Tuberculosis

History, Now, and Why the Future Requires New TB

Vaccines
Lung Health Media Training
Cape Town, South Africa
December 2, 2015

Matt Feldman MSc MA

Senior Manager, Strategic
Communications

About Aeras: A Non-profit Biotech

Advancing TB Vaccines for the World

Aeras works through partnerships

in both the public and private
sectors, with individuals, research
organizations, academic
institutions, funders, policymakers
and others around the world to
develop new, effective TB vaccines.
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Infectious Diseases Have Shaped Civilizations

1350 BCE

460-377 BCE

Smallpox

Hippocrates

165-180
Antonine Plague

1104-1110

1345

Plague

Black Plague

Vaccines Have Turned the Tides of History

1960

1967

1980

2000

Polio

Smallpox

Measles

Pneumonia

Tuberculosis today is humanitys greatest killer,

and it is out of control in many parts of the world.
The disease, preventable and treatable, has been
grossly neglected and no country is immune to
it.
Arati Kochi, Manager WHO Tuberculosis Program, 1993

The Worlds #1 Infectious Disease Killer in History

Source: Nature; WHO, 2013; WHO, 2015

Source: WHO, 2015

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A Global Problem

Source: WHO, 2015

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A US Problem: 2015 TB Cases

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Source: CDC, 2015

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Extensively Drug-Resistant TB (XDR-TB): Ebola with

Wings
Airborne
transmission like a
common cold, with
mortality similar to
Ebola (30-70%)
Found in 105+
countries
At least 2x as many
cases (43,200) last
year as the total
number of cases of
Ebola (20,206)

Source: WHO, 2015

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Drug Resistance: A Matter of Time

Source: Maryn McKenna, 2014

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Vaccines: The Future of Fighting Tuberculosis

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BCG: Most Widely Used Vaccine in the World

190
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201
5

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How Could Vaccines Halt TB?

Transmission

A1

Breakpoints

C
Transmissi
on cycle
breakpoint
s
Infectio
us TB

Preventing
transmission and
infection

Blocking progression
to infectious TB

Treating and
sterilizing active TB

A2

Infected individuals
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The Potential of New TB Vaccines

Goal: develop new TB vaccines that
would:
Be safer and more effective in preventing TB
in children, adolescents and adults, including
people with HIV
Protect against all forms of TB including MDR
and XDR
Reduce the cost and burden of TB on patients,
healthcare systems and national economies

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Projected Acceleration of TB Incidence Decline:

Elimination Requires a Vaccine

At the current rate of

decline, it will take
until 2180 to reach
WHO target of 10
cases per 100,000
population
Introduce new vaccine,
new prophylaxis

Source: WHO, 2014; Stop TB Partnership, 2015

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Funding Priorities Have Not Matched Morbidity &

Mortality
TB has received significantly less funding in the last 10 years compared to HIV and
malaria

Sources: WHO, 2012; Nature, 2013; IHME, 2012

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The Public Health Impact of New TB Vaccines

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The Global Clinical Pipeline of TB Vaccine

Candidates
Yes, there are TB
vaccines in
development
Progress has been
made since 2000,
when the first new TB
vaccine was tested
Since then, 30+
clinical trials around
the world

Aerass Global Efforts

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The Global Clinical Pipeline of TB Vaccine

Candidates
Phase I

Phase IIa

Phase IIb

Phase III

DAR-901

RUTI

VPM 1002

Vaccae

Dartmouth, Aeras

Archivel Farma, S.L

SII, Max Planck, VPM, TBVI

Anhui Zhifei Longcom

MTBVAC

H1/H56: IC31

M72 + AS01E

Biofabri, TBVI, Zaragosa

SSI, Valneva, Aeras

GSK, Aeras

Ad5 Ag85A

H4: IC31

McMaster, CanSino

Sanofi Pasteur, SSI, Aeras

ChAdOx1.85A / MVA85A

ID93 + GLA-SE

Oxford, Birmingham

IDRI, Wellcome Trust, Aeras

MVA85A / MVA85A (ID,

Aerosol)
Oxford

TB / FLU-04L
RIBSP

Viral Vector
Protein / Adjuvant
Mycobacterial Whole Cell or Extract

Please note: Information is self-reported by vaccine sponsors.

Revised on Nov 6th, 2015

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Success Requires Diversity

Or: Why you cant rest firmly on a one-legged stool
Protein/Adjuvant

Scientific Scores

50 60

Viral Vector

80 75 70

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30

Mycobacterial
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Effective Decision Making:

It Matters What You Dont Do
Novel approaches help accelerate the learning curve
Greater scientific understanding/answering key questions
Defining and Differentiating Vaccine Platforms

Diversity increases efficiency and the likelihood of success

Success is based on transparency, trust, coordination and
collaboration among global stakeholders
Better data = better decision-making

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Lesson from Ebola: Innovation Can Happen!

The 2014 Ebola outbreak
accelerated vaccine
development: 4
candidates entered
clinical trials
How?
Partnerships
Political will
Increased funding

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Funding for TB Vaccine R&D

is Just 25% of Whats Needed
Source:
T.A.G.,
Source: Treatment Action
Group,
20142014

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Advocating for R&D

TB vaccine R&D is a long-term, high-risk endeavour
We need to engage the global community to grow interest
and support for TB vaccine R&D
New audiences, new demand, new funding

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TB
Unmasked
A Global Campaign About the
People
on the Front Lines of the TB
Epidemic

A Workforce at Risk
Healthcare workers are on the
front lines of the global TB
epidemic, putting themselves at
risk of TB exposure and infection
on a daily basis, as they care for
others
They deserve protection
We need to start now

Dying to Help: TB in Context

Greater risk of developing TB than the general population:
USA: 2x
High burden countries: >3.5x
South Africa: 5x
Russia: 10x
India: 5x-11x

Up to 80% of cases from occupational exposure

Sparking Advocacy and Action

The stories of healthcare

workers need to be heard
and used to help
advance the cause of
protecting this critically
important workforce.

TB Unmasked: Goals
Mobilize a global community of
healthcare workers informed and
empowered to seek better protection
from TB
Emphasize TB prevention and
protection for healthcare workers in the
global TB dialogue
Create a sustainable movement, where
local advocates can drive progress for
short- and long-term solutions

Building on Success: EXPOSED

EXPOSED film series (Aeras, 2013) was launched to

ignite attention around the need for new TB vaccines
>100,000 views, available in 9 languages
Screened at 43 events in 16 countries
International awards and media attention
How can we do better?

Campaign Components
Documentary Films
Diverse stories, perspectives and geographies
Distributed with partners, online and at screenings
In-depth extras on key issues

Thought Leadership/Material Development

Publication in peer-reviewed journal
Op-eds, influencer engagement, educational materials

Online Social Platform

Education, sharing stories, empowering action
Reaching new audiences

Personal Stories
Hearing directly from healthcare workers around the
world: Kenya, Peru, Mongolia, South Africa, China, India,
USA
Incredible tales, fascinating new dimensions to TB
These stories are all around you:
Will you bring them to your audiences in local context?

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Video: Susheela

TB Unmasked: Impact
Incredible online viewership
Positive responses across the
TB community
Content being used in new
and unexpected ways

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Challenge: What healthcare

worker stories are around you?

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The Ripple Effect:

The Broad Impacts of TB Vaccine Clinical Trials

The Ripple Effect

Clinical trials are more than
just the scientific questions.
Value extends far beyond
vaccine science:

Jobs
Capacity building
Infrastructure
Access to healthcare
Community engagement

The Ripple Effect

Communicating the value

of TB vaccine trials and
the need for additional
support to continue this
important work.

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Video: Mark Hatherill

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Challenge: What benefits would TB vaccine R&D

bring to your communities?
Why should your policy makers and donors support this
work?
What benefits would your communities see?
How could this become a reality?

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Matt Feldman MSc MA

Senior Manager, Strategic
Communications

mfeldman@aeras.org