No new vaccine has been licensed for tuberculosis (TB) for more than three-quarters of a century, and no new drug has been licensed for half a century. One major drawback has been the attrition caused by the lack of a reliable biological indicator (biomarker) to predict toxicity and efficacy early in the development pipeline. This review portrays the landscape of biomarker discovery for TB in the context of drug and vaccine development using emerging global biomics platforms. The time is ripe to move from single markers for correlates of protection to a biosignature comprising a well-defined set of robust indicators in TB that can accelerate rapid screening and early selection of potential drug and vaccine candidates.
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