New vaccines could help us consign tuberculosis to history: here’s how we can do it

When I was a physician in Pakistan, I would see tuberculosis (TB) in every form. I saw the death, disability and suffering it causes first-hand. Later, as Minister of Social Protection, I witnessed the terrible consequences this disease has for whole communities, and the impact it had on health systems and economies. Today, as the leader of Gavi, the Vaccine Alliance I will do everything I can to ensure that new vaccines, when they arrive, are made immediately available to those that need them most.

New tuberculosis vaccines on the horizon

With 1.2 million succumbing to TB in 2024, with more than 10 million people falling ill with the disease over the same period, it is clear that the world needs a new tool to fight the disease. With the existing vaccine, BCG, providing protection to infants and young children against severe disease only, new vaccine candidates currently advancing through clinical trials are showing promising signs of effectiveness in adolescents and adults. If their promise bears fruit, the benefits could be huge, not just in terms of saving millions of lives but also generating up to US$ 400 billion worth of economic benefits worldwide by 2050.

Turning opportunity into impact

At Gavi, the Vaccine Alliance, we have a mandate to ensure these vaccines, once they are licensed and recommended, are made accessible to those that need them. We are already acting decisively to execute against that mandate.

In December 2024 we sent a signal to vaccine manufacturers by including TB in our future vaccine portfolio. Since then, we have worked with our partners to forecast potential demand, estimating that about 120 million courses per year could be required in the first five years of introduction. We are now working closely with partners to develop a market shaping roadmap to ensure we can meet that demand. This is not about reinventing the wheel. We will put the full weight of the diverse suite of instruments that are in our portfolio to work. Tools that have already transformed other vaccine markets and delivered equity for other diseases.

Crucially, part of the demand for any future TB vaccine could be met by vaccines produced in Africa. Our support for regional manufacturing, including through the African Vaccine Manufacturing Accelerator, is designed to stimulate regional manufacturing, and could help to hard-wire resilience into TB vaccine supply chains.

Collective action

Preparatory work to ensure we are able to hit the ground running as soon as TB vaccines are approved for use is essential to ensure they are successfully integrated alongside other critical TB interventions. For this to succeed, we need coordinated and collective action from all stakeholders.

WHO’s work, alongside regulators, policy makers and its own global policy body SAGE will be vital in helping ensure the data generated from current trials expedites access to vaccines to protect the broadest population possible. We look forward to continuing our work with the TB Vaccine Accelerator and in particular the Finance and Access Working Group, which we are honoured to co-lead with WHO and South Africa throughout 2026 and 2027. And we will intensify our collaboration with the Global Fund and continue working in close alignment with other partners Africa CDC, the African Development Bank, the Gates Foundation and many others.

TB has plagued humanity since before historic records began, and defeating it will require a truly global effort. All stakeholders must come together to support a joint strategy for TB vaccine access — one that combines early demand signaling, coordinated financing and shared accountability.

World TB Day is an important opportunity to mark the fact that for the first time in over a century, we are approaching a turning point in the global fight against TB. We may soon have the power to consign the world’s deadliest disease to history, and we must do everything we can to ensure new lifesaving TB vaccines are able to reach the millions of people who need them, without delay.