Roundup: Gates TB vaccine grant; NEJM paper on renewed typhoid vaccination efforts

Two items in the news recently regarding vaccines against TB and typhoid...

-- Last week, the Gates Foundation announced a $200 million, 5-year grant to the Aeras Global TB Foundation, providing renewed support for its work next-generation tuberculosis vaccines. Here are press releases from Gates and Aeras and coverage from Reuters and the Seattle Times.

-- A perspective in last week's New England Journal of Medicine (dated September 13) advocated "Putting Typhoid Vaccination on the Global Health Agenda" (subscription required for full text). The paper notes that the number of deaths attributed to typhoid are comparable or greater than those caused by cervical cancer and meningococcal meningitis, yet typhoid vaccination "has largely fallen off the international radar screen" while HPV and meningococcal vaccines receive considerable attention. The paper reviews probable causes for this development and the potential of vaccination as part of global typhoid control efforts.

Gates-sponsored effort working toward a new TB vaccine

For the second time in the last seven days, the Washington Post looks at issues related to new vaccine development. (Last Friday was this story on setbacks for VaxGen's anthrax vaccine, which we wrote about here.) Today's story highlights tuberculosis and the efforts of the Aeras Global TB Vaccine Foundation to develop the first new vaccine for the disease in over 80 years. An excerpt:

"Though nearly forgotten in rich countries such as the United States, the lung ailment sickens many millions of people every year and kills nearly 2 million of them. The 1921 vaccine, to this day the most widely used vaccine in the world, protects babies from the worst forms of TB but doesn't do much to cut the toll in adults. Backed by tens of millions of dollars from the Bill and Melinda Gates Foundation, Aeras is working on an improved vaccine that might finally banish the disease."

Here's the Aeras website. It's worth noting that 2012 is cited as the earliest date that the aforementioned vaccine could be widely available.

As is increasingly the case with any large-scale global health initiative, the Gates Foundation has played a central role in this project. Of particular interest is the model for vaccine development employed by Aeras, one that replicates that of the major vaccine manufacturers on a scale few private entities could match. The Post explains...

"Aeras, with $108 million in Gates money, has gone further than any of the other Gates-funded groups. Not only has it set up a pipeline, but it has now built a $10 million drug factory that will allow it to produce any vaccine that emerges from the far end of that pipe. Except for its nonprofit charter and its financing, Aeras is hard to distinguish from a small drug company."

In the past, a common complaint about the pharmaceutical industry has been their apparent unwillingness to invest in vaccine research for diseases most prevalent or most severe in the developing world. The thought has been that the potential profitability of such vaccines is too limited to make their development investment worthwhile. (The Merck and GSK rotavirus vaccines may partially dispel this perception, although their potential market in the U.S. and Europe is far greater than any vaccine against TB or malaria would be.)

If this Gates/Aeras TB initiative is successful (far too early to tell), it would signal the existence of a novel pathway to develop vaccines for diseases primarily of the developing world, irrespective of concerns over profitability. A story well worth following in the years ahead.