For more than a century, humanity has fought the world’s deadliest infectious killer with a vaccine designed in the 1920s. It protected many babies from severe tuberculosis, or TB, but did little to stop the disease from silently spreading among adults—the very people who keep families, workplaces, and economies running.

Now, a powerful international coalition in Geneva believes that this situation could finally change.

The World Health Organization convened a high-level meeting of the Tuberculosis Vaccine Accelerator Council on May 19 during the World Health Assembly, bringing together ministers and delegates from Brazil, France, Indonesia, Kenya, Pakistan, the Philippines, Russia, and South Africa, along with representatives from the Bill & Melinda Gates Foundation, the World Bank, Gavi, the Vaccine Alliance, the Global Fund, Unitaid, the Wellcome Trust, and the Stop TB Partnership.

The message from the meeting was blunt: the era of relying solely on childhood TB protection is ending.

Scientists tracking the vaccine race say the first crucial efficacy data for new TB vaccines aimed at adults and adolescents remain on schedule for 2028. If successful, experts believe the breakthrough could reshape the global fight against a disease that still kills more than a million people every year, according to WHO estimates.

TB is caused by bacteria that usually attack the lungs and spread through the air when infected people cough or sneeze. Doctors often describe it as a disease of poverty, overcrowding and weak healthcare systems. Yet it also thrives quietly among working adults and elderly people whose immune systems become weaker with age.

That reality is now driving what some public health officials privately describe as a scientific revolution.

Inside meeting rooms in Geneva last week, discussions went far beyond laboratory science. Delegates concentrated on financing their own vaccine programmes, establishing regional manufacturing hubs, and preparing hospitals well in advance of vaccine approval. Officials reviewed new plans for “country readiness”, community partnerships and locally produced vaccines aimed at avoiding the chaos seen during the COVID-19 vaccine race, when poorer nations were pushed to the back of the queue.

In South Africa and Indonesia, regional manufacturing plans are already being discussed as part of a broader push to reduce dependence on Western pharmaceutical supply chains. Health economists attending the meeting emphasised that domestic financing, which involves utilising national funds rather than relying on aid, has become a key component of the strategy.

Researchers say the science itself remains difficult. TB bacteria are unusually stubborn and can hide inside the human body for years before becoming active. Several earlier vaccine attempts failed to provide strong adult protection. However, scientists participating in current trials assert that newer vaccine technologies and a deeper understanding of immune responses are providing renewed optimism.

One global health official involved in the discussions warned that discovering a successful vaccine alone will not be enough. “Countries must prepare now,” the official said, emphasising that the success of the next vaccine depends on health systems, cold-chain storage, and public trust campaigns.

For families across Asia, Africa and other high-burden regions, the stakes are enormous. For decades, TB has remained history’s “most wanted” killer germ, surviving wars, economic crises and medical advances. Now, as the deadline approaches in 2028, governments are striving to create what they envision as the world's first genuine protection for parents, workers, and grandparents alike.