Draft WHO Framework for TB Vaccine

Context: World Health Organisation (WHO) has released a draft document outlining the global framework to prepare countries for the introduction of new TB vaccines for adults and adolescents.

About Tuberculosis (TB)

• TB is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. Tuberculosis is curable and preventable.
• TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. A person needs to inhale only a few of these germs to become infected.

• Global impact of TB: TB occurs in every part of the world.
  • In 2021, the largest number of new TB cases occurred in the WHO South-East Asian Region, with 46% of new cases, followed by the WHO African Region, with 23% of new cases and the WHO Western Pacific with 18%.
  • In 2020, 87% of new TB cases occurred in the 30 high TB burden countries.
  • Eight countries accounted for more than two thirds of the global total: India, Indonesia, China, the Philippines, Pakistan, Nigeria, Bangladesh and the Democratic Republic of the Congo.
  • As per the Global TB Report, 2022, the incidence of TB in India has reduced by 18% from 256/lakh population in 2015 to 210/lakh population in 2021, which is 7 percentage points better than the global average of 11%.
• Current vaccination: Bacillecalmette-guérin (BCG) vaccine is a key component of national childhood immunisation programmes in several countries.
  • Limitation of BCG Vaccine: It does not prevent primary infection and, more importantly, does not prevent reactivation of latent pulmonary infection, the principal source of bacillary spread in the community.
  • It has shown poor effectiveness in preventing pulmonary TB in adolescents and adults.

About Draft Framework for New TB Vaccines

• It aims to guide countries and global stakeholders in preparing for the introduction and coverage scale-up of new TB vaccines for adolescent and adult populations as new vaccines become available.
• It is aligned with the vision of WHO’s End TB Strategy, to “achieve a world free of TB, with zero deaths, disease and suffering due to the disease” through rapid and equitable access to and distribution of new adolescent and adult TB vaccines.
• Goals of the global framework are
  • Ensuring the availability of vaccines and doing so sustainably with a sufficient and timely supply chain.
  • Establishing an equitable delivery system beneficial to all and meeting the requirements of key stakeholders including policymakers, end-users and health systems.
• WHO’s Preferred Product Characteristics for New Tuberculosis Vaccine
  • Vaccine providing protection to both adults and adolescents with and without evidence of latent Mycobacterium tuberculosis infection.
  • The vaccine should have an efficacy of at least 50 per cent, where protection lasts at least two years and a booster every five-ten years.
  • To replace the existing BCG vaccine for infants with a safer, more effective and more efficiently produced version.

Global Goals to Eradicate TB

• SDG Target: Eradicating TB is a key health target of the United Nations Sustainable Development Goals (SDG).
  • SDG Target 3.3 includes ending the TB epidemic by 2030.
• WHO-End TB Strategy:
  • Reduce TB incidence by 80 per cent.
  • Reduce TB deaths by 90 per cent.
  • To eliminate catastrophic costs for TB-affected households by 2030.

Government of India Interventions to Eliminate TB

• National Tuberculosis Elimination Programme (NTEP)
  • To strategically reduce TB burden in India by 2025, five years ahead of the Sustainable Development Goals.
  • It is a multi-pronged approach which aims to detect all TB patients with an emphasis on reaching TB patients seeking care from private providers and undiagnosed TB in high-risk populations.
  • It initiated strategies to engage the community and create a Jan Andolan against TB.
  • It is supporting creation of Patient Support Groups (PSGs) to facilitate conversations between patients, doctors and their caregivers to address common issues in treatment.
• Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA) Or Ni-kshay Mitra initiative
  • To ensure additional diagnostic, nutritional, and vocational support to those on TB treatment, and encourage elected representatives, corporate, NGOs, and individuals to come forward as donors to help the patients complete their journey towards recovery.
• Ni-kshay 2.0 portal
  • It will facilitate in providing additional patient support to improve treatment outcome of TB patients, augmenting community involvement in meeting India’s commitment to end TB by 2025 and leveraging Corporate Social Responsibility (CSR) opportunities.

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