The Clock is Ticking: as TB claims some 1.4 million lives in 2019

More than a century has passed since the March 24, 1882, announcement by Robert Koch that Mycobacterium tuberculosis (Mtb) bacteria cause tuberculosis (TB), but the disease still ranks as one of the world’s great killers, claiming some 1.4 million lives in 2019 alone.

The National Institute of Allergy and Infectious Diseases (NIAID) of the United states on Wednesday joined the World Health Organization and others in acknowledging the need for continued, concerted efforts to combat TB, even as the world stand in the shadow of the COVID-19 pandemic, which threatens to slow or reverse progress in global TB control.

“The 2021 World TB Day theme, The Clock is Ticking, reminds us that time is of the essence. We cannot delay the research needed to identify, develop, test, and deliver new or improved TB diagnostics, treatments, and vaccines. On this World TB Day, NIAID stands with the global health community in a renewed commitment to ending this disease”.

TB-causing bacteria spread through the air and the disease usually affects the lungs, although other organs and parts of the body can be involved. Most people infected with the disease can co-exist with the bacterium for months, years or a lifetime without ever developing symptoms (termed latent TB infection.)

By some estimates, up to a quarter of the world’s population has latent Mtb infection. People with latent TB infection cannot transmit the bacteria to others. However, they have a 5-to-10% lifetime risk of developing active TB. Symptoms of active pulmonary TB disease include cough, fever, and weight loss. Malnourished individuals, smokers, people receiving immunosuppressive therapies, and those with compromised immune systems, including those with untreated HIV infections, are at increased risk of developing active TB.

In collaboration with the Bill and Melinda Gates Foundation, NIAID is funding studies to analyze clinical samples collected in trials of BCG and M72/AS01 E vaccines. These studies aim to define the immunological basis of the observed protection from TB disease. Defining how and which immune responses correlate with high degrees of disease protection allows investigators to design new and improved TB vaccines.

To further advance the development of potential TB vaccines, NIAID established three Immune Mechanisms of Protection Against Mycobacterium tuberculosis (IMPAc-TB) Centers in 2019. Multi-disciplinary research teams in the Centers are elucidating the immune responses involved in preventing initial TB infection, establishing latent TB infection, or transitioning from latent infection to active TB disease. Findings are informing development of novel TB vaccine candidates.

NIAID says the clock is indeed ticking, and on World TB Day 2021, NIAID takes time to reflect on the dedication of scientists, clinicians, trial volunteers, and others who work tirelessly to make TB a disease of the past.

“We stand with global health partners in firm resolve to apply cutting-edge research, investment, and collaboration to make that day come soon.”