PHM-Exch> TB VACCINE PROTECTS BEFORE AND AFTER EXPOSURE / Pneumonia vaccine 'to save 1000s of lives'

[Claudio Schuftan]

TB VACCINE PROTECTS BEFORE AND AFTER EXPOSURE

*A new vaccine that can fight tuberculosis (TB) before and after infection
has been developed by Danish scientists.*

It could offer protection for many years more than is now possible.

TB is a huge global problem, particularly in developing countries, where
access to antibiotics to treat the disease is limited.

The latest vaccine, so far tested in animals, is featured in the journal
Nature Medicine.

TB is a disease of the lungs, causing symptoms such as coughing, chest pains
and weight loss. Untreated, it can be deadly.

However, only in a small number of cases - fewer than 5% - do the symptoms
develop immediately after infection.

In more than 90% of cases, once Mycobacterium tuberculosis, the bacterium
which causes the disease, has invaded the body it changes its chemical
signature, and lives in a dormant - or "latent" - state.

Usually the bacterium never emerges from this latent state, but in around
10% of cases it reactivates - often years or even decades later - to trigger
severe symptoms.

Current vaccines, such as the BCG vaccine, work only if given before
exposure to the bacterium.

They do not prevent infection, but do prevent acute symptoms and disease
from emerging.

But once the bacterium has changed into its latent form it is effectively
immune to the vaccine, and can bide its time, reactivating after the vaccine
has ceased to have a preventative effect.

If successful in human trials, the new vaccine would be able to tackle that
problem.

*'Major breakthrough'*

Developed by a team at the Statens Serum Institute in Copenhagen, it
combines proteins that trigger an immune response to both the active and
latent forms of Mycobacterium.

Researcher Professor Peter Lawætz Andersen said: "It might be possible to
give a booster jab post-exposure to older children or even young adults
which would protect them well into adulthood."

Although TB can be treated with antibiotics, those drugs are often not
easily accessible in the developing world, where the new vaccine could have
the greatest benefit.

Professor Andersen said: "In these areas you cannot go in and treat more
than half the local population. For instance, in Capetown 60% of people are
thought to be infected."

Professor Peter Davies, secretary of the group TB Alert, said: "A vaccine
which can both protect against initial infection and protect from a
breakdown of infection into disease is a major breakthrough.

"One of the main disadvantages of BCG was that it could only prevent
infection going on to disease in the initially uninfected individual. It was
therefore of no use in protecting infected adults who would become an
infectious source of disease. Protecting children, though of value, does not
protect against transmission, as children with active disease do not usually
transmit disease.

"So far so good but we must remember that mice are not men (or women)."

Professor Francis Drobniewski, Director of the Health Protection Agency's
National Mycobacterium Reference Laboratory said: "This is an exciting and
thoughtful piece of research. The existing BCG vaccine is cheap, safe,
widely used but of limited efficacy.

"With over nine million new TB cases globally each year and increasing
levels of drug resistance new diagnostics, drugs and especially effective
vaccines are desperately needed."
GAVI: PNEUMONIA VACCINE 'TO SAVE THOUSANDS OF LIVES'

*By Fergus Walsh  *Medical correspondent, BBC News

The pneumonia vaccine is given as a series of three injections

* *

*A new vaccine against pneumonia is being rolled out in Africa which, it is
estimated, could eventually save more than half a million lives a year
globally.*

Children in Kenya have begun receiving the jab, which will also be used this
year in Sierra Leone, Yemen, Honduras and Guyana.

Infants in Nicaragua started receiving the vaccine a few weeks ago.

The Gavi Alliance - a global health partnership of public and private
sectors for immunisation - says 19 countries are set to receive the jab, but
many more could benefit if the funding becomes available.

Gavi says it needs an extra £500m ($800m) annually for the next five years
to meet a shortfall in immunisation for existing and new vaccines.

*Preventable illnesses*

The pneumonia vaccine protects against pneumococcal disease, the leading
cause of severe pneumonia in children. It also guards against a form of
meningitis and blood poisoning.

Pneumonia kills more children than any other illness, claiming around 1.7
million lives every year.

“The money needed for basic immunisation is in doubt, let alone for this
effective new vaccine against pneumonia”  Catherine FitzgibbonSave the
Children

At the Langata health centre in Nairobi, scores of mothers brought their
babies along for the first of three injections.

Beatrice Aching's son Wesley died from pneumonia in November. She brought
her three-month-old daughter Tamara to be immunised. She said: "My son's
death happened very suddenly. Wesley got sick in the morning and by evening
he had died in hospital - I don't want that to happen to Tamara."

Leah Otieno's nine-month-old son Emmanuel got pneumonia before Christmas but
recovered after antibiotic treatment - she says she is delighted to get him
protected.

The charity Save the Children has launched a report, No Child Born to Die,
which highlights the potential funding shortfall for global immunisation.

The report also says there is a critical shortage of 3.5 million health
workers in poor countries, without whom millions of children will face
illness and early death.

"Too many children are dying every day of vaccine-preventable illnesses and
from the lack of basic healthcare," said Catherine Fitzgibbon from Save the
Children. "The money needed for basic immunisation is in doubt, let alone
for this effective new vaccine against pneumonia."

*Price deal*

The pneumonia vaccine is given as a series of three injections

In June 2011, the UK government is hosting a meeting of Gavi in London which
will be attended by world leaders. The UK provides a quarter of all Gavi's
funding - more than any other nation.

Save the Children says it will be campaigning for rich nations to increase
support for global immunisation, and for the pharmaceutical industry to
lower the price of vaccines.

The pneumococcal vaccine costs £2.20 ($3.50) in Africa compared to £38 in
Europe as a result of a deal between Gavi and two manufacturers: Pfizer and
GSK. The roll-out in the developing world comes just a year after the same
vaccine was introduced in the United States.

GSK said the discounted price is only fractionally above the cost of
production. A spokesman said the vaccine takes a year to produce and is the
most technically sophisticated of all its vaccines.

A second vaccine against rotavirus - the main cause of serious diarrhoea -
is also being ready to be rolled out. But this, too, is far more expensive
than the basic childhood vaccines against diseases like measles, whooping
cough and polio.

Pneumonia and diarrhoea account for a third of all deaths in young children
in the developing world. Gavi and Save the Children say a comprehensive
roll-out of the pneumococcal and rotavirus vaccines could potentially
prevent more than one million deaths annually.
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