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Do not fill this in! == Research == {{see also|International Congress on Tuberculosis}} The BCG vaccine has limitations, and research to develop new TB vaccines is ongoing.<ref name=VacRes2011>{{cite journal | vauthors = Martín Montañés C, Gicquel B | title = New tuberculosis vaccines | journal = Enfermedades Infecciosas y Microbiologia Clinica | volume = 29 | pages = 57–62 | date = March 2011 | issue = Suppl 1 | pmid = 21420568 | doi = 10.1016/S0213-005X(11)70019-2 }}</ref> A number of potential candidates are currently in [[clinical trial|phase I and II clinical trials]].<ref name=VacRes2011/><ref>{{cite journal | vauthors = Zhu B, Dockrell HM, Ottenhoff TH, Evans TG, Zhang Y | title = Tuberculosis vaccines: Opportunities and challenges | journal = Respirology | volume = 23 | issue = 4 | pages = 359–368 | date = April 2018 | pmid = 29341430 | doi = 10.1111/resp.13245 | doi-access = free | hdl = 1887/77156 | hdl-access = free }}</ref> Two main approaches are used to attempt to improve the efficacy of available vaccines. One approach involves adding a subunit vaccine to BCG, while the other strategy is attempting to create new and better live vaccines.<ref name=VacRes2011/> [[MVA85A]], an example of a subunit vaccine, is in trials in South Africa as of 2006, is based on a genetically modified [[vaccinia]] virus.<ref name=Ibanga_2006>{{cite journal | vauthors = Ibanga HB, Brookes RH, Hill PC, Owiafe PK, Fletcher HA, Lienhardt C, Hill AV, Adegbola RA, McShane H | display-authors = 6 | title = Early clinical trials with a new tuberculosis vaccine, MVA85A, in tuberculosis-endemic countries: issues in study design | journal = The Lancet. Infectious Diseases | volume = 6 | issue = 8 | pages = 522–8 | date = August 2006 | pmid = 16870530 | doi = 10.1016/S1473-3099(06)70552-7 }}</ref> Vaccines are hoped to play a significant role in treatment of both latent and active disease.<ref>{{cite journal | vauthors = Kaufmann SH | title = Future vaccination strategies against tuberculosis: thinking outside the box | journal = Immunity | volume = 33 | issue = 4 | pages = 567–77 | date = October 2010 | pmid = 21029966 | doi = 10.1016/j.immuni.2010.09.015 | doi-access = free }}</ref> To encourage further discovery, researchers and policymakers are promoting new economic models of vaccine development as of 2006, including prizes, tax incentives, and [[advance market commitments]].<ref>{{cite journal| vauthors = Webber D, Kremer M |url=https://www.who.int/bulletin/archives/79(8)735.pdf |title=Stimulating Industrial R&D for Neglected Infectious Diseases: Economic Perspectives|journal=Bulletin of the World Health Organization|volume=79|issue=8|year=2001|pages=693–801|url-status=live|archive-url=https://web.archive.org/web/20070926012031/http://www.who.int/bulletin/archives/79(8)735.pdf|archive-date=26 September 2007}}</ref><ref>{{cite journal| vauthors = Barder O, Kremer M, Williams H |s2cid=154454583|url=http://www.bepress.com/ev/vol3/iss3/art1|title=Advance Market Commitments: A Policy to Stimulate Investment in Vaccines for Neglected Diseases|journal=The Economists' Voice|volume=3|year=2006|issue=3|doi=10.2202/1553-3832.1144|url-status=dead|archive-url=https://web.archive.org/web/20061105083659/http://www.bepress.com/ev/vol3/iss3/art1|archive-date=5 November 2006}}</ref> A number of groups, including the [[Stop TB Partnership]],<ref>{{cite book | author = Department of Economic and Social Affairs |title=Achieving the global public health agenda: dialogues at the Economic and Social Council|year=2009|publisher=[[United Nations]]|location=New York|isbn=978-92-1-104596-3|page=103|url=https://books.google.com/books?id=VeF9dv74C4MC&pg=PA103 |url-status=live|archive-url=https://web.archive.org/web/20150906212013/https://books.google.com/books?id=VeF9dv74C4MC&pg=PA103|archive-date=6 September 2015}}</ref> the South African Tuberculosis Vaccine Initiative, and the Aeras Global TB Vaccine Foundation, are involved with research.<ref>{{cite book| vauthors = Jong EC, Zuckerman JN |title=Travelers' vaccines|year=2010|publisher=People's Medical Publishing House|location=Shelton, CT|isbn=978-1-60795-045-5|page=319|url=https://books.google.com/books?id=BKRpWFEy66wC&pg=PA319|edition=2nd|url-status=live|archive-url=https://web.archive.org/web/20150906203627/https://books.google.com/books?id=BKRpWFEy66wC&pg=PA319|archive-date=6 September 2015}}</ref> Among these, the Aeras Global TB Vaccine Foundation received a gift of more than $280 million (US) from the [[Bill and Melinda Gates Foundation]] to develop and license an improved vaccine against tuberculosis for use in high burden countries.<ref>{{Cite web|last=Bill and Melinda Gates Foundation Announcement |title=Gates Foundation Commits $82.9 Million to Develop New Tuberculosis Vaccines |date=12 February 2004 |url=http://www.globalhealth.org/news/article/4134 |url-status=dead |archive-url=https://web.archive.org/web/20091010163118/http://www.globalhealth.org/news/article/4134 |archive-date=10 October 2009 }}</ref><ref>{{Cite web| vauthors = Nightingale K |title=Gates foundation gives US$280 million to fight TB|date=19 September 2007|url=http://www.scidev.net/en/news/gates-foundation-gives-us280-million-to-fight-tb.html|url-status=live|archive-url=https://web.archive.org/web/20081201175618/http://www.scidev.net/en/news/gates-foundation-gives-us280-million-to-fight-tb.html|archive-date=1 December 2008}}</ref> In 2012 a new medication regimen was approved in the US for multidrug-resistant tuberculosis, using [[bedaquiline]] as well as existing drugs. There were initial concerns about the safety of this drug,<ref name="Zumla2012">{{cite journal |vauthors=Zumla A, Hafner R, Lienhardt C, Hoelscher M, Nunn A |date=March 2012 |title=Advancing the development of tuberculosis therapy |url=http://www.nature.com/articles/nrd3694 |url-status=live |journal=Nature Reviews. Drug Discovery |volume=11 |issue=3 |pages=171–2 |doi=10.1038/nrd3694 |pmid=22378254 |s2cid=7232434 |archive-url=https://web.archive.org/web/20200112192759/https://www.nature.com/articles/nrd3694 |archive-date=12 January 2020 |access-date=8 May 2020}}</ref><ref>{{cite news |date=31 December 2012 |title=J&J Sirturo Wins FDA Approval to Treat Drug-Resistant TB |url=https://www.bloomberg.com/news/2012-12-31/j-j-sirturo-wins-fda-approval-to-treat-drug-resistant-tb.html |url-status=live |archive-url=https://web.archive.org/web/20130104110903/http://www.bloomberg.com/news/2012-12-31/j-j-sirturo-wins-fda-approval-to-treat-drug-resistant-tb.html |archive-date=4 January 2013 |access-date=1 January 2013 |newspaper=[[Bloomberg News]]}}</ref><ref name="Avorn 2013 1349–1350">{{cite journal |vauthors=Avorn J |date=April 2013 |title=Approval of a tuberculosis drug based on a paradoxical surrogate measure |journal=JAMA |volume=309 |issue=13 |pages=1349–50 |doi=10.1001/jama.2013.623 |pmid=23430122}}</ref><ref name="US Food and Drug Administration website">{{cite web |last=US Food and Drug Administration |title=Briefing Package: NDA 204–384: Sirturo |url=https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/Anti-%20InfectiveDrugsAdvisoryCommittee/UCM329258.pdf |url-status=live |archive-url=https://web.archive.org/web/20140104212835/https://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/Anti-%20InfectiveDrugsAdvisoryCommittee/UCM329258.pdf |archive-date=4 January 2014 |website=[[Food and Drug Administration]]}}</ref><ref>{{cite journal |vauthors=Zuckerman D, Yttri J |date=January 2013 |title=Antibiotics: When science and wishful thinking collide |url=https://www.healthaffairs.org/do/10.1377/forefront.20130125.027503 |url-status=live |journal=Health Affairs |doi=10.1377/forefront.20130125.027503 |archive-url=https://web.archive.org/web/20220329211404/https://www.healthaffairs.org/do/10.1377/forefront.20130125.027503 |archive-date=29 March 2022 |access-date=29 March 2022}}</ref> but later research on larger groups found that this regimen improved health outcomes.<ref>{{Cite journal |last1=Mbuagbaw |first1=Lawrence |last2=Guglielmetti |first2=Lorenzo |last3=Hewison |first3=Catherine |last4=Bakare |first4=Nyasha |last5=Bastard |first5=Mathieu |last6=Caumes |first6=Eric |last7=Fréchet-Jachym |first7=Mathilde |last8=Robert |first8=Jérôme |last9=Veziris |first9=Nicolas |last10=Khachatryan |first10=Naira |last11=Kotrikadze |first11=Tinatin |last12=Hayrapetyan |first12=Armen |last13=Avaliani |first13=Zaza |last14=Schünemann |first14=Holger J. |last15=Lienhardt |first15=Christian |date=May 2019 |title=Outcomes of Bedaquiline Treatment in Patients with Multidrug-Resistant Tuberculosis |journal=Emerging Infectious Diseases |volume=25 |issue=5 |pages=936–943 |doi=10.3201/eid2505.181823 |issn=1080-6040 |pmc=6478224 |pmid=31002070}}</ref> By 2017 the drug was used in at least 89 countries.<ref>{{Cite journal |last1=Khoshnood |first1=Saeed |last2=Taki |first2=Elahe |last3=Sadeghifard |first3=Nourkhoda |last4=Kaviar |first4=Vahab Hassan |last5=Haddadi |first5=Mohammad Hossein |last6=Farshadzadeh |first6=Zahra |last7=Kouhsari |first7=Ebrahim |last8=Goudarzi |first8=Mehdi |last9=Heidary |first9=Mohsen |date=2021-10-07 |title=Mechanism of Action, Resistance, Synergism, and Clinical Implications of Delamanid Against Multidrug-Resistant Mycobacterium tuberculosis |journal=Frontiers in Microbiology |volume=12 |pages=717045 |doi=10.3389/fmicb.2021.717045 |doi-access=free |issn=1664-302X |pmc=8529252 |pmid=34690963}}</ref> Another new drug is [[delamanid]], which was first approved by the European Medicines Agency in 2013 to be used in multidrug-resistant tuberculosis patients,<ref>{{Cite web |date=2013-12-03 |title=European Medicines Agency - News and Events - European Medicines Agency recommends two new treatment options for tuberculosis |url=http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2013/11/news_detail_001972.jsp&mid=WC0b01ac058004d5c1 |access-date=2024-04-09 |archive-url=https://web.archive.org/web/20131203022613/http://www.ema.europa.eu/ema/index.jsp?curl=pages/news_and_events/news/2013/11/news_detail_001972.jsp&mid=WC0b01ac058004d5c1 |archive-date=3 December 2013 }}</ref> and by 2017 was used in at least 54 countries.<ref>{{Cite journal |last1=Khoshnood |first1=Saeed |last2=Taki |first2=Elahe |last3=Sadeghifard |first3=Nourkhoda |last4=Kaviar |first4=Vahab Hassan |last5=Haddadi |first5=Mohammad Hossein |last6=Farshadzadeh |first6=Zahra |last7=Kouhsari |first7=Ebrahim |last8=Goudarzi |first8=Mehdi |last9=Heidary |first9=Mohsen |date=2021-10-07 |title=Mechanism of Action, Resistance, Synergism, and Clinical Implications of Delamanid Against Multidrug-Resistant Mycobacterium tuberculosis |journal=Frontiers in Microbiology |volume=12 |pages=717045 |doi=10.3389/fmicb.2021.717045 |doi-access=free |issn=1664-302X |pmc=8529252 |pmid=34690963}}</ref> Steroids add-on therapy has not shown any benefits for active pulmonary tuberculosis infection.<ref>{{cite journal | vauthors = Critchley JA, Orton LC, Pearson F | title = Adjunctive steroid therapy for managing pulmonary tuberculosis | journal = The Cochrane Database of Systematic Reviews | issue = 11 | pages = CD011370 | date = November 2014 | volume = 2014 | pmid = 25387839 | pmc = 6532561 | doi = 10.1002/14651858.CD011370 }}</ref> Summary: Please note that all contributions to Christianpedia may be edited, altered, or removed by other contributors. 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