Accelerating research and development of new vaccines against tuberculosis: 5-year progress on the global roadmap

In 2021, a global tuberculosis vaccine research and development roadmap proposed a series of actions to accelerate the development of new, effective, and affordable vaccines that are urgently needed to eliminate tuberculosis globally. Since then, the pipeline has diversified, several candidates are currently in phase 3 clinical trials, and many low-income and middle-income countries have made important steps in anticipating regulatory approval. However, the number of candidates in active clinical trials is small and product development challenges persist. Engagement with vaccine manufacturers has increased but is hampered by unclear demand and insufficient committed procurement. Investment in tuberculosis vaccine research and development therefore remains risky and inadequate. In parallel, more work is needed to identify and plan for cost-effective implementation while mitigating potential hesitancy and stigma to ensure uptake of new tuberculosis vaccines once licensed. Increased diversification of funders and strategic coordination of multiple stakeholders is needed more than ever.