Gates's Big Bet on Better TB Modeling

This February, the Bill and Melinda Gates Foundation granted the Critical Path Institute (C-Path) $11.8 million over the next three years to improve clinical trials of tuberculosis (TB) treatments. The grant is just one more in the Gates Foundation's multiyear campaign to build on the progress made in combating TB over the past two decades. 

The Gates Foundation's large grant to C-Path won't surprise anyone familiar with the foundation's priorities and past giving behavior. The foundation prefers to identify and approach potential grantees whose demonstrated capabilities align with the foundation's strategy, as opposed to soliciting fully-formed proposals. The Gates Foundation has historically collaborated with the organizations that it approaches to design massive, transformational projects instead of supporting ready-made programs which the foundation did not help design.

The foundation's latest C-Path grant targets the institute's Critical Path to TB Drug Regimens Initiative (CPTR), a public-private partnership that C-Path, the Gates Foundation, and the Global Alliance for TB Drug Development collaborated to co-found in 2010. The initiative uses mathematical models to improve the efficiency of TB treatment development.

The Gates Foundation's ultimate mission is to level the global economic playing field to provide each individual with a fair shot at a successful, healthy life. The foundation acknowledges that many residents of the West view TB as “a disease of the past.” However, as the foundation pointed out in 2012, more than 8 million people receive a TB diagnosis each year. Because citizens of developing countries account for 95 percent of TB-related deaths, it makes sense for the Gates Foundation to focus on combating TB as part of its opportunity-equalizing strategy.

Another reason the foundation is deep into TB work is because it relates closely to another of its priorities, countering the scourge of HIV/AIDS in low- and middle-income countries. TB infections cause of 1/5 of all AIDS-related deaths in the developing world, redoubling the Gates Foundation's incentive to support counter-TB programs such as CPTR.

Related: Gates Foundation: Grants for Global Health

The Gates Foundation lays out its counter-TB strategy for 2011 through 2016 on its website. The foundation's grant to C-Path fits neatly into the strategy's emphasis on improving treatment for the debilitating respiratory disease. Developing faster-acting TB treatments is one of the Gates Foundation's six counter-TB focus areas, which include vaccine development, detection improvement, innovation dissemination, and reduction of socioeconomic barriers to TB-related medical resources. The foundation also advocates for increased cooperation in the fight against TB among governments, international organizations, and medical industry stakeholders.

The Gates Foundation tailors its evaluations of each grant using its internally developed actionable measurement approach. CPTR's heavy use of mathematical models to accelerate TB treatment development should provide Gates Foundation evaluators with relatively easily measured progress in the race against treatment-resistant TB and the foundation's campaign to improve the health and opportunities of residents of the developing world.