Breakthroughs Blog: Tuberculosis

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email.Last week, the Coalition for Epidemic Preparedness Innovations (CEPI) announced plans for a US$1.76 million investment to advance and expand the scope and technology of the Spillover app, a platform created at the University of California, Davis that could be key to identifying and preparing for “Disease X,” a virus with pandemic potential that has yet to be identified. The platform includes a database with more than 500,000 samples from an estimated 74,000 animals in 28 different countries around the world, and CEPI’s investments will further its capabilities to identify viruses that are most likely to spill over to humans. The platform is hoping to use that data to prioritize and streamline investments in a library of vaccines, aimed at protecting against the viral families that pose the greatest threats, that are ready to be adapted against “Disease X” within 100 days of its identification.South Africa will begin piloting a new every-other-month HIV prevention shot as new modelling released last week showed that the shot could prevent as many as 52,000 new infections over the next 20 years if rolled out nationally. The pilot will begin after approval from the South African Health Products Regulatory Authority, which is expected early next year. Two large clinical trials found that the shot was more effective than the oral HIV prevention pill, Truvada, in part because it is taken much less frequently than the daily pill. However, the shot will only be available, at least in the short-term, in small pilot projects, and the high price is still a major barrier to the product being cost-effective in South Africa.Results from the STREAM clinical trial, shared last week at the Union World Conference at Lung Health showed that two shorter treatment regimens for multi-drug resistant tuberculosis (MDR-TB) including a fully oral nine-month bedaquiline-based regimen and a six-month injection-containing regimen have been shown to be safer and more effective that the nine-month regimen, which combines pills and injections, that is still in wide use. The STREAM trial was the largest-ever MDR-TB trial ever conducted with more than 1,000 participants across eight countries. The findings from the trial strengthen the evidence for bedaquiline as a component of improved drug-resistant therapies (bedaquiline is also a component of the six-month BPaL and BPaLM regimens, which were endorsed for use against most forms of drug-resistant tuberculosis in the World Health Organization's rapid communication on tuberculosis treatment guidelines released earlier this year).

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email.While the COVID-19 pandemic has led to serious setbacks in progress against tuberculosis (TB) with mortality now rising again after a slow but steady decline before the pandemic, COVID-19 has also demonstrated the feasibility of large-scale investment into the rapid development of urgently needed technologies when political will and a sense of urgency exists. Researchers were working on developing new tests, drugs, and vaccines for TB before the pandemic, including one vaccine candidate currently in advanced clinical trials that was developed by GSK and the Bill & Melinda Gates Foundation. Now, powerful technologies that were employed in the development of vaccines for COVID-19, like messenger ribonucleic acid (mRNA), are starting to be employed against TB, with BioNTech and Pfizer planning trials of an mRNA TB vaccine in the next few months.The World Health Organization (WHO) has published its first-ever list of fungal priority pathogens in response to the expanding geographic range of dangerous fungi due to climate change, the rise in cases of fungal disease during the COVID-19 pandemic, and the growth in resistance of fungal diseases to treatments. The list includes 19 pathogens that have been identified as posing the greatest threat to human health. The goal of publishing the list is to catalyze funding for research into fungal infections, which receives less than 1.5 percent of all funding for infectious diseases, as well as to encourage improvements to the treatment guidelines for these infections.The University of Minnesota’s Center for Infectious Disease Research and Policy (CIDRAP) recently published a draft of a Coronavirus Vaccines Research and Development Roadmap, a project supported by the Bill & Melinda Gates Foundation and The Rockefeller Foundation, for public review and comment. The roadmap, which builds on lessons learned from the development of successful COVID-19 vaccines, identifies strategies to develop effective vaccines for new COVID-19 variants as well as coronaviruses that have yet to emerge. In particular, the roadmap emphasizes the need for durable, broadly protective vaccines that are simple to deliver and that protect against multiple coronaviruses.

At GHTC, we get to read stories every day about incredible innovations in global health. Most of the technologies we see are inventive, some are revolutionary, and a few are so unusual, one might think they were ripped from the pages of a science fiction novel. Now, we’re testing how well you know these global health technologies with our annual Halloween game: the TRICK or TREATment quiz.For each question, we will present a description of a global health technology. Choose TREATment if you believe this innovation exists. Choose TRICK if you think we are trying to pull one over on you and, instead, the product is still in development or is just a figment of our imagination. 

Interested in more global health innovation news? Every week GHTC scours media reports worldwide to deliver essential global health R&D news and content to your inbox. Sign up now to receive our weekly R&D News Roundup email. In a new report, the US Department of Health and Human Services’ (HHS’) Office of the Inspector General (OIG) analyzed the US Food and Drug Administration’s (FDA’s) policies during the COVID-19 pandemic response and made recommendations for improving responses to future health emergencies. The report recognized several strong practices including the creation of templates for emergency use authorization (EUA) submissions and communication forums for the agency and developers. However, continual policy shifts and the decision to ease EUA requirements, possibly leading to the authorization of substandard assays, to increase the availability of COVID-19 tests were among the challenges identified. The report’s six recommendations include a revised device-tracking platform to facilitate the EUA submission process, formal communication channels with the lab community, and a national testing strategy.The messenger RNA (mRNA) hub, established last year in South Africa with support from the World Health Organization (WHO), began development of an mRNA vaccine for tuberculosis. The hub’s objective is to develop inoculations to address high-burden diseases in low- and middle-income countries. It is also working on developing a local mRNA vaccine candidate for COVID-19 (which will enter human trials in the coming months) after low- and middle-income countries faced major challenges accessing COVID-19 vaccines during the pandemic. The first approved mRNA vaccines were developed for the COVID-19 pandemic, but the technology has potential to accelerate vaccine development for other diseases as well, including tuberculosis.Last week, the government of Uganda declared an outbreak of a relatively rare strain of Ebola. The Sudan strain has not been reported globally in a decade and there is no approved vaccine to use against it. The rVSV-ZEBOV vaccine, or Ervebo, is currently used across Africa to limit the spread of Ebola outbreaks but it is only approved for the Zaire strain, which is responsible for the majority of outbreaks. However, WHO has pointed to a different Johnson & Johnson vaccine that has potential in targeting the Sudan strain, which could be confirmed through testing.