Time for vaccines for the ‘Big Three’

mRNA vaccine technology shows huge promise for tackling malaria, HIV, and TB, writes Fiona Broom.

The fight against COVID-19: People waiting to be vaccinated fill up a hall at the Asia Pacific Vaccine Access Facility (APVAX) in Caloocan City, Philippines. Copyright: Asian Development Bank, (CC BY-NC-ND 2.0).


Three historically neglected diseases – the ‘Big Three’, namely tuberculosismalaria and HIV/AIDS – could be set to benefit from the phenomenal strides that have occurred in vaccine technology in the 2020s.

Ever since mRNA vaccines burst onto the global scene to fight COVID-19, a world of possibilities has opened up as research teams explore ways to harness mRNA technology to take on the world’s most deadly diseases.

The so-called “Big Three” infectious diseases are the deadliest communicable diseases in the world. Together, they killed more than 2.8 million people in 2020.

These diseases are the result of poverty and disproportionately affect developing countries. TB thrives in crowded, enclosed spaces, while children in poor living conditions are exposed to malaria mosquitoes. They are also drivers of poverty, as they can cause frequent and long-term illnesses that are costly to treat and prevent people from being able to earn a living.

With billions poured into COVID-19 vaccine research, it is time for a comparable commitment to the Big Three. Investment in research and development for TB, malaria and HIV is desperately needed, but R&D targets are not being met, according to the World Health Organization.

In our Spotlight on mRNA vaccines, The new frontier, we have looked at whether mRNA vaccines will succeed in tackling HIV, malaria, and TB. And, crucially, how access and affordability can be ensured.

Our facts and figures article outlines the history of mRNA vaccine technology, explains how the vaccines work, and what they could be used for in the future.

With new clinical trials launching in the United States, an mRNA vaccine for HIV could be on the horizon. But questions remain about who will produce any future vaccines and how access will be guaranteed.

While researchers are still in the early stages of development for new mRNA vaccines, global health leaders focused on the world’s most neglected infectious diseases say that conversations about access should begin now.

Scientists are eagerly anticipating the first data on mRNA vaccines for malaria, which researchers say are in advanced stages – though trial results will determine if and when they become available.

A successful mRNA vaccine for tuberculosis could be rapidly developed and save up to 1.5 million lives every year. Researchers are pushing to capitalise on the success of mRNA technology against COVID-19 by exploring whether the platform could be effective against TB, the world’s second most deadly infectious disease.

It’s time to get behind vaccine research and immunise the world against the burden of the Big Three deadliest infectious diseases.


Fiona Broom


This article is republished from the SciDev.Net under a Creative Commons license.

This piece was produced by SciDev.Net’s Global desk as part of the Spotlight series ‘The new frontier’.