TB vaccine trials kick off amid funding woes

Clinical trials of a new tuberculosis (TB) vaccine recently kicked off in Kenya, meanwhile international TB researchers and activists are worried by funding gaps that may worsen in the global financial crisis.

In the first stage of human testing, known as Phase I trials, the new vaccine will be tested for safety on healthy adults with no previous history of TB in Kombewa, near Kisumu in western Kenya.

Researchers hope the candidate vaccine, which has already undergone similar testing in the United States, will improve immunity in people who have already received the standard Bacille Calmette Guerin (BCG) vaccine, created in 1921 and used the world over.

"Many people have been vaccinated with BCG but it is no longer as effective as it once was," said Oya Yavuz, director of corporate communications and investor relations for the Dutch vaccine company Crucell N.V., which has partnered the Aeras Global TB Vaccine Foundation in the testing process.

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In Africa, TB is the biggest killer of people living with HIV, who are 50 times more likely than HIV-negative people to develop TB, according to the World Health Organisation (WHO). Without proper treatment, 90 percent of those co-infected with HIV and TB usually die within months, according to the international health body.

According to Yavuz, phase II clinical trials, in which larger samples sizes will be used, should begin in Cape Town, South Africa, in coming weeks. These trials will be conducted in adults with a history of active TB, in the hope that they will show an increased immunity to future episodes of the disease.

Funding worries and silver linings

The trials were announced just days after Francoise Barre-Sinousi, a co-discoverer of AIDS and recent Nobel Prize winner, told international journalists that the current global financial crisis could lead to further funding shortfalls in the fight against TB.

The declining US dollar and the global financial uncertainty are expected to slow the pace of TB research said the Treatment Action Group, a US-based AIDS research and policy think-tank. The group released a report earlier this week analysing funding trends from 2005 to 2007, and noted that investment in research and development in the TB field was slowing, and said this was likely to be exacerbated by the devaluing dollar.

Many people have been vaccinated with BCG but it is no longer as effective as it once was

Judith Mandelbaum-Schmid, spokeswoman for the Stop TB Partnership, said she could not comment on the impact of the crisis on the fight against TB, but said a funding shortage was apparent long before the current economic meltdown.

The WHO's annual stock-taking report on the fight against TB, released in March, cited the stagnation of funding in all but five high-burden countries, creating a global funding gap of at least a $328 million, which was likely to widen.

However, not all the news is bad. Hassan Mahomed, clinical director for the South African TB Vaccine Initiative at the University of Cape Town, agreed with Mandelbaum-Schmid that it might be too soon to tell how funding would be affected, but commented that so far there had actually been a slight benefit for foreign-funded researchers.

"There has been a paradoxical beneficial effect because of the weakening of the [South African] rand against the dollar and [British] pound," said Mahomed, who has seen the dollars and pounds funding his research going farther as the rand weakened.

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