Elevating The Leadership Of High Tb Burden G20 States In The Development And Delivery Of New Tb Vaccines

Tuberculosis (TB) is the world’s deadliest infectious disease. G20 states must show leadership and mobilise the resources needed to deliver new TB vaccines to meet the 2030 End TB targets. Universally accessible TB vaccines targeting adolescents and adults would prevent disease, combat antimicrobial resistance, sustain pandemic preparedness and response infrastructure, fight health inequalities, and return US$7 for every $1 invested in their delivery over 25 years. Brazil holds the third of four consecutive high TB burden country (HBC) G20 presidencies, beginning with Indonesia’s 2022 call to action on financing the TB response. Multiple late-stage TB vaccine trials are ongoing or planned in these countries, applying decades of experience in HIV vaccine trials with robust community participation. Increased multilateral investments by G20 states can efficiently advance TB vaccine development to fulfil commitments made at the 2023 High-Level Meeting on TB. The leadership and ownership of HBC G20 states are critical as new TB vaccines will save millions of lives while saving costs in almost all HBCs. This brief, building on the 2023 T20 brief that proposed a TB vaccine investment toolbox for joint action, adaptable to a country’s economic and research capacities and disease burden, outlines recommendations for where investments can meaningfully advance TB vaccine development and delivery among HBC G20 states to ensure globally affordable and equitable access. Recommendations concern optimising research and development, country-level investments, harmonising regulatory review, and technology transfer. Opportunities for enhanced multilateral collaboration among HBC G20 states and via existing global initiatives are explained.