Act Now: An Open Letter to World Leaders to Increase Investment in TB Vaccine R&D

As concerned Tuberculosis (TB) survivors, advocates, and researchers, we are writing to world leaders to demand that they finance TB vaccine R&D so that new TB vaccines can be developed and widely deployed this decade. Without this, the 2030 End TB goals will be a far-fetched dream.

TB is the world’s deadliest infectious disease and has affected our civilization for thousands of years. Almost 4,400 people die from TB disease every day1.6 million people died of TB in 2021 alone – all this despite TB being a preventable and curable disease! 

Recent improvements in treatment regimens are greatly welcome, yet treating TB remains an expensive and time intensive process with often debilitating side effects, especially for drug-resistant TB. But this doesn’t have to be the case – if we have new and effective TB vaccines.

New TB vaccines hold huge potential to overcome and eradicate this age-old disease. Yet progress in developing new TB vaccines has simply not been fast enough. 

We urge you to join our urgent call for increased global investment and political support for TB vaccine R&D. With the United Nations High-Level Meeting on TB taking place on 22 September 2023, this call will play an important part in amplifying the voices of the global TB community in demanding new TB vaccines. This letter is also in direct support of the recently launched call to action ‘Deadly Divide: Priorities to Close the Deadly Divide’ from the Stop TB Partnership community and non-governmental organization delegations.

You can read the full letter and find translations below.

This letter has been written by a cohort of TB advocates, community members, and early career researchers from India, Nigeria, South Africa, Uganda, and Zimbabwe as part of the 2023 TB Vaccine Advocacy Fellowship. Click here to learn more.

Dear world leaders,

As concerned tuberculosis (TB) survivors, advocates, and researchers, we write to you on behalf of millions of people affected by this deadly disease each year. TB is one of the world’s deadliest infectious diseases. Each day, nearly 29,000 people fall ill with TB and almost 4,400 people die from this preventable and curable disease. New and effective vaccines are essential to tackle this global health crisis.

We urge you to prioritize investment in TB vaccine research and development (R&D).

TB is a matter of social and economic justice. This disease disproportionately affects the poor and marginalized communities, leading to major consequences such as social isolation, stigma, job loss, catastrophic household costs, and mental distress. TB reduces worker productivity and exhausts national health budgets, undermining global development. But this doesn’t have to be the case if we have effective TB vaccines.

We need new TB vaccines to end TB, mitigate the impact of COVID-19 on the global TB response, and control the spread of drug-resistant TB, a key driver of antimicrobial resistance. Yet, the only available TB vaccine is the century-old Bacillus Calmette-Guérin (BCG) which is largely ineffective in adolescents and adults, who are most at risk for developing and spreading TB.

With five promising vaccine candidates currently in phase 3 trials, new TB vaccines can be developed and deployed this decade. However, we need greatly increased support to make this possible.

Failure to act now would result in immense human suffering. New and effective TB vaccines can help achieve the 2030 End TB goals, which could prevent up to 23.8 million deaths and US$13.1 trillion in economic losses by 2050. In fact, every $1 invested in a TB vaccine for adolescents and adults could generate $7 of economic returns over the next 25 years.

The rapid development and roll-out of multiple COVID-19 vaccines contributed significantly to controlling the pandemic. We require a similar response to end TB. Importantly, investing in TB vaccine R&D can also fortify pandemic preparedness and response against existing and emerging infectious diseases.

At the 2018 United National High Level Meeting (UNHLM) on TB, governments pledged to invest $2 billion annually in TB R&D over five-years, including $550 million for TB vaccines. By 2021, only 30% of the pledged amount had been invested, with TB vaccine R&D receiving only 15% of its target.

The Global Plan to End TB 2023-30 now estimates that an annual investment of $1.25 billion in TB vaccine R&D is needed to achieve the 2030 End TB goals. Cutting corners will have major repercussions on the global TB response and world economy.

World leaders will convene at the UNHLM on TB on September 22, 2023, to set the global TB response agenda for the coming years new TB vaccines must be a central component of this.

We call on you as world leaders to take immediate action and prioritize TB vaccine R&D, through:

  1. Increasing and sustaining investments in TB vaccine R&D in line with the Global Plan targets;
  2. Strengthening partnerships between governments, research institutions, private and multilateral organizations, and pharmaceutical companies for coordinated TB vaccine development;
  3. Ensuring TB vaccines are universally available and accessible as soon as they are ready, especially to those most vulnerable to developing TB disease;
  4. Including TB R&D as a central element of pandemic preparedness and response agendas to improve global public health.

Investing in TB vaccine R&D can help end the TB pandemic, reduce needless suffering, and save millions of lives. Let us work together to create a healthier, more equitable, and TB free world!


The undersigned