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Foundation Gives HMS $45 Million To Fight TB

By Tova A. Serkin, Crimson Staff Writer

In the largest ever private donation to fight tuberculosis, the Bill and Melinda Gates Foundation last week awarded a five-year, $44.7 million grant to a Harvard Medical School program that will use the funds to battle multi-drug resistant tuberculosis (MDR-TB) in Peru.

"What the foundation has done has really shaken up the entire public health world," said Instructor in Medicine Jim Y. Kim, the principal investigator for the grant. "Even a year ago no one would say we have to think about MDR-TB all over the world...but the Gates Foundation is taking [it] on."

A treatment for tuberculosis, the number one infectious killer in the world, was found in the 1940s, but the disease continues to spread, especially in developing countries. HIV has made the problem worse, as those infected with the HIV virus are far more likely to contract tuberculosis.

And in recent years, a bigger problem has begun to loom. Improper use of tuberculosis medications has led to the creation of the MDR-TB strains, which are resistant to cocktails of even four or five drugs. Currently 11 percent of all tuberculosis cases are resistant to at least one drug.

Until now, few funds and support have gone to treat MDR-TB because some have argued that it is too expensive or too difficult to treat and that it is more important to focus on regular tuberculosis.

But according to Kim and other noted public health experts, MDR-TB is a rising threat that must be addressed before it is too late.

"It's very important to treat MDR-TB in other parts of the world because ultimately we need to prevent the further spread of MDR-TB into the United States," said a spokesperson for the Center for Disease Control's Division of TB Elimination.

The Plan

The Gates Foundation grant will be used to try to eradicate all cases of MDR-TB in Peru, the first effort by any organization to eliminate the resistant strains.

"There is no program that has effectively taken on MDR-TB," Kim said. "Because we've been working in Peru and they have the best national program for TB control it's a great place for us to start."

The hope, according to a press release from the Gates Foundation, is that the project in Peru will then be able to be used as a model for other countries.

"We've done a lot work in TB. I think this is just another component in what we're trying to do in that area," said Annemarie Hou, a spokesperson for the Foundation.

The goal is two-fold Kim said.

"On the one hand, the first and most important part is that we'll get to treat patients," he said.

The other side of the project is to learn more about drug resistance and how to diagnose it quickly.

Kim stressed how important this grant is to furthering the goal of global health equity.

"The world is changing for poorer people and their health," he said. "Where we would like to end up is for people to look back at this time and say there was a day when we thought it was okay not to treat TB and HIV in poor countries, can you imagine, what were they thinking?"

The Foundation, funded by Bill Gates, a member of the Class of '77, is dedicated to helping stop vaccine-preventable diseases, alleviate conditions of the poor and improve maternal and child healthcare, according to Hou.

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