What's the Latest in the Gates War on TB?

Fighting tuberculosis (TB) is a classic kind of challenge for the Gates Foundation: On the one hand, TB kills on a big scale, taking nearly 2 million lives a year. On the other hand, though, the right application of resources can reduce those numbers. Indeed, deaths from TB have already fallen a lot since 1990. TB also interacts with HIV, another major focus of the foundation, and people who are coinfected with both TB and HIV are especially vulnerable. 

All of this explains why the foundation has committed nearly a billion dollars over time to fight TB, starting back in 2006. The grants keep going out the door. The foundation awarded funds just this month to the Infectious Disease Research Institute in Seattle for researching new treatments for TB. 

This grant totaled $3.4 million and went out through Gates’ TB Drug Accelerator program, a partnership that’s now paying four other nonprofits and eight pharmaceutical companies to collaborate on developing cheaper, more-effective, and faster-acting TB drugs. Gates has previously given the Infectious Disease Research Institute $4.4 million through this program.

Related: Gates Foundation: Grants for Global Health

And this institute isn’t the only one that Gates has helped in recent years. Separately, the foundation has given funds to Aereas, a nonprofit R&D partnership, for pursuit of new TB vaccines. Aearas’ Gates-funded work includes looking into delivering TB vaccines via aerosol sprays, and searching for “biomarkers”—health indicators within the patients’ body—that doctors might use to make TB vaccines, drugs, and diagnostic tools work better.  

Gilla Kaplan of the foundation’s Global Health Division heads up the Gates TB effort, and China, India, and South Africa, where TB infection rates are among the world’s highest, and are therefore some of the places where the program is most active. The program’s page notes with dismay the 9 million or more new cases of the disease that break out every year, and its status as one of the leading causes of death worldwide.

Gates' TB strategy for 2011 to 2016 is articulated in detail on its website. The foundation is pulling a lot of levers: New treatments, vaccines, diagnostic tools—all of these get support.

Bonus points if you’re focused on vaccine research. The program calls development of new TB vaccines its “top priority,” and notes that the current vaccines don’t work for infants or children. Some adult sufferers need better vaccine options, too: Adults suffering from pulmonary TB, for instance, don’t get much benefit from the current vaccine options.

Gates’ interest in better diagnostic tools is also quite high. The program’s page points out that the standard diagnostic tool is still the microscope, and microscope analyses are a lot of work and fail to detect infections about half the time.

Better treatment regimens that cure an infection more quickly form a third action item for Gates’ TB strategy. A regimen that takes a long time to complete might end with patient discouragement and abandonment of therapy, further endangering themselves and others.  

“Patients who do not complete their treatment as prescribed are likely to transmit TB to others and may develop drug-resistant strains that can take up to two years to treat with more expensive, second-line drugs,” it states.