A proposed national strategy for tuberculosis vaccine development

The global tuberculosis epidemic causes similar to 5% of deaths worldwide. Despite recent concerted and largely successful tuberculosis control effort s, the incidence of tuberculosis in the United States remains 74-fold highe r than the stated elimination goal of <l case per million population by the year 2010. Current bacille Calmette-Guerin vaccines, although efficacious in preventing extrapulmonary tuberculosis in young children, have shown wid ely variable efficacy in preventing adult pulmonary tuberculosis, confound skin test screening, and are not recommended for use in the United States. The Advisory Council for Elimination of Tuberculosis recently stated that t uberculosis would not be eliminated from the United States without a more e ffective vaccine. Recent scientific advances have created unprecedented opp ortunity for tuberculosis vaccine development. Therefore, members of the br oad tuberculosis research and control communities have recently created and proposed a national strategy, or blueprint, for tuberculosis vaccine devel opment, which is presented here.