Nick says that with leadership a vaccine could transform the fight against TB

Speech at the high-level side event ‘Together for a TB-free world: Financing and access solutions for novel TB vaccines’, G20 Health MinisterS’ Meeting, Polokwane, South Africa, 6 November 2026

Honourable Ministers, distinguished representatives.

It is a privilege to address you today.

Sixty years ago the Nobel prize-winning biochemist Selman Waksman published a book entitled “The Conquest of Tuberculosis”.

He concluded that with the discovery of antibiotics “the final chapter of the battle against tuberculosis appears to be at hand.”

Of course we know now that the conquest never happened.  Over the following six decades some 100 million people were to die unnecessarily from what had become a curable disease.

The advent of an effective new medicine wasn’t enough.  Not because the drugs didn’t work, but quite simply because they never got to those who needed them most.

Today we stand on the brink of an exciting new medical discovery, the elusive adult vaccine to prevent TB infection.

It could be a moment where we turn the tide in the fight against the disease.

Where we deliver the Sustainable Development Goal to End TB — even if years overdue.

But that is what they said 60 years ago.  That they had an effective new tool to end TB.  And they didn’t end it.

Do we want history to repeat itself, where once again we have the means to save lives but fail to deploy them?

Would it not be another epic tragedy if, having waited for so long, having raised such hope, it took years to get the vaccine to the people?

The dawn of a vaccine will be final proof of what has been true for some time — that TB is no longer a medical or scientific challenge, but rather a political one.

And the simple question is whether we have the political will to commit the resources to beat this disease.

Today we will hear that producing and delivering new TB vaccines over the decade after they become available could cost up to $15 billion.

It’s not an insignificant sum.  But it’s not an impossible one, either.

And we’ll also hear that the projected return on investment will be $7 for every $ spent.

And what a return.

A healthier and more productive workforce.

A reduced call on our health systems.

A lower threat of drug resistance.

And above all over a million lives a year saved.

So how will we find the political will to commit these resources?

To make tough choices when times are hard?

It is great leaders who will find the will.

And we’ve already seen that strong new leadership is changing the  odds against TB for the better.

Here in South Africa, Dr Motsoaledi has inspired the turnaround in this nation’s battle against tuberculosis.

In India, Indonesia, Nigeria, the Philippines and many more countries, new leadership has started to turn the tide against TB, committing domestic resources even as financial support from Western countries has ebbed.

This is leadership which refuses to accept that it can’t be done, and instead says it must be done.

And now we need all of our politicians to act.  Not just the few, but all those who will take decisions on our behalf.

Over the past decade, the Global TB Caucus which I chair has worked with some 3,000 parliamentarians in 161 countries.

There were only five national TB caucuses when we launched.  Now there are over 70 — and we are building more.

We have mobilised parliamentarians to pass laws, to vote funds, to use their influence and to raise their voice to demand that their governments act.

And now we must mobilise parliaments to support the roll-out of a vaccine when it comes.

We have all been at conferences on TB before.

We have talked endlessly about winning the war against TB.

We have had High Level Meetings and low level delivery.

But this moment could be different.

Together with the new technologies that are revolutionising  diagnosis

… with more effective drugs …

… and innovative financing mechanisms …

… a TB vaccine could now transform the fight against tuberculosis.

It could enable us to tackle a problem of which we’re increasingly aware, asymptomatic TB which is still infectious.

It could give us the power, as vaccines against other diseases have, to protect those most at risk, the poor and the vulnerable.

It is the moment where we could actually end the forever war against the white plague, the biggest killer in human history.

For no epidemic has been truly beaten without a vaccine.

Of course there are huge hurdles ahead.

Regulatory barriers to surmount.

Misinformation and hesitancy about vaccines to challenge.

Considerable resources to find.

And every single one of these hurdles will require political will to overcome them.

So this is the moment for politicians at every level to step up.

Our job is to represent the people, and now we must speak and act for the people.

If, as we all fervently hope, the trials are a success, and in just a few years we have a safe and effective vaccine that could prevent TB …

… what is the story that we would like to be written about this remarkable moment in history?

That we seized the opportunity of another ground-breaking medical advance, or that we missed it?

That we acted, or that we waited?

That we found the resources, or that we pointlessly paid the price in more cost down the line and more lives lost?

The story to be written will depend on our decisions over the months ahead.

We have waited so long for a vaccine — too long.

And finally it seems we might have one.

Will we show the leadership needed to give this gift to the people?

I say let us demand that leadership.

So that the book can be written again, but this time accurately.

On how TB was finally conquered.