Carol Nyirenda
CITAMplus

Being able to better prevent TB infection and disease would have an enormous impact on TB elimination.

Vaccines are one of the best tools for preventing death and disease. While the anticipated impact varies by country and by the epidemiological setting, statistical modeling carried out in different countries projects that vaccines would have a significant impact on
reducing the numbers of people who get sick from TB and who die from TB. This would also help free up capacity of health systems because health facilities would be providing care for fewer people with TB.

Vaccines also offer the best chance to contain the spread of drug-resistant tuberculosis. A new vaccine would also reduce the risk of TB drug-resistance by preventing people from becoming sick with resistant TB and transmitting resistant forms of TB. It would also
reduce the risk of new cases of drug resistance from emerging in part, because it would reduce the need for treatment and therefore would reduce the need to use antibiotics.

So vaccines are essential tool that our TB toolbox is lacking right now. With more advocacy and more resources we can deliver new vaccines that will make a big impact in the global fight to end TB.

The Global Plan also uses statistical modeling to project the impact of vaccinating adults and adolescents with new TB vaccines in specific countries, including Indonesia, Kenya, and Uzbekistan. The modeling for these countries projected that it will not be possible to
end the TB epidemic by 2030 in any of them, without at least one new vaccine.

At the same time, the Global Plan projects that alongside better diagnostics and getting treatment to people earlier, having a new vaccine will make it possible to achieve the 2030 goal.

Right now for us who work in TB, we are still pushing for a vaccine, but COVID has shown us that the world has the money and they have the capacity because, we are talking about a TB vaccine that is over a hundred years old and we've been advocating to get more
money into this.

But with COVID countries came together and they put money together. And there was a vaccine.

And to make matters worse during this period, resources were diverted from the TB clinics or TB hospitals, for example, the GeneXpert, which is one of the main machines using for diagnosing TB was moved from the TB departments into the COVID departments. And also healthcare workers, including just financial resources, all that were moved.

We know that it was an emergency, but then in the meantime, that really affected TB and as activists, as people in the TB community, we say that it's taken us back about twelve years.

The symptoms of TB and COVID unfortunately are sort of similar. So when people go to the facility, they'll check them for COVID. And usually they don't ask them, if the COVID test is negative, they'll usually not check them for TB. And so they're sent back home and they go back and still continue transmitting the TB. So for the advocacy what we are doing now is we are trying to actually use the gains of COVID, against the donors to say, if you did this for COVID, why can't you do it for TB.
Because a person who has TB and the person of COVID, they're all human beings. So we
are also using the human rights perspective. And sometimes you find it's the same person
who has COVID and has TB. So how do you then bring out resources to take care of my
COVID and leave out my TB. I'm the same person.
So we are trying to use the gains of COVID to see if we can also speed up having new
vaccines for TB, seeing if we can mobilize resources, and also using whatever avenues
that were used to speed up the new vaccine for COVID to do the same for TB.