris Vandeputte, Senior vice president advocacy and resource mobilization at TuBerculosis Vaccine Initiative (TBVI) reaffirmed the need to deal with stigma at the TB vaccines press briefing. "Stigma has consequences for advocacy efforts and resource mobilization for TB as well," he said, at the same time acknowledging the achievements made with the (limited) funding available. "There are currently 12 vaccine candidates ready to be translated into vaccines that are globally accessible as well as promising diagnostics and treatment avenues. We have to work hard to translate these into products ready to be used in the field. For vaccine candidates to be translated, financial resources must be multiplied by 3 to 4 compared with the present effort. To overcome this huge challenge, we will have to be innovative."
Babs Verblackt - CNS
(The author is a freelance journalist, a Fellow of CNS Writers' Bureau and Associate Communications at TuBerculosis Vaccine Initiative – TBVI)
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