Marking the beginning of a new chapter in the fight against TB, South Africa is preparing for what could be one of the most significant public health breakthroughs since the discovery of antibiotics for TB.
The first national TB vaccine preparedness workshop, recently hosted in Johannesburg, has signalled a renewed urgency in tackling TB at its source — with vaccine innovation at the forefront.
Health Minister Dr Aaron Motsoaledi and WHO country representative Shenaaz El-Halabi outlined the major implications of the upcoming TB vaccine in an op-ed following the event. After more than 100 years of relying on the BCG vaccine, which only protects young children, a vaccine effective in adolescents and adults could be available as early as 2028.
"A TB vaccine that is 50% effective could prevent up to 76 million people from developing TB and 8.5 million deaths globally over 25 years."
These numbers are not abstract — they represent real lives, with enormous social and economic implications for high-burden countries like South Africa. The urgency is clear.
The Covid-19 pandemic reminded us how quickly science can move when backed by political will, cross-sector collaboration, and community trust. But it also showed us that science alone is not enough. Public confidence, early community engagement, and a clear strategy for equitable access are just as critical.
The workshop aimed to move beyond the science to prepare the policy, procurement and community structures needed to ensure timely and equitable delivery of any future vaccine. Attendees included scientists, regulators, policymakers, community leaders and civil society organisations.
"This time, we have a window, however brief, to prepare intentionally and inclusively."
Discussions focused on six core areas:
- Assessing South Africa’s readiness across health systems, regulation, finance and community engagement;
- Identifying knowledge and evidence gaps to enable timely decisions;
- Fostering collaboration between science, government and community stakeholders;
- Exploring how TB vaccine introduction might be financed and which populations should be prioritised;
- Outlining national priorities to guide future policy and adoption of TB vaccines alongside other prevention tools; and
- Ensuring political commitment translates into real-world delivery and readiness.
The national TB vaccine workshop marked the first of several engagements to strengthen vaccine readiness and introduce effective, scalable systems for delivery.
"This workshop was not the final word. Rather, it was the first of many steps we must take as a country."
A Community-Driven Scientific Advance
Professor Lee Fairlie, a South African co-principal investigator on a leading TB vaccine trial, noted the potential impact of the new candidates currently in development.
If successful, these new vaccines will be a game-changer for TB prevention, especially in communities of highest need. Reducing or eliminating the need for TB preventive treatment, often in capacity-constrained environments where adherence is challenging, would be revolutionary.
With around 60% of participants in a 20,000-person trial based in South Africa, the country’s role in TB vaccine science is not only leading-edge but also deeply rooted in community participation. It’s a reminder that scientific progress depends on those most affected being part of the solution.
What Comes Next?
Introducing a TB vaccine for adults and adolescents would support South Africa’s 2023–2028 National TB Strategic Plan and strengthen the country’s broader HIV, TB and STI response.
"Since the expanded programme of immunisation was introduced in 1974, vaccines are estimated to have saved 154 million lives."
But vaccines alone do not save lives — vaccination does. And that requires trust, access and systems that reach everyone. As the workshop made clear, preparation must happen on all fronts: science, systems, policy and public confidence.
We gathered in Johannesburg with humility, urgency and hope — hope that we can finish what BCG started a century ago.
This moment marks the beginning of a focused national effort. A vaccine is coming — and this time, South Africa intends to be fully ready.
