New TB vaccines are coming. How are countries preparing for the rollout?
New tuberculosis vaccines that could save millions of lives are on the horizon. In South Africa, VaccinesWork spoke to two experts researching how best to deploy them.
- 20 October 2026
- 6 min read
- by Naledi Sikhakhane
At a glance
- New tuberculosis vaccines that can protect adolescents and adults are in the offing. Researchers are already trying to figure out the best ways to deploy them.
- TIMBER, a research project being conducted in South Africa, Kenya and the Gambia, is building a bank of evidence to inform national roll-out strategies.
- VaccinesWork interviewed two experts involved with the study to learn what insights it is generating, and what the new vaccines are expected to achieve.
Tuberculosis (TB) remains the world’s deadliest infectious disease, claiming about 1.2 million lives per year.
The BCG vaccine has played an important role in protecting children against severe forms of TB for over a century. Now, novel tuberculosis vaccines that aim to protect adults and adolescents are on the horizon, with promising candidates entering the final stages of clinical trials.
These new vaccines have huge potential. Preliminary modelling from the London School of Hygiene and Tropical Medicine estimates that they could help to save 7.3 million lives, generate up to US$ 135 billion in economic benefits and support efforts to combat antimicrobial resistance.
One candidate, the M72/AS01E vaccine recently impressed in preliminary efficacy trials. If that vaccine continues to perform well in larger clinical studies, it could be introduced into immunisation programmes as soon as 2029–2030.
In anticipation of these game-changer new-generation jabs, South Africa, Kenya and The Gambia have stepped up to be part of a research project designed to help generate evidence to inform roll-out plans and support the decision-making led by National Immunisation Technical Advisory Groups (NITAGs) in Africa.
The project, called the Tuberculosis Integrated Model-Based Evidence and Recommendations (TIMBER) study, was launched in August 2025 and will last 36 months. It is led by the Vaccines for Africa Initiative (VACFA) at the University of Cape Town (UCT) and funded by the Wellcome Trust.
VaccinesWork reached out to Dr Benjamin Kagina and Dr Waasila Jassat, two key experts working on TIMBER in South Africa, to learn more.
Why new TB vaccines?
“For more than a century, TB prevention has relied primarily on the Bacille Calmette–Guérin (BCG) vaccine,” explained vaccinologist Dr Benjamin Kagina, Associate Professor at the University of Cape Town and Principal Investigator (PI) of the TIMBER research team.
“Although BCG protects against severe forms of TB in infants and young children, its effectiveness against pulmonary TB in adolescents and adults is limited.”
Modelling studies suggest that targeting adolescents and adults could produce substantial public health benefits, he said. But those demographics come with their own challenges: many African countries have limited or no established immunisation delivery platforms for these age-groups.
“The introduction of an effective new TB vaccine would require African National Immunisation Technical Advisory Groups (NITAGs) to develop timely, evidence-informed recommendations on its use and implementation,” Kagina explained. That’s where TIMBER comes in.
What will TIMBER do?
“When you make a policy recommendation for a new vaccine, you need evidence to map out why the vaccine needs to be introduced. Will it reduce disease? Will it be safe, will it be easy to implement, will it save the Department of Health money? TIMBER will help us identify all the evidence we need, so we can synthesise and package it and produce a policy document for the Department of Health,” said Dr Waasila Jassat, who serves as the Chair of the TB Vaccine Working Group of South Africa’s National Advisory Group on Immunisation (NAGI).
When the time comes, that evidence will be an important part of accessing funding for deployment from the National Treasury, Jassat explained. It may also inform prioritisation: people who are at greater risk may need first access to the new generation vaccines. In South Africa, mining communities, health workers and HIV-infected people are likely to number among them – but more evidence is required.
How will the research help governments?
“Mathematical modelling can provide valuable evidence to support NITAGs and policymakers in assessing the potential health impact, resource requirements and feasible implementation strategies associated with introducing a new TB vaccine,” Dr Kagina said.
Have you read?
He works with the NITAG Support Hub (NISH), which has identified that NITAGs across Africa could improve on their capacity to interpret and apply model-based evidence in the evidence-to-recommendation process.
“The TIMBER study provides an opportunity to build this capacity by supporting NITAGs to understand, critically assess and apply model-based evidence when developing recommendations on TB vaccine introduction and implementation,” Kagina shared.
What do the scientists hope the real-world impact will be?
Kagina said the potential new vaccine presents a great opportunity to significantly reduce South Africa’s persistently high TB burden.
Despite substantial investments in prevention, diagnosis, and treatment, an estimated 56,000 South Africans still lose their lives to TB every year, more than half of whom are also people living with HIV.
“A new, effective TB vaccine could be a transformative public health intervention and may represent the most sustainable long-term strategy for reducing TB disease and mortality,” Kagina explained.
A second major opportunity is strengthening adult and adolescent immunisation platforms. Immunisation has traditionally primarily targeted infants and young children in the country.
“The introduction of new TB vaccine presents an opportunity to develop and strengthen [adolescent and] adult immunisation infrastructure in South Africa while advancing a broader life-course immunisation agenda. Investments made for new TB vaccine delivery could have additional benefits for future life-course immunisation programmes,” the vaccinologist explained.
What challenges face new TB vaccination programmes?
“Cost and fiscal affordability are key considerations, as large-scale vaccine procurement and delivery must be balanced against competing health priorities within a resource-constrained public health system,” Kagina said. “Regulatory approval processes may also take time, requiring robust evidence of vaccine safety and efficacy in African populations before licensure and policy adoption.”
The TIMBER study team and the National Advisory Group on Immunisation are working on how best to identify, prioritise and reach the target populations.
“In addition, supply chain requirements and local manufacturing capacity will influence vaccine availability, sustainability, and resilience against global shortages. Finally, successful integration with existing immunisation and TB services will be essential to avoid overburdening health facilities, and to ensure efficient delivery and monitoring of the new vaccine. The vaccine also needs to be accepted by the community, and vaccine hesitancy can be a problem. Importantly, the TIMBER study will be exploring these challenges,” Kagina said.
What about the potential for vaccine hesitancy?
Although South Africans tend to trust vaccines that have been around for a long time, like BCG, the COVID-19 vaccine roll-out revealed that unfamiliar jabs could produce mixed responses.
Kagina says transparency is key – a principle he says is baked into TIMBER’s study design. “Transparency about the evidence, modelling assumptions, uncertainties and decision-making process is essential for building trust,” he explained.
“[Study] findings should be shared through trusted messengers, including healthcare workers, community leaders, and civil society organisations, using clear, accessible language and local languages where appropriate. Providing opportunities for dialogue and addressing community concerns openly can further strengthen confidence in vaccines and support informed decision-making.”
Kagina says the COVID-19 pandemic demonstrated how modelling can shape public understanding and policy when evidence is communicated clearly and transparently. “It highlighted both the value of modelling for decision-making and the importance of engaging communities in interpreting and responding to evidence.”
More from Naledi Sikhakhane
