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How to stop TB: new vaccine and decrease of drug prices

October 26, 2018

Tuberculosis is soon to face a complete reboot: scientists are working on updating the diagnostics, treatment and vaccines. Yesterday, on October 24, the 49-th International Union Conference on Lung Health opened in The Hague (the Netherlands). The conference brought together 4,000 delegates from 80 countries, including doctors, clinicians, activists, human rights defenders.

This is the first Union event after the high-level meeting on TB in New York in September of this year, where the global plan to combat this top priority infectious disease was approved.

Princess Margriet, the aunt of the present King of the Netherlands Willem-Alexander, recalled in her welcoming speech that her grandfather and father were sick with tuberculosis. But this ailment was never discussed in the royal family because of stigma.

Jeremiah Chakaya, President of the Union, noted that tuberculosis is currently the most burdensome infectious disease in the world.

The disease kills more people than HIV/AIDS: last year, 10 million people contracted tuberculosis. Of the 1.6 million of those who died from tuberculosis, about 240,000 were children. For comparison: 1.3 million people died from HIV/AIDS.

During three days of the conference, its participants will discuss human rights, political commitment to the fight against tuberculosis, research on new drugs and vaccines.

José Luis Castro, CEO of the International Union Against Tuberculosis and Lung Disease (the Union), formulated the objectives of the conference as follows:

“We need a new diagnostics of tuberculosis, a new treatment and a new vaccine.”

Protests against expensive drugs

After the grand opening, representatives of the public organization Treatment Action Group broke through to the stage; they demanded a reduction in the price of drugs to treat TB.

Activists with posters “Halve the price! Allow generics!” demanded to decrease the price of innovative antibiotic Bedaquilin.

They indicated that the cost of the treatment course of this drug varies depending on how developed the country is. For example, the six-month course of Bedaquilin is estimated at $900- $3,000 and as high as $30,000, depending on the country welfare level.

“We are protesting because we have a hope that more people will have access to the drug,” the protest organizers said.

Vaccines are still being under testing

One of the main topics of the conference is the development of a safe vaccine. The BCG vaccine, which is known to everyone, was invented at the beginning of the last century and can protect children to some extent, but not adults.

Paula Fujiwara, Scientific Director of the International Union Against Tuberculosis and Lung Disease, noted that several vaccines are currently being developed.

“However, we need more encouraging news to defeat tuberculosis and stop the epidemic in 2030. Research and development in the field of tuberculosis must be considerably boosted”, she said.

Lucica Ditiu, CEO of Stop TB, noted that global research is under-financed for about two billion dollars and each meeting or conference helps raise funds.

So far, TB studies have received 1/10 of the money spent on HIV research.

International organizations first and foremost rely on the vaccine Aeras M72, developed by the British pharmaceutical company Glaxo Smith-Kline (GSK). This drug demonstrated a 54 percent reduction in TB morbidity.

Interestingly, the British vaccine is not a replacement for BCG. It is designed to contain latent tuberculosis. According to experts, 40% of patients are unaware that they are carriers of a hidden tuberculosis infection.

However, the mass vaccination is still far from being implemented: according to GSK representative Marie-Ange Demottis, the company has been working on the vaccine for more than twenty years. The vaccine has now been tested in three African countries — South Africa, Kenya and Zambia — and a new phase of testing is currently being prepared.

The preliminary publication of research results by a group of doctors from the Republican Scientific and Practical Center for Pneumology and Tuberculosis in Minsk (Belarus) under the leadership of Alyona Skarkhina, which is scheduled for October 26, not only caused the great interest of the conference participants, but also received the appraisal from the world’s leading media. Even before the opening of the conference, the work of Belarus scientists was called a breakthrough and a sensation.

Thus, the center doctors successfully treat patients with multidrug-resistant tuberculosis (MDR-TB) with Bedaquiline in combination with other antibiotics. As a result, 168 out of 181 patients are completely cured, while according to the World Health Organization (WHO), only 55% of people with multidrug-resistant tuberculosis can be cured.

The innovativeness of this approach is that the treatment is targeting not the bacteria, but the enzymes, which it reinforces.

Previously, WHO had remarks as to the drug and recommended to introduce monitoring procedures due to its effect on the heart.

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