Many people think of tuberculosis (TB) as a disease of the past, but in 2017, more than 10 million people became sick with TB

Many people think of tuberculosis (TB) as a disease of the past, but in 2017, more than 10 million people became sick with TB and 1.6 million people died from the disease – making it among the world’s top infectious disease killers. TB is the leading cause of death among people living with HIV, and the main cause of deaths related to antimicrobial resistance. This epidemic is an urgent threat that deserves an urgent response.

Tuberculosis is an airborne infectious disease that has existed for millennia, with evidence of the disease found in ancient Egyptian mummies, and in the 19th and 20th centuries was the leading cause of death in industrialized countries. TB is Ccaused by a bacterial infection with Mycobacterium tuberculosis (MTb), and TB most commonly affects the lungs but can affect any organ in the body.

About 1/4 of the world is infected with Mtb - that is more than 2 billion people. Most of those people will contain the infection on their own, but around 10% will in their lifetime progress to TB disease – meaning they have active symptoms and can spread the infection to others simply by coughing or sneezing. On average, a person with active TB will spread the disease to 10 to 15 people within a year. Symptoms of tuberculosis include coughing up blood, night sweats, weight loss and exhaustion.

Tuberculosis (TB) differs from most other bacterial infectious diseases by a very long duration of combination antibiotic therapy required to achieve relapse-free cure. Although the standard recommended “short-course” treatment length for TB is 6 months, the World Health Organization recommends a duration of 20 months for the treatment of patients with multidrug-resistant and extensively drug-resistant TB (M/XDR-TB). Apart from the long duration of anti-TB therapy, treatment of M/XDR-TB is very expensive and often associated with adverse drug events.

Without new and better TB vaccines, it will be impossible to reach the ambitious World Health Organization End TB Strategy targets of a 95% reduction in TB mortality and a 90% reduction in TB incidence worldwide by 2035. In addition, as vaccines are expected to be equally effective against both drug-resistant and drug-sensitive strains of TB vaccine, intervention is the ultimate tool to contain the accelerating spread of multi-drug resistant tuberculosis.