Tuberculosis – a silent pandemic
Tuberculosis (TB) is one of the “big three” infectious diseases, together with AIDS and Malaria. In Europe, tuberculosis is almost forgotten, the times of consumption seem to be over. But this impression is false.
Worldwide, 10 million people get TB every year and approximately 1.5 million people die each year from Mycobacterium tuberculosis. Tuberculosis is widespread in Southeast Asia and Africa. In some regions, the proportion of drug-resistant strains has been increasing since the 1990s. Although new drugs regimens have been introduced in the last years, there are forms were virtually no antibiotics are effective anymore.
Many antibiotics are most effective against bacteria that are actively dividing. However, M. tuberculosis replicates extremely slowly or even remains in a dormant state for extended periods. As a result, treatment for tuberculosis takes several weeks or months, even when dealing with non-resistant strains. Another challenge: M. tuberculosis is surrounded by an exceptionally dense, waxy cell wall that makes it difficult for many active ingredients to penetrate.
An infection with M. tuberculosis is not the same as having tuberculosis. After infection, the bacteria can hide unnoticed and the infection is controlled by the immune system. Only about 5–10 percent of those infected actually develop symptomatic tuberculosis. The disease breaks out in the first years after infection or when their immune system is weakened.
Scientists at the Helmholtz Centre for Infection Research are searching for new strategies to combat this disease. At the Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), they are researching natural compounds against tuberculosis, particularly those that work according to principles entirely different from those of existing drugs. In addition, the HIPS department “Microbial Natural Products,” headed by Prof. Rolf Müller, is a member of the “Tuberculosis Drug Accelerator.” Funded by the Bill & Melinda Gates Foundation, this network brings together research institutions and companies that are exploring new strategies and treatment options for tuberculosis.
A 100-Year-Old Vaccine
The only tuberculosis vaccine, BCG (Bacillus Calmette-Guérin), is already about 100 years old. It contains attenuated, live mycobacteria and primarily protects infants and young children against severe forms of tuberculosis. Its effectiveness against infection or disease for example pulmonary tuberculosis is missing or just very low. Therefore, In Germany, the BCG vaccine is not recommended anymore since 1998 because the risk of infection with tuberculosis is low here, and risks outweigh the benefits.
Tuberculosis is a rare disease in Germany and the risk of infection and disease is unequally distributed. To acknowledge for this, epidemiologists at the HZI, in collaboration with the German Society for Pneumology and Respiratory Medicine (DGP) and the German Central Committee for Tuberculosis Control (DZK), have developed an S3 guideline on tuberculosis prevention among newly arrived immigrants. The experts recommend that greater consideration be given to tuberculosis incidence in countries of origin and to individual circumstances. This evidence-based approach is intended to ensure that available resources are used more efficiently and in a more targeted manner.
HIV and tuberculosis
In sub-Saharan Africa, the combination of tuberculosis and HIV infection is a particularly serious public health problem: Patients living with HIV are at a much higher risk of developing active tuberculosis. In many countries in this region, tuberculosis is the single leading cause of death among people living with HIV/AIDS and contributes significantly to high mortality rates.
(jsg, cwe)
Status: July 2026
