Bali, 13 November 2024 – On 8–9 November 2024, the World Health Organization (WHO) and Indonesian Ministry of Health convened for the first national consultation on new tuberculosis (TB) vaccines in Bali. Held ahead of the Union World Conference on Lung Health, the meeting focused on the potential impact of new TB vaccines for adults and adolescents, programmatic use considerations, potential financing scenarios and evidence needs for vaccine introduction in Indonesia. The meeting is part of an effort to expedite the development of new TB vaccines for adults and adolescents, and to prepare for their financing and access as part of the TB Vaccine Accelerator Council.
New TB vaccines are urgently needed to tackle the TB burden in Indonesia and globally. For this reason, Indonesia is participating in a Phase 3 clinical trial for the most advanced TB vaccine candidate in development, M72/AS01E. If successful, this could mark the first TB vaccine to be approved in over 100 years. Preliminary results have shown that the vaccine meets WHO’s preferred product characteristics. If its efficacy is confirmed in this late-stage trial, it could lead to the introduction of a new TB vaccine for adults and adolescents by 2030.
Commenting on the meeting, Minister of Health, Budi Gunadi Sadikin, said: "The president has entrusted me with accelerating our response to reduce the burden of TB by 50% in five years. Well over a million lives are lost to TB globally every year, and the number of deaths caused by TB in the last decade far surpasses the death toll of COVID-19. With the arrival of new TB vaccines, we have a critical opportunity to strengthen our efforts and save more lives."
Director General of Pharmaceuticals and Medical Devices, Rizka Andalusia, said:
The meeting also brought together representatives from the Coordinating Ministry for Community Empowerment, Indonesia’s TB Expert Committee, Stop TB Indonesia, the Gates Foundation, Wellcome, Global Health Strategies Indonesia and other key national, regional and global stakeholders. Participants discussed TB vaccine research, policy planning and the future integration of new TB vaccines into Indonesia’s National Immunization Strategy (NIS), thereby accelerating early adoption.
WHO Representative to Indonesia, Dr N. Paranietharan, said: "Indonesia's commitment to fighting TB is impressive, as demonstrated by its participation in the development and clinical testing of new TB vaccine candidates. These promising candidates, many of which are now in late-stage trials, could significantly reduce TB transmission and save millions of lives. WHO is proud to work with Indonesia and other high TB-burden countries to make these vaccines available and integrate them into national health programmes. Together, we can take a critical step toward ending TB and building a healthier future."
New TB vaccines: A priority for Indonesia’s National Immunization Strategy
The 2024 Global TB Report confirms that the highest incidence and transmission occurs in adult and adolescent populations. Modelling suggests that a TB vaccine for adolescents and adults that is 50% effective in preventing disease is expected to prevent between 37 and 76 million cases and save 4.6 to 8.5 million lives by 2050 globally. For infants, an improved vaccine with 80% efficacy could prevent 5.8 to 18.8 million cases and save 0.8 to 2.6 million lives in the same timeframe.
These findings show that a safe and effective TB vaccine could significantly reduce the number of TB cases and deaths, with vaccines for adolescents and adults having a bigger impact than those for infants. The effectiveness of a vaccine depends on how well it works, how long it provides protection, who it is delivered to, and how widely it is distributed.
The introduction of new TB vaccines is a key element of Indonesia’s NIS, which outlines the country’s immunization goals over the next five years. Investing in TB vaccines, including in the support systems needed for effective access and delivery, is not only critical for health but also highly cost-effective in most countries. WHO estimates that for every US$ 1 dollar invested in TB vaccines, there will be a sevenfold return in health and economic benefits globally over the next 25 years.
“As we know from the history of global epidemics and elimination of some communicable diseases, it cannot be possible without effective vaccines. And new TB vaccines may become real game-changers in the fight against this millennia-old disease, which kills and brings suffering to millions of people worldwide,’’ added Dr Tereza Kasaeva, Director, WHO Global TB Programme.
The meeting identified key data and evidence gaps that must be addressed to inform Indonesia’s decision-making, as well as critical opportunities to accelerate the introduction of new safe and effective TB vaccines in the country. The Government of Indonesia’s active participation in these trials and discussions positions the nation as a leader in the global effort to eliminate TB.