Table 2.

Recommendations to accelerate the development of new TB vaccines.

Recommendation	Comments
Improved definition of trial endpoints for POI and POD trial designs and harmonisation across efficacy trials to allow direct comparison between vaccine candidates	Recognition of continuous spectrum of M. tuberculosis infection/disease including incipient/subclinical disease should replace simplistic categorisation into LTBI and clinical disease
Head-to-head testing of vaccine candidates in murine and NHP models in independent laboratories	Requires coordination and funding
Identification of biomarkers for use in vaccine trials	Must be quantifiable, and include exploration of new platform technologies including single cell analyses
Better definition of protective immunity within the lung	Most human immunology performed on peripheral blood
Evaluate BCG replacement vaccine candidates for induction of non-specific protection against non-mycobacterial infections that is at least equivalent to BCG	Non-specific protection or innate training should be at least equivalent to that given by BCG
Acceleration of vaccine trials	Requires funding for trials and site infrastructure
Source more financial support for both laboratory-based research and for clinical trials	Should provide funding for at least 5 years; coordination mechanisms required