The vaccine against tuberculosis was discovered 90 years ago.  Since then, no new vaccine has appeared, alhough new, resistant forms of TB have.

On World Stop Tuberculosis Day it has to be conceded that the infectious disease was not deemed 'sexy'enough for the pharmaceutical industry to invest much energy in it.  But new public/private co-operation offers possible alternatives. 

New vaccines, medicines and treatment of TB are desperately needed.  Next to old and moderately effective BCG vaccines, diagnostics and medication are crying out to be updated.  But there's a lack of money, says Professor Charles Mgone of the EDCTP, a European organization which finances research into malaria, hiv/aids and tuberculosis.
 
"The majority of patients come from poor countries without any money to permit new medicines.  Also, the pharmaceutical industry was never too keen to develop new medicines."
 
"Agreed", says Marieke van der Werf, Head Researcher at the KNCV Tuberculosis Fund. "Those patients, cynically enough, do not make an interesting market for the medicine manufacturers.  Moreover the antibiotic form of treatment for TB, must only be taken for 6 months.  Manufacturers are more motivated by medicines that need to be taken for life, such as aids inhibitors or pills for high blood pressure."
 
Co-operation
But Van der Werf is hopeful all the same, now that the pharmaceutical industry and public fundraisers have joined forces. "With that money, the funds will work with the industry, with Crucell (Dutch biotech business) for example, to develop a new vaccine.  As Crucell itself does not have to pay for all investment, it's interesting for them to work on the development of a new vaccine."
 
Aids
In West Europe and the United States,  thanks to the treatment with antibiotics, TB has
almost been wiped out. So, too, in the 1980's the interest in investing in a better vaccine disappeared.  Just when the West was starting to have to deal with HIV/aids, TB started to spread amongst people whose resistance had been seriously weakened. 
 
In Asia, Africa and Latin America, 9 million people a year become infected with tuberculosis.  In 2008 that meant that there were 5000 deaths every day worldwide from TB, according to the WHO. 
 
Vulnerable through AIDS
The Dutch lung doctor Martin Boeree worked in a hospital in Malawi at the end of the 90's where he saw many young people between the age of 15 and 35 succumb to the disease:
 
"Tuberculosis is especially evident in the African countries south of the Sahara.  That's  a result of the AIDS epidemic.  People have a weaker immune system and are less resistant to this bacterial sickness."
 
Cure shortened
TB patients can recover with a lengthy antibiotic treatment.  Most people don't keep it up that long.  According to Boeree, that's because after a couple of weeks they start feeling better.  Meanwhile, there's hope of a shorter cure.  Lung doctor Boeree:
 
"There are a number of new - as well as old - products on the market. Through a good combination of a heightened dosage, the treatment can be brought down from six to four months even less".
 
Seeing that the time needed to develop new medicines can take 10 years, it'll be some time before a new vaccine appears on the market.  The shorter antibiotic cure is expected in 2012.  Meanwhile, the threat of medicine-resistant tuberculosis - also in the West - continues to advance.
 
(gsh/js)



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