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Prevention of disease

Prevention of disease refers to the ability of the vaccine to protect individuals from becoming sick from the tuberculosis (TB) bacteria after exposure to it. It does not necessarily prevent a person from getting infected with the TB bacteria.

Advancing evidence-informed in-country decision-making for new TB vaccine introduction: A responsive and integrated vaccine modelling approach from India

hypothetical
Ongoing
As new TB vaccines move into late-stage development, it is imperative for high-burden countries like India to ensure timely and effective evidence-generation to inform decision-making and accelerate vaccine development and introduction. To enable this, an in-country vaccine mathematical modelling effort has been initiated in India.

Part of Change 2.0

2024-2027
Hypothetical vaccines
Planned
Actionable market intelligence, including vaccine demand forecast/scenarios, generated to strategically guide manufacturers and partners in their planning for introduction in high burden countries. The objectives include: 1. Strategic assessment of appropriate market-shaping interventions, 2.Stakeholder and decision process mapping , 3.Demand dynamics understanding and realistic market forecast development, 4. Commercialization strategy support for lead candidate(s).

TBVacMod

Ongoing
Estimate the health impact of introducing a prevention of disease vaccine for adult and adolescents in moderate to high TB burden countries. Explore different vaccine introduction scenarios based on input from country stakeholders, including national TB program and immunization program officials, on priority groups for vaccination and likely vaccine coverage. The project's key questions include: 1) who are the priority groups in different countries and what is expected level of vaccine coverage in those groups 2) how will vaccine impact differ in different introduction scenarios (vary age, priority group, coverage)

Facing up to reality? What to do if M72/AS01E doses are limited

M72/AS01e
Ongoing
The Ph3 trial for the vaccine candidate M72/AS01E is underway, and, assuming a positive result, could be licensed by 2030. Modelling suggested a large potential impact from introducing M72/AS01E but assumed an unconstrained dose supply. However, at least initially, it is likely that M72/AS01E will be supply-constrained. We estimated the effect of decisions surrounding the allocation of constrained doses on the potential global impact of M72/AS01E

Modelling to estimate the health impact of novel tuberculosis vaccines on TB burden in people living with HIV

2023-2024
Hypothetical vaccine
Ongoing
This project will inform tuberculosis (TB) prevention efforts by estimating the health impact of novel tuberculosis vaccines on TB burden in people living with HIV (PLHIV) using a novel Mycobacterium tuberculosis transmission model. HIV confers the largest relative risk of TB, and new TB vaccines could be an important tool to prevent TB; however, modelling studies have not systematically investigated how new vaccines will affect TB burden in PLHIV. In stage 1 of this project, we aim to investigate TB vaccine impact in PLHIV where vaccine product characteristics and delivery vary by recipient HIV status. In stage 2, we aim to quantify how complex vaccine targeting strategies and incorporating additional granularity in HIV/AIDS natural history might affect vaccine impact estimates in PLHIV

FAST-TB MOD

2023-2026
Hypothetical vaccine
Ongoing
FAST-TB population and cost-effectiveness modelling core: This project will accelerate tuberculosis (TB) research translation by using mathematical modelling to address key priority questions as part of FAST TB, linking an expanded state-of-the-art modelling framework with country level data and cross consortium communication around new TB treatment regimens, diagnostics and other interventions.

Creating evidence to support tuberculosis (TB) national and global decision-makers in reducing the global burden of TB

2024-2028
Hypothetical vaccine
Ongoing
In strong collaboration, we (India, South Africa, Brazil, Indonesia, UK) will create evidence to strengthen capacity and sustainably support high tuberculosis (TB) burden countries (HBC) and global decision-makers in reducing the global burden of TB, by using modelling tools to address key questions on drug-resistant (DR-)TB, new TB vaccines and other interventions, and extend and apply a state-of-the-art TB model, to estimate the relative health, cost-effectiveness, and budget impact, of new and existing interventions, as well as their optimal combination.

Prep4TBVax

2023-2025
M72/AS01e, MTBVAC
Planned
New TB vaccines are likely to be crucial in addressing the ongoing TB pandemic. With multiple promising vaccine candidates in the pipeline and the earliest availability of a candidate expected by 2028, it is of outmost importance that once available, the vaccine can be implemented rapidly and effectively. Limited research has looked at the delivery strategies available to provide a new TB vaccine to beneficiaries and therefore, this study assesses the acceptability and feasibility of delivery strategies for the vaccine candidates M72/AS01e and MTBVAC in Ethiopia, Nigeria, and Tajikistan.

Potential implications of reduced tuberculosis vaccine efficacy in those with undernutrition on overall vaccine impact in India

Hypothetical vaccine
Ongoing
Nutritional status is a leading risk factor for tuberculosis (TB). In India up to half of all TB episodes are attributed to undernutrition. Given the impact of nutrition on the immune system, vaccine characteristics such as efficacy and duration of protection could vary depending on nutritional status. Therefore, previous vaccine impact estimates may be overestimated. We re estimated vaccine impact in India with reduced efficacy with undernutrition
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