Why New Tuberculosis Vaccines Will Improve Women’s Health
By Jennifer Woolley, Director of Advocacy at Aeras
Last week in Lille, France, the 42nd Union World Conference on Lung Health opened with the WHO Stop TB Symposium titled “Meeting the unmet needs of women and children for tuberculosis (TB) prevention, diagnosis and care: expanding our horizons.” The new WHO Global Tuberculosis Control 2011 report states that 320,000 women died from TB in 2010. The new statistics and global focus on TB and maternal health emphasize the impact of this disease on the world’s women.
Tuberculosis is known as a disease of poverty – a terrible illness that targets those who are poor, often robbing them of their ability to work and forcing them into impossible decisions such as whether to buy food for their children or medicine to get better.
Tuberculosis is the third leading cause of death for women in prime reproductive years (ages 15-44). In many countries, women suffering from TB are left undiagnosed and end up spreading the disease to their children.
While most forms of tuberculosis respond to treatment, it is far from pleasant. Treatment of drug-susceptible TB involves taking a handful of drugs daily for at least six months. When treatment is not completed, it can cause multi-drug resistant (MDR) tuberculosis or extensively drug-resistant tuberculosis (XDR-TB), which are more complicated to treat and in some cases virtually untreatable. Treatment of these drug-resistant forms of TB requires expensive second-line drugs with heavy duty side effects.
Not only do women suffering from TB face significant health challenges, but they may also face discrimination. In many settings stigmas exist against those with TB that may prevent women from seeking diagnosis or treatment in a timely manner.
Tuberculosis and maternal health are inherently linked. According to Amita Gupta, Deputy Director of the Center for Clinical Global Health Education and speaker at the Stop TB Symposium, when women have TB while pregnant, the disease can be transmitted to the baby in utero. Maternal TB is also associated with increased risk of mother-to-child HIV transmission. There are also concerns about second-line TB drugs for pregnant women and their effects on infants.
ACTION (Advocacy to Control TB Internationally) released a report last summer on Women and Tuberculosis that cites studies from Mexico and India showing that women with tuberculosis are twice as likely to give birth prematurely or have an infant with low birth weight. Tuberculosis can also cause infertility and damages reproductive health in other ways, especially for those who are also infected with HIV.
Fortunately, international efforts to fight TB have gained traction in recent years. The Stop TB Partnership’s Global Plan to Stop TB includes a highly ambitious goal to eliminate TB by 2050. But experts agree that TB will not be eliminated with the tools we currently have.
The world needs new drugs, diagnostics and vaccines to fight TB. My organization, Aeras, is a non-profit product development partnership dedicated to developing new vaccines against tuberculosis and making them affordable and available to all who need them worldwide. The current tuberculosis vaccine, Bacille Calmette-Guérin (BCG), is over 90 years old, and while it is effective against some forms of non-pulmonary TB in children, it does not protect against adult pulmonary TB, the most common and contagious form of the disease. For infants with HIV, the vaccine can cause disseminated BCG disease, which is often fatal.
After decades of stagnation, research and development of new tuberculosis vaccines has progressed rapidly in the past 10 years. There are currently 12 TB vaccine candidates in clinical trials globally. Aeras has six TB vaccines candidates in its pipeline, two at the pivotal proof-of-concept stage. It is our goal to develop vaccines that are effective at preventing tuberculosis in all populations – men, women and children globally – and that are safe for infants with HIV.
A mother and infant wait to participate in a clinical trial of a new tuberculosis vaccine, conducted by the South African Tuberculosis Vaccine Initiative in Worcester, South Africa. Credit: Aeras
Developing vaccines is a long and complicated process, with major benefits to be gained in the future – but there are immediate benefits to R&D as well. In communities where clinical trials are run in partnership with locally based research institutes, TB awareness is raised and information on how to detect symptoms and prevent TB is shared widely during trial recruitment efforts. Participants in the trials receive tuberculosis screenings, regular medical examinations, basic healthcare and referrals. In communities where many people do not have access to even basic health services, the benefits can be profound.
The burden of tuberculosis can be staggering for women and their families. It is our hope that new TB vaccines, which could be available within the decade, will drastically reduce the number of women who have to deal with this devastating disease.