Reflections from the TB Vax ARM Webinar on the #Wins4TBVax

Thursday, 4 April 2024

The TB Vaccine Advocacy Roadmap (TB Vax ARM) were joined by Birgitte Giersing (WHO), Rupali Limaye (SMART4TB), Suvanand Sahu (Stop TB Partnership), and Maiko Tonini (Ministry of Health, Brazil) at the #Wins4TBVax webinar on Thursday 4 April. The #Wins4TBVax outline key advocacy goals for the field to achieve by 2026 to advance TB vaccine development and ensure their equitable and affordable access this decade. The wins are:

1. Measurable increases in national and joint, multilateral funding and financing for TB vaccine R&D
2. Explicit and transparent commitments and plans from developers and governments to ensure equitable access
3. TB vaccines and TB R&D are integrated into AMR and other relevant global health agendas

• Read the recap of the webinar and watch the recording below
• Read the full transcript here
• Click here to endorse the #Wins4TBVax

WHO access initiatives and the TB Vaccine Accelerator Council

Birgitte Giersing, Team Lead, Vaccine Prioritization & Platforms, WHO

The WHO has developed a range of initiatives to support of TB vaccine development and delivery. Efforts are largely focused on TB vaccines for adolescents and adults, who are most at risk of developing and spreading TB and for whom established immunization programs do not exist in many countries. WHO initiatives include the development of guidance on the necessary evidence to inform policymaking for TB vaccine introduction. Financing across the value chain, from clinical development to procurement and health system readiness, has been identified as a major need to support collective efforts of the field.

In 2023, the WHO launched the Tuberculosis Vaccine Accelerator Council to facilitate high level coordination and alignment between funders, global agencies, governments, and community members. The Council comprises ministers of health from high burden countries and key donor countries, funders, and civil society representatives. Priorities include diversifying the pipeline of TB vaccine candidates, devising novel financing strategies and market solutions, and supporting equitable manufacturing and distribution. The Council hopes to announce their final objectives and milestones toward the end of May 2024. Further, the WHO is exploring the feasibility of setting up a Strategic Coordination Office to integrate efforts across various aspects.

Learn more about the WHO’s efforts via the links below:

• Preferred product characteristics for TB vaccines (2018)
• Global roadmap for research and development of tuberculosis vaccines, EDCTP & AIGHD (2021)
• An investment case for new tuberculosis vaccines (2022)
• Evidence Considerations for Vaccine Policy Development (ECVP) (2022)
• Global Framework to prepare for Country Introduction of New TB Vaccines for Adults and Adolescents (2023)

Country preparedness research under SMART4TB

Rupali Limaye, Johns Hopkins Bloomberg School of Public Health & TB Vaccine Lead of SMART4TB, USA

The COVID-19 pandemic changed the vaccination landscape, testing the world’s ability to deliver an adult vaccine at scale and demonstrating the importance of understanding vaccine hesitancy drivers, including misinformation, polarization, and distrust. In the context of this new landscape, the SMART4TB consortium is conducting research exploring aspects of demand and health system readiness to support deployment of new TB vaccines. SMART4TB aims to address these factors comprehensively, including by drawing lessons from COVID and HPV vaccine delivery.

Research by SMART4TB to date has looked at country-level data and infrastructure needs, including barriers to TB vaccine acceptance and strategies to mitigate them. Research is now planned in Kenya and South Africa to deepen understanding on readiness, with plans to expand to more countries annually. By engaging healthcare workers, policymakers, and community leaders, they aim to ensure readiness and acceptance when TB vaccines become available. Rupali’s intervention underscored the holistic approach needed to overcome vaccine hesitancy and ensure successful vaccine deployment, with a resounding call that “Vaccines don’t save lives, vaccination does.”

Advocating for TB vaccines at the HML on AMR

Suvanand Sahu, Deputy Executive Director, Stop TB Partnership

It’s critical to integrate TB into the antimicrobial resistance (AMR) agenda, with TB a key driver of the global AMR crisis. TB vaccines will likely prevent both drug-sensitive and drug-resistant TB (DR-TB), playing an important role in tackling DR-TB alongside advancements in diagnostics and treatment. In 2022, the WHO published an urgent call to use and develop new vaccines to tackle AMR, highlighting that TB vaccine development should be accelerated. This reflected an earlier call for the accelerated development of more effective TB vaccines, with the highest level of ‘Priority 1: critical’ in the WHO’s 2020 Action Framework on Leveraging Vaccines to Reduce Antibiotic Use and Prevent AMR.

Stop TB is supporting the inclusion of TB vaccines in advocacy demands in the run up to the UN High-Level Meeting on AMR taking place on 26 September 2024 in New York.

Check out other key resources and opportunities below:

• TB Vax ARM policy brief on New TB vaccines needed to tackle AMR
• Click here to read the final Modalities Resolution for the HLM on AMR
• Register here by 24 April for the Multi-Stakeholder Hearing on AMR on 15 May 2024

Country championship & the role of Brazil

Maiko Tonini, Research and Project Management Advisor for HIV/AIDS, TB, Viral Hepatitis, and STIs in the Ministry of Health, Brazil

Internationally, Brazil is working to prioritize TB within the G20 agenda following Indonesia’s 2022 call to action for financing TB. Brazil’s presidency health directive is to support the strengthening of inclusive and resilient healthcare systems and to promote health equity. This includes a proposed initiative to establish a regional production and innovation alliance among all G20 states to foster innovation and production of medical countermeasures, including vaccines.

Regionally, Brazil is committed to developing local capabilities for healthcare production, reducing dependence on international markets. To this end, Brazil has partnered with WHO to establish an mRNA vaccine hub at its state-of-the-art research institution, Fiocruz. Domestically, Brazil is tackling TB and other socially determined diseases through inter-ministerial collaboration. For example, Brazil is planning a robust investment program to develop its national healthcare complex, including investments in the national development and production of vaccines and high-cost drugs.

Brazil is also supporting dedicated efforts for TB vaccines, including as co-chair of the WHO TB Vaccine Accelerator Council. Further, Brazil is proudly hosting the 7th Global Forum on TB Vaccines at the Cidade das Arte in Rio de Janeiro from 8-10 October. The theme Driving innovation from discovery to access speaks to Brazil’s commitment to making health innovations accessible.

Final reflections

With new TB vaccines set to be available this decade, perhaps as early as 2028, globally coordinated efforts to advance late-stage candidates through licensure and prepare for their implementation are more critical than ever. The TB Vax ARM looks forward to continuing to collaborate with stakeholders across the field to support our shared mission. Together, we can bring about new TB vaccines to help end TB once and for all.