Gates Funds More TB R&D

THE BILL & MELINDA GATES FOUNDATION, already one of the world's leading backers of tuberculosis R&D, has just increased its commitment by $280 million. Spread across 11 new grants, the money will help accelerate the development of new drugs, vaccines, and diagnostics. Existing therapies and diagnostics have failed to control the disease, including drug-resistant forms, making TB a global health problem (see page 21).

"Current TB tools are outdated and inadequate," says Tachi Yamada, president of the Gates Foundation's Global Health Program. "Very important progress has been made in TB R&D, particularly in the past five years, and the new grants will build on this."

The grants address priorities in the Global Plan to Stop TB, a detailed program put together last year by the Stop TB Partnership, a network of more than 500 public and private organizations. Last year, the Gates Foundation pledged to invest at least $900 million in the plan by 2015, and the latest grants bring its total to $740 million.

The largest grant, $200 million over five years, goes to the Aeras Global TB Vaccine Foundation, a public-private development partnership. Aeras will use the funds to conduct Phase I and II clinical trials of up to six new vaccine candidates (see page 34). Its goal is to identify the best candidates for Phase III trials and have at least one vaccine ready for approval by 2014.

"A better vaccine could reverse at least 30 million deaths worldwide by 2030," says Aeras CEO Jerald C. Sadoff. The grant will also help Aeras support research centers in South Africa, India, and other places seriously affected by TB.

The Foundation for Innovative New Diagnostics (FIND) will receive $62 million over five years to develop more accurate and easier-to-use TB tests (see page 39). Today's standard diagnostic test works only 50% of the time; a more sensitive test takes months to complete.

"Many people with TB are never diagnosed or do not receive treatment in a timely manner," says Giorgio Roscigno, CEO of FIND. An improved point-of-care diagnostic test could save 400,000 lives every year, he adds. FIND will advance up to 10 new tests and, it hopes, obtain World Health Organization approval of at least three of them within five years.

Nine grants totaling $18 million are going to individual research institutions under the Gates Foundation TB Drug Accelerator initiative. These early-stage drug discovery projects will work toward better understanding TB and identifying drug leads. Although many potentially more effective compounds are in clinical testing, "what we need is a sustained effort to build a much more robust set of candidates," adds Ken Duncan, senior program officer at the Gates Foundation.

Funding for TB R&D is supported largely by public and philanthropic sources. "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," said Marcos Espinal, Stop TB executive secretary, when the awards were announced. Earlier this year, the Stop TB Now Act, which would set targets for increased funding, was introduced in Congress.

To fully enact its plan, Stop TB envisions that $56 billion will be needed between 2006 and 2015. About $47 billion of that would go to medications, health care, and social services. Another estimated $9 billion, of which about $3 billion has been identified, would be needed to develop new drugs, vaccines, and diagnostics.