SEATTLE — Out of all infectious diseases worldwide, tuberculosis (TB) remains the top cause of death. In 2016, approximately 10.4 million people were infected with TB and 1.7 million people died from the disease. The Bill & Melinda Gates Foundation has made the development of new tuberculosis treatment a top priority. The foundation pledged to provide at least $900 million to TB funding by 2015.
Tuberculosis Treatment Needs New Innovation
Current tuberculosis care successfully diagnoses and cures only 50 percent of patients. The TB vaccine, which has not changed in decades, does not protect against the most common strain of the disease. The most widely used TB test detects only 50 percent of cases of infection. Even patients who are properly diagnosed and prescribed often fail to complete treatment. The standard drug regimen lasts six months, requires constant monitoring by a physician and can cause unpleasant side effects.
Additionally, drug-resistant strains of TB have increased in prevalence. Multi-drug resistant TB (MDR-TB) has appeared in almost every country, with 490,000 cases occurring in 2016. Extensively drug-resistant TB (XDR-TB) can survive both first-line and second-line drugs and is becoming more common.
The most effective innovation in the fight against TB would be the introduction of a new vaccine. A new TB vaccine, even if only partially effective, would save an estimated 30 million lives by 2030.
Initiatives Implemented by The Bill & Melinda Gates Foundation
The Bill & Melinda Gates Foundation created a practical program that both funds research to develop a new vaccine and implements short-term initiatives to curb the spread and lower the mortality rate of TB in the present. Two short-term focuses of the nonprofit are the development of a new tuberculosis treatment drug regimen and the creation of a more accurate TB test.
The foundation has made very real strides toward the development of new TB drugs to replace the current, cumbersome regimen. The TB Drug Accelerator program links academic and private partners and creates a shared pool of data between partner organizations. The nonprofit collaborated with pharmaceutical companies to create two new drugs that are now approved for sale. An additional six new drugs are in clinical trials.
The foundation has also directed resources toward developing simpler, more accurate TB tests, as an estimated 400,000 lives per year could be saved with improved diagnostics. The resulting GeneXpert diagnostic test has increased the number of TB cases diagnosed and can better detect newer, drug-resistant strains.
In addition to developing new drugs and diagnostics, the program advocates for greater public and private commitments to eradicating tuberculosis. The Bill & Melinda Gates Foundation works to strengthen links between government officials and industry leaders. Strong public-private partnerships spur increased investments in the delivery of existing solutions and research into new tuberculosis treatment.
The Foundation’s Work in Developing Countries
In addition to funding cutting edge research, the Bill & Melinda Gates Foundation has had tangible success implementing TB countermeasures in India and China.
In India, the Bill & Melinda Gates Foundation works with the World Health Organization, the World Bank, USAID and the Indian government to expand TB prevention and treatment measures into the private healthcare industry. Efforts are being made to expand the technological tracking of patients throughout their treatment.
The Chinese government, with the support of the Bill & Melinda Gates Foundation, has worked to shift TB care to hospitals. This allows patients to access top-notch treatment while increasing the number of referrals between health centers.
Overall, the Bill & Melinda Gates Foundation’s tuberculosis program encompasses a wide range of interdependent initiatives. This broad focus has spurred significant new developments in TB detection and treatment over a relatively short period of time. Continued effort by the organization could catalyze major breakthroughs in the creation of new tuberculosis treatment.
– Katherine Parks