Context
The new Indian vaccine trial data shows meaningful protection from extrapulmonary tuberculosis (TB). The Bacille Calmette-Guérin (BCG) vaccine is used to help protect children from tuberculosis, but its protection decreases as people grow older. The introduction of India’s ambitious plan to eradicate TB before the Sustainable Development Goals (SDGs) can be met is reliant on targeted vaccinations in the future and strong public health measures.
The Burden of Tuberculosis in India
India bears a large burden of TB in the world. The disease continues to be a public health problem associated with overcrowding, socio-economic inequalities and malnutrition. Pulmonary TB (PTB) affects the lungs and is associated with transmission, and extrapulmonary TB (EPTB) affects organs such as the lymph nodes, bones and brain, is notoriously difficult to diagnose and often causes death, and causes disability.
Breakthroughs in Recent Vaccine Trials
Due to the multi-pathogenic nature of TB, it has been challenging to develop one vaccine that would be effective against all strains and types of TB. But recently, Indian Council of Medical Research (ICMR) trials assessing next generation TB vaccine candidates such as VPM1002 and Immuvac have shown encouraging results.
- Targeted Efficacy: High efficacy of these vaccines has been shown in clinical studies, with protection against severe extrapulmonary TB of more than 50%.
- Age-Specific Protection: These vaccines have been demonstrated to be safe and effective for adolescents and adults, filling an immunity gap caused by the BCG vaccine developed a century ago.
- Prevention of Latent Progression: The vaccines demonstrated good potential for preventing the latent (dormant) infection from progressing to debilitating disease.
The Need for a Holistic Approach
New trial results also show that vaccines are not a “magic bullet. The researchers say both vaccines had no significant effect on those who were severely malnourished. This shows the importance of polyvalent approaches:
- Nutritional Support: Biologically, good nutrition is essential for vaccine effectiveness, especially for children and socio-economically disadvantaged groups.
- Enhanced Public Health: In addition to early screening, prevention of latent TB and better clinical management of PTB and EPTB, targeted vaccination should be carried out.
India’s Strategies for TB Elimination
- With the vision of Sustainable Development Goal 3, the Government of India has come up with one of the world’s ambitious health mission; Eradication of TB. However, the National Strategic Plan to End TB places emphasis on innovative pillars of infrastructure development, disease prevention, early detection and effective treatment.
- The Pradhan Mantri TB Mukt Bharat Abhiyaan is a program that involves the community in patient care and offers essential nutritional support. In addition, tools and technologies for digital transformation such as the TB-WIN platform, are transforming the way vulnerable adults are tracked, screened and vaccinated for targeted interventions.
Conclusion
The innovative vaccine trials are a huge leap in terms of fighting the most debilitating and severe forms of the disease. India needs to sustain its efforts towards targeted immunization alongside robust socio-economic and nutritional public health interventions to achieve the ultimate objective of eradicating TB. The biological complexity of TB can only be addressed through a comprehensive, patient-centred approach and a vision of a TB free nation can only be realised through this approach.
Source: The Hindu
.png)
