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BMGF TB Vaccine Strategy

The Bill & Melinda Gates Foundation’s TB strategy addresses many of the factors associated with the TB epidemic. A new vaccine would provide the most effective way to decrease the incidence of TB, so our top priority is to explore innovative and accelerated approaches to vaccine development. However, the combined deployment of vaccines, diagnostics, and drugs is essential to addressing the epidemic. A vaccine that is able to interrupt TB transmission is likely to be the most impactful tool in efforts to control the disease.

In 2014, the Bill and Melinda Gates Foundation revised its TB vaccine strategy. The new strategy builds on initial recommendations of an external advisory committee for the TB team, and on extensive input from global stakeholders. To address innovation, collaboration and coordination in the upstream space, the foundation created the Collaboration for TB Vaccine Discovery (CTVD) - an international network of scientists and experts dedicated to foster innovation and collaboration in the up-stream TB vaccine discovery and development space. Early sharing of scientific information and standardization of laboratory techniques and data analysis will be prominent themes. Further activities include improved alignment with other funders, initiatives to engage new or younger researchers, and coordination with global portfolio management efforts for clinical testing of vaccines. The collaboration will have strong IT support to facilitate communication.

The revised TB vaccine strategy

1. To understand the natural immune response associated with protection against infection and disease. We will learn from prospective cohort studies focusing on outlier populations, and from smaller experimental medicine studies. Newly-acquired knowledge will guide rational vaccine design.

2. To develop new vaccine concepts that exploit immunological diversity. We will expand current efforts to explore vaccination approaches that target “uncommon” immunity, and/or the lung directly. We will consider induction of immunity that occurs in the natural infection setting, as well as explore induction of immunity not commonly found in this setting.

3. To develop improved tools and infrastructure to support an efficient, iterative process to test vaccine concepts. We are continuing to refine the paradigm for testing vaccine candidates, as we seek to more efficiently test candidates in human studies, use improved animal models to support up selection of these candidates, and improve learning along the experimental pathway. We will continue to support development of improved non-human primate (NHP) models, including the repeated low-dose challenge model, and natural transmission models.

4. To foster greater innovation, collaboration and coordination within the TB vaccine landscape. We are proposing the introduction of the Collaboration for TB Vaccine Discovery (CTVD) to address innovation, collaboration and coordination in the upstream space. Further activities include improved alignment with other funders and exploring global portfolio management for clinical testing of vaccines.