Tuberculosis (TB) is one of the top 10 causes of death globally and the leading cause of death from a single infectious pathogen. The disease represents a significant threat to public health; according to the WHO, it led to 1.5 million deaths last year alone.

The disease is caused by a bacterium called Mycobacterium tuberculosis, and typically affects the lungs, especially in adults, but can also lead to meningitis in children. While several advancements in the fight against TB have been made over the last two centuries, the need for better treatments remains high, as the disease is estimated to place a 12 BUSD burden on the global economy.

Current treatments do not do enough

Antibiotics are the most common treatment for TB, and, in the majority of cases, they are effective and can prevent death.

However, patients can require up to 6 months of antibiotic treatment in order to eliminate all the Mycobacterium tuberculosis in the body, and the side effects can be heavy ranging from jaundice to neuropathy.

There is a vaccine against TB available called BCG – (Bacillus Calmette-Guèrin) named after French scientists Albert Calmette and Camille Guérin, who introduced the vaccine in 1921. Unfortunately, the vaccine does not provide solid protection against pulmonary TB, which is the most common form of TB in adults.

Moving towards an ambitious goal

The WHO considers it a priority to develop a more effective vaccine in order to bring the burden of TB closer to zero. The organisation’s goal is to reduce the number of new cases by 90 per cent between 2015 and 2035 and the number of deaths from TB by 95 per cent.

While the goal is ambitious, some biotech companies, including big pharma giant GlaxoSmithKline (GSK), are closing in on a potential solution.  In a phase II study sponsored by the Bill & Melinda Gates Foundation, GSK’s experimental tuberculosis vaccine M72/AS01_E has produced positive results, which were published October 29, 2019 in the New England Journal of Medicine. The findings show that the vaccine was effective in 54 per cent of pulmonary TB cases and displayed very few signs of toxicity.

Iconovo playing a major role

In Lund, Sweden, the medtech company Iconovo is also doing its part in helping the WHO reach its goal. In late 2018, the inhalation device company signed an agreement with McMaster University in Canada for the joint development of a vaccine against TB. The agreement relates to the development of a dry powder preparation of inhalable vaccine against tuberculosis to be administered through Iconovo’s unique single-dose inhaler ICOone. The aim of the project is to develop a next-generation inhalation powder vaccine that is stable at room temperature. This is key to combating TB because vaccines today are typically delivered as injectable solutions that need to be stored in cold temperatures, which makes it challenging for distribution in parts of the world with a hot climate like parts of Africa.

Another benefit of an inhalable vaccine is that the solution will be easier to administer to people compared to an injection, which is invasive and can be painful. Furthermore, an inhalable vaccine eliminates the accumulation of waste with a high risk of contamination, which is typical of used syringes, and it reduces the risk of ineffective vaccinations due to lack of refrigerators.

The project calls for the use of Iconovo’s unique disposable ICOone inhaler, which will be used as a test platform to facilitate future commercialisation and large-scale manufacturing. The project is still ongoing and is scheduled to go on until the end of 2021.

World TB Day

Unfortunately, for many people in industrialised nations, TB feels like a thing of the past, with its place restricted to the history books. However, today, World Tuberculosis Day, serves as a reminder that TB remains a huge health issue around the world, especially in underdeveloped nations where poverty levels are high. By raising awareness, companies like GSK and Iconovo have a better shot of helping the WHO reach its goal of reducing the number of new cases of TB.

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