Scientist in Tres Cantos

Ruben, a senior scientist working in the tuberculosis imaging laboratory at Tres Cantos, Madrid

TB: uniting scientists to tackle one of the world’s biggest killers

We have been working with IAVI (formely Aeras) to develop a TB candidate vaccine, with the support of the Bill & Melinda Gates Foundation, the UK’s Department for International Development and others.

Our candidate vaccine has been tested in a phase II clinical trial in TB-endemic regions of Africa. Final results published in the New England Journal of Medicine, showed the candidate vaccine could help prevent adults with latent TB infection from becoming sick with pulmonary TB over at least three years. We have recently licensed our TB candidate vaccine to the Bill & Melinda Gates Medical Research Institute for its continued development and potential use in low-income countries with high TB burdens.

For the first time in almost a century, we have taken a major step towards finding a potential new vaccine for TB.

Our TB candidate vaccine is a great example of using our unique scientific expertise to find new vaccines or medicines against some of the biggest health threats and working with others to enable their sustainable development

The TB challenge

Known for its fever and persistent cough that can sometimes lead to coughing up blood, tuberculosis – better known as TB – was once believed to be under control. However, since the 1980’s, the world has seen a resurgence of this highly contagious and potentially fatal disease. There is now an estimated 28 million people at risk of death from TB by 2030

At GSK our scientists are taking significant steps towards advancing TB science to fight the world’s deadliest infectious disease.

There are several reasons why TB has made a comeback. One is the lengthy and complicated course of antibiotics that is the current treatment for the bacterial infection. Typically, patients might take up to four different medicines, for six to nine months and long treatment courses can last up to two years.

Around 20-30% of patients do not finish their treatment which creates opportunities for deadlier, drug-resistant strains to develop. Combined with the lack of new treatment options in recent years, this has contributed to a surge of new cases of TB.

  • 4000

    lives are claimed by TB every day, according to the World Health Organization (WHO)

Against this backdrop, one of the United Nations’ sustainable development goals states that by 2030, we must end the epidemic of tuberculosis. If the global community is to achieve the United Nations’ goal, then it needs to improve diagnosis of the disease and find more effective treatments and vaccines.

The search for a new vaccine

Image of mycobacterium tuberculosis (MTB), the bacteria that can cause TB.

Currently, there is only one TB vaccine available – the Bacillus Calmette–Guérin vaccine, better known as the BCG. Given to babies, the vaccine prevents severe disease in children but its effectiveness against pulmonary TB in adults varies. The BCG vaccine plays an essential role to protect babies in TB endemic countries, but it is not enough to control the disease at a global scale.

“Developing a new vaccine for TB is tough. It is a very complex disease and presents major scientific challenges,” explained Emmanuel (Manu) Hanon, Senior Vice President, Head of Vaccines R&D, GSK.

Mycobacterium tuberculosis (MTB) – the bacteria that can cause TB – is unique. “These bacteria have the amazing ability to remain latent in their host by creating a kind of niche micro-environment, protecting them from our immune system,” added Manu.

“This means that it is even harder to displace the bacteria with a vaccine. What’s more, the unique latency mechanism cannot really be reproduced in the laboratory so the only way to find a potential vaccine against TB is through clinical trials with very large numbers of participants. This is exactly what we are doing.”

A TB vaccine researcher at GSK’s Vaccines R&D site in Rixensart, Belgium

Joining forces to fight TB

Developing a vaccine is not the only field in which GSK is teaming up with others to fight TB.

At our Global Health R&D site in Tres Cantos, Spain, around 120 GSK and visiting scientists collaborate on research dedicated to developing treatments for diseases that disproportionately affect developing countries.

We have a world-leading portfolio of innovative new medicines for TB, which span several new and different mechanisms of actions. In combination with other medicines, we hope to transform the TB landscape to create a treatment course that is effective in all patients, even those that are resistant to the currently available TB medicines.

“We know we cannot succeed in tackling TB alone. As with other global health challenges, such as HIV or malaria, we must work together to combat this deadly disease,” said Pauline Williams, SVP, Global Health R&D at GSK.

“Sharing information and scientific expertise and building public-private partnerships will help address some of the barriers to the development of a new generation of TB interventions.”

Pauline Williams, Senior Vice President Global Health R&D at GSK’s R&D site in Tres Cantos, Madrid.

In 2010, we opened up our Tres Cantos campus enabling our scientists to work more collaboratively with scientists from universities, not-for-profit partnerships and other research institutes. The Tres Cantos Open Lab Foundation provides fellowships to individual researchers to develop their projects at our Tres Cantos labs.

We joined the first EU funded project for TB in 2011, and now after participating in more than 10 EU funded consortiums, we continue to be an active member of several EU funded collaborations. These are focused on developing new tools and models much needed in developing new TB treatments, validating new biomarkers, and repurposing drugs in clinical trials.

In 2012, our scientists screened our entire library of more than two million compounds – the building blocks of future medicines – for any showing signs of activity against TB. The 200 compounds subsequently identified were made freely available online, for external scientists to carry out their own research. To date, we have shared copies of these compounds with 30 research groups around the world, who are also working to tackle TB. 

We are part of the TB Drug Accelerator Program – a partnership with several other pharmaceutical and public sector research institutions and the Bill & Melinda Gates Foundation (BMGF), aiming to speed up the discovery of new medicines by collaborating on early stage research.

We also became the industrial leader of the Innovative Medicines Initiative’s Antimicrobial Resistance (AMR) Accelerator program. Its aim is to progress the development of new medicines to treat or even prevent resistant bacterial infections in Europe and worldwide. Under one structure, the program addresses the scientific challenges of AMR by supporting the development of new approaches to prevent and treat AMR, of which TB is the main cause of death.

“When the best scientific minds join forces, we can make great strides in improving global health,” said Pauline. 

“We believe that researching TB medicines is an area where we can achieve a united front – opening up our labs, and sharing our resources, our data and our expertise – and help save lives.”

References

[1] http://www.who.int/tb/strategy/end-tb/en/

[2] https://sustainabledevelopment.un.org/sdg3