On Tuesday, the Bill & Melinda Gates Foundation announced its largest package of grants ever to combat tuberculosis globally. With the new $280 million commitment, the foundation brings its total spending on TB research to $740 million. "The goal is to translate promising scientific leads into tools that can save millions of lives," said Dr. Tachi Yamada, president of the foundation's Global Health Program Around one-third of the world's population is infected with the TB bacteria. Travel and immigration are causing a resurgence of the disease in areas where it was largely wiped out decades ago. Yamada said the case of Atlanta attorney Andrew Speaker, who traveled internationally while infected with a drug-resistant TB strain, shows how woefully unprepared the world is to confront the disease.

The new funding will build on previous foundation grants to accelerate development of vaccines to fight TB and improve diagnostic techniques.

TB is still diagnosed by examining sputum samples under a microscope, an approach that misses about half of infections. Culturing TB bacteria to confirm a positive test takes 45 days. "Many people with tuberculosis are never diagnosed and do not receive treatment in a timely manner," said Dr. Giorgio Roscigno, CEO of the Foundation for Innovative Diagnostics, which will receive $62 million over five years. The Geneva- based group aims to develop an accurate TB test that provides results in approximately two hours.

The foundation is also delving into research on new TB drugs in the hope of reducing treatment from the standard six to nine months. But the biggest portion of grant money, $202 million, will go to the Aeras Global TB Vaccine Foundation to fund early clinical trials on six vaccine candidates. "We expect one or two of these candidates may make it all the way," said Dr. Jerald Sadoff, Aeras' president and CEO. If one of the vaccines is proven effective, it could be approved as early as 2015.

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