SEATTLE -- The Bill & Melinda Gates Foundation announces grants totaling $280 million to help fight tuberculosis, an epidemic that infects one-third of people on earth and kills nearly 2 million yearly, mostly in the poorest countries. The 11 new grants will speed research and development on promising vaccines, diagnostic tests, and treatments to help reduce the global TB burden.
"TB science has advanced significantly over the past five years, and these grants build on this momentum and the progress that has been made," said Dr. Tachi Yamada, president of the Gates Foundation's Global Health Program. "By bringing together a wide range of partners, including scientists from countries heavily affected by TB, we hope to help translate promising ideas into tools that can save millions of lives."
The grants focus on three key areas:
--Â Vaccine development:Â $200 million over five years to the Aeras Global TB Vaccine Foundation to conduct clinical trials of up to six TB vaccine candidates
--Â Diagnostics:Â $62 million over five years to the Foundation for Innovative New Diagnostics (FIND) to develop TB tests that are more accurate and simpler to use
--Â Drug discovery:Â Nine grants totaling $18 million to identify new TB treatments to combat drug resistance
The urgent need for better TB-fighting tools received worldwide attention earlier this year when an airline passenger from the United States traveled across borders with drug-resistant TB and exposed fellow travelers to the disease. This case highlighted the inadequacy of current TB diagnostic tools, which use technology that is more than 100 years old. In addition, the TB vaccine is more than 80 years old and rarely works after childhood, while TB drugs require long and cumbersome regimens, and are losing their effectiveness to rising drug resistance.
"Even in rich countries, efforts to fight TB are severely hampered by the lack of effective tools," said Dr. Peter Small, senior program officer for TB at the Gates Foundation. "Better vaccines, diagnostics, and drugs could dramatically improve the fight against TB, especially in poor countries where large numbers of people are affected by the disease."
The Aeras Global TB Vaccine Foundation will use its new grant to conduct Phase I and II trials of up to six TB vaccine candidates, which are expected to involve 8,500 participants in 10 countries in Africa, Asia, Europe, and the United States. The goal is to identify the best TB vaccines for Phase III trials, the final stage of testing before a new vaccine can be licensed for use.
"Over the past few years, scientists have gained important insights into the immune responses needed to protect against TB," said Dr. Jerald Sadoff, president and CEO of Aeras. "We're working as quickly as possible to test promising vaccine candidates that could help turn the tide of TB around the world."
It has been projected that even a partially-effective new TB vaccine could avert more than 30 million deaths worldwide by 2030. Aeras and its partners have assembled a diverse portfolio of TB vaccine candidates that are ready, or may soon be ready, for clinical trials. Aeras has also helped establish world-class TB research centers in South Africa and India, two of the countries most seriously affected by TB.
"Scientists in Africa and other developing countries are playing a critical role in TB vaccine development," said Dr. Gregory Hussey, director of the South African TB Vaccine Initiative and professor at the University of Cape Town. "An effective vaccine is essential for slowing the spread of TB, and we're proud to be part of the global vaccine effort."
The Foundation for Innovative New Diagnostics (FIND) will use its new grant to advance development of up to 10 new TB diagnostic tests, in the hope of obtaining World Health Organization approval of one or more tests within five years.
Over the past few years, FIND and its partners have identified a number of new diagnostics that could be more accurate than existing TB tests, and could improve diagnosis of the disease in areas that lack sophisticated healthcare facilities.
"The difficulty of diagnosing TB is one of the greatest obstacles to controlling the disease, particularly in patients who also have HIV/AIDS," said Dr. Giorgio Roscigno, CEO of FIND. "We're closer than ever to improved diagnostics, which will help ensure that people infected with TB receive prompt and proper care."
The standard test used to diagnose TB misses half of cases, and requires culturing a patient's sputum sample in the laboratory and examining it with a microscope after an intensive multi-step process. It has been estimated that improved diagnostics could help save at least 400,000 lives every year.
The nine grants for early-stage discovery projects will identify leads for new TB drug compounds that are more effective than current treatment options. Developing new TB treatments is an urgent priority because resistance is growing to drugs that were once widely effective for curing the disease -- last year there were more than 400,000 cases of drug-resistant TB. In addition, there is a need for faster-acting TB drugs; current drugs must be taken for at least six months to be fully effective.
"To stay ahead of TB drug resistance, we need to pursue new, out-of-the- box ideas that have not yet been tested," said Yamada. "These grants could help bring about a new generation of more effective drugs to significantly advance our ability to fight TB."
The TB drug discovery grants include:
--Â $7.5 million to Seattle Biomedical Research Institute
--Â Two grants totaling $3.7 million to Colorado State University
--Â Two grants totaling $2.4 million to Weill Cornell Medical College
--Â $1.8 million to Johns Hopkins University
--Â $1.7 million to Ordway Research Institute
--Â $750,000 to Northeastern University
--Â $453,000 to Ecole Polytechnique Federale de Lausanne
The new grants support priorities in the Stop TB Partnership's Global Plan to Stop TB, a detailed blueprint for reducing the TB burden over the next decade. The plan calls for worldwide spending on TB to triple by 2015. Last year, the foundation pledged to support the plan by providing at least $900 million in TB funding by 2015. With the new grants, the foundation has fulfilled more than half of that commitment.
"TB is a major threat, and stopping it must be a top global priority," said Dr. Marcos Espinal, executive secretary of the Stop TB Partnership. "We have an achievable action plan to reduce the TB burden, and it is encouraging to see new resources going to Stop TB partners to support this plan."
Source: The BillÂ & Melinda Gates Foundation