South Africa BCG booster trials seek low-cost weapon against COVID-19

The idea of testing the BCG vaccine in Africa against COVID-19 was bound to cause controversy, yet officials say efforts under way could, if successful, give the continent a cheap and easily deployable weapon against the virus.

South African biotech group, TASK, this month started the continent’s first trial to see whether 250 high-risk workers given a booster dose of BCG vaccine show better protection against COVID-19 than the same number given a placebo.

Three thousand health workers are eventually expected to be involved in the trial overall. Researchers expect preliminary results within six months in the year-long trial.

Tests to see if the century-old Bacille Calmette-Guerin (BCG) vaccine, widely used in Africa for tuberculosis, protects against the new coronavirus have also begun in the Netherlands and Australia.

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But unlike those countries, where BCG vaccinations at birth aren’t the norm, South Africa’s trial involves injecting people for a second time. BCG injections are mandatory at birth in South Africa, where TB is a leading killer.

“We are trying to see if … reminding the immune system of that vaccine will make a difference,” said Andreas Diacon, a professor at Stellenbosch University’s medical school who founded TASK in 2005 to hunt for novelty medicines and vaccines.

“Perhaps it works, perhaps it doesn’t, but it’s definitely worth trying … (because) we just need to know if it can help us through this COVID-19 crisis,” he told Reuters at TASK’s high-security mycobacteriology laboratory.

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Trying out a new medical intervention in Africa always rings alarm bells because of an unfortunate history of big pharmaceutical companies using Africans as guinea pigs.

So when a French doctor last month suggested that the BCG should also be tested in Africa as a possible shield against COVID-19, it provoked a predictable social media backlash.

Yet the vaccine is widely regarded as safe, and officials involved in the trial at Tygerberg hospital in Cape Town point out that it is so readily available in Africa and the developing world that poor countries with limited health resources could benefit massively from the discovery that the jab is effective.

“If you look at BCG as a potentially cheap and available tool that African countries could afford … it does make sense,” Diacon said. “The results will be relevant for … parts of the world that do not have access to first-world medicine.”

The World Health Organisation has warned that the next epicentre of the pandemic could very well be Africa, where measures to contain it are harder to implement and health services much more likely to be overwhelmed than in the West.

Across Africa, there is less than one intensive care bed and one ventilator per 100 000 people, a Reuters survey found. The continent has around 85 329 confirmed coronavirus cases and 2 784 deaths, compared with 300 000 worldwide since the virus emerged from China late last year.

There is no known cure for COVID-19 and scientists worldwide are scrambling for vaccine candidates.

“Our experts have ensured stringent … criteria for trial participants, as well as all the requisite safety and efficacy monitoring measures during the trial,” said a spokesman for the South African Health Products Regulatory Authority.