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The last time the TB vaccine had an update Warren Harding was president.

For the first time in over a century, a new tuberculosis vaccine is entering large-scale critical trials, courtesy of a more than half-billion dollar contribution from two of the world's leading medical charities: The Bill & Melinda Gates Foundation and Wellcome Trust.

TB Determined

Yes, a tuberculosis vaccine has already existed for more than 100 years. But it's primarily effective for infants, offering little protection for adults and adolescents. In the US and similar advanced countries, it's now mostly administered on a hyper-specific case-by-case basis, thanks in large part to the incredibly low rates of tuberculosis. But on a global level, TB remains quite prevalent -- and deadly. In 2021, TB led to roughly 1.6 million deaths worldwide, second only to covid. Worse, the World Health Organization is now warning of drug-resistant strains.

Cracking an effective vaccine for older kids and adults has been difficult. The bacterial infection's pathogens can lay dormant in the human body for years before deadly symptoms manifest. And there's little financial incentive. "TB is the quintessential disease of poverty," Trevor Mundel, the Gates Foundation's head of global health, told the Financial Times. "Its incidence very much tracks poverty around the world. There's no commercial market really for TB drugs, diagnostics or vaccines."

It's why the vaccine, dubbed M72, could mark a major breakthrough:

  • Starting next year, doses will be administered to 26,000 young adults already carrying the pathogen but currently without symptoms in Africa and Southeast Asia. Vaccinologists are expecting efficacy of around 50% and durability of around 5 years, based on available data.
  • That may sound minor, but even a vaccine with 50% efficacy could save up to 8.5 million lives by 2050, according to WHO calculations.

The Gates Foundation is contributing $400 million to conduct the Phase 3 trial, while Wellcome is adding another $150 million.

Off the Shelf: It's been an arrival long in the making for M72. A prototype version was developed and tested on humans back in 2004 by US biotech firm Corixa, which has since been acquired by global pharma giant GSK. GSK continued to develop it for years, before handing the Gates Foundation a non-exclusive commercial license to deliver the vaccine to around 100 middle- and low-income nations, according to the FT, and the world will be a little healthier.