The global status of MDR- and XDR- tuberculosis (TB) infection is considered a public health crisis. The United Nations Global Plan to End TB 2018-2022 is intended to stop and reverse the incidence of TB by:
- Successfully treating 40 million people with TB.
- Successfully treating 1.5 million people with drug-resistant TB.
- Providing TB preventive therapy for at least 30 million people.
- Increasing global investment in TB prevention, diagnosis, treatment, and care.
- Increasing global investment in TB research and development.
- Member states committing to taking concrete actions.
Global target: End TB by 2030.
Drug-resistant infection (MDR- and XDR-TB) requires a greater effort to improve healthcare facilities, create new diagnostic methods, develop new anti-TB drugs, and develop vaccines. Although newer molecular testing methods rapid and specific for MTB/rifampin (RIF) resistance, the cost is prohibitive in certain developing countries; pharmaceutical companies are reluctant to support new antimicrobial products they expect will not be lucrative. Vaccine development remains the only hope of eradicating selective antimicrobial resistance, which has precipitated the transmission of quasi-incurable strains of MTB.
TB Vaccine Initiatives (such as the TuBerculosis Vaccine Initiative, funded by European countries, non-governmental organizations, The Gates Foundation, and private individuals) have supported the research and development behind new vaccines. MVA85A, once a highly promising TB vaccine, is now being reworked (trials ran from 2009-2019 and results were disappointing, according to Brazier and McShane, 2020). Although the MVA85A TB vaccine trial did not improve protection (when used in combination with BCG) against M. tuberculosis, other vaccine candidates such as M72/ASO1E are proving to be highly effective in clinical trials. Other promising vaccine candidates include VPM1002 and H56:IC31. No fewer than 18 vaccine candidates are currently in different stages of development at this time.
