Introduction TB Vaccines

Tuberculosis is the most ubiquitous pathogen in the world. It is estimated that one third of the world's population is infected resulting in around 2 million deaths per annum worldwide, most of which are in Asia, China and Sub-Saharan Africa. Nevertheless, Tuberculosis is becoming a major public health issue in developed markets such as Europe and the US. This is due to the following factors:

> The emergence of drug-resistant strains of TB which are increasingly difficult to treat.

> the rise in HIV infection as a cofactor that facilitates the transmission and progression of the disease

> The greatly reduced effectiveness of the current TB vaccine (BCG) against the new mutations of the disease; many western countries no longer vaccinate routinely against TB for this reason.

> Global travel patterns and the relative ease whereby the illness can be transported to different.

Current antibiotic treatments must be given over long periods, partially in isolation which is also problematic. However, more worrying is the rise of multi-drug resistant (MDR), extreme multi-drug resistant (XDR) and totally drug resistant (TDR) TB strains. There is a clear need for both an improved vaccine and for improved methods of treating TB. The estimated global market size for an improved TB vaccine to be given prophylactically is around $1-2bn and for improved TB therapy (such as a therapeutic vaccine) $1.5-2bn.
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