Bill & Melinda Gates Foundation | 2000 Annual Report

Partners for TB Control

Gates Millennium Scholars

Northwest Territories

First Place

Harvard Medical School
$44,712,896 over 5 years to support PARTNERS for TB Control.

"WHAT I LOVE MOST ABOUT OUR MEETINGS is that they are contentious!" offers Dr. Kim, describing the sparks that sometimes fly when some of the brightest minds in the fight to stop TB gather together to share information and plot strategy. The progress being made at these gatherings ripples through hard-hit places like Carabayllo, Peru, where the DOTS strategy is saving lives.

Dalia Guerra explains treatment to a new patient with MDR-TB

Dalia Guerra - Changing Her Community and Her Future

Dalia grew up in the poverty-ridden community of Carabayllo, outside of Lima, Peru. Determined to change her future, she enrolled in the local college. When her family could no longer afford the tuition, she was forced to end her education and, with it, her hopes of becoming a nurse. Now, funding provided to Carabayllo through PARTNERS for TB Control has paid her tuition while she works as a healthcare volunteer. She is currently finishing her thesis and about to receive her bachelor’s degree.

"It is so good to help these people that had no chance of a cure in the past. Some were considered terminal patients. Now the miracle has happened...they are cured, alive, and with more years to enjoy time with their families. They can make their dreams and aspirations reality. I am very fortunate to be able to help them."

Dr. Bayona reviews an x-ray

Dr. Jaime Bayona - Reawakening a Community’s Spirit

Dr. Jaime Bayona has worked in the community of Carabayllo just south of Lima, Peru, for most of his professional life. He is intimately familiar with the insidious consequences of tuberculosis and the obstacles that can prevent effective treatment: slow and cumbersome methods of diagnosis, complicated drug regimens, unaffordable pills, and fear and distrust of the healthcare system trying to deliver the cure. When he learned that PARTNERS for TB Control was going to fund tuberculosis treatment for his community, he was stunned. "I couldn’t believe that anyone from the outside was willing to support our treatment plans and work in our poor neighborhood," he says. "These resources came at such a critical time for us." The grant reached Carabayllo in time to buy additional drugs and train new healthcare volunteers to deliver them. "When we got the news that the first patient had been cured after being sick for so many years, we had such a party!"

Most heartening to Dr. Bayona, the newly invigorated program’s success has reawakened a sense of community that had been waning. Financial support for volunteer training builds on traditional values and local support systems that had begun to lose hope in the face of poverty, chronic illness, and a sense of abandonment by higher officials. Some funds are being used to pay for higher education in exchange for volunteer work. Many students are becoming nurses, health aides, or doctors, infusing the neighborhood with a higher employment rate and standard of living.

A support group meeting for TB patients

The World Health Organization (WHO) likes to describe multidrug-resistant tuberculosis (MDR-TB) as "Ebola with wings." It’s an infection with the capacity to travel the globe, multiplying and increasing in virulence on a geometric scale. As director of the Program in Infectious Disease and Social Change at Harvard University, Dr. Yong Kim has a unique understanding of the cultural and political factors influencing diseases such as tuberculosis, which vies with HIV/AIDS for killing more people than any other infectious agent on the planet. The bacteria responsible for causing this potentially fatal lung disease can usually be killed with a combination of several antibiotics taken over six to nine months. But, resilient and adaptable, tuberculosis organisms that are not eradicated during initial therapy will emerge highly resistant to the same antibiotics that were originally curative. Each time a patient is left only partially treated, the risk of developing MDR-TB is ignited. To stop its spread, accurate and complete drug dosing is critical. Effective TB treatment models that can help prevent resistance exist, but lack of organization, manpower, and affordable medications often limit their potential.

A $44.7 million grant from the Bill & Melinda Gates Foundation is being used to create a new coalition, PARTNERS for TB Control. PARTNERS stands for Partnership Against Resistant Tuberculosis, a Network for Equity and Resource Strengthening. Dr. Kim’s group at Harvard will join forces with the World Health Organization, the U.S. Center for Disease Control, the Massachusetts State Laboratory Institute, and the Task Force for Child Survival and Development.

Any one of these groups can claim a proud record in the TB battle. But combined, they carry the scientific clout, field experience, and financial resources to build the groundwork needed to fight MDR-TB at a global level. Uniting their talent vastly multiplies their independent chances for eradicating TB. "What I love most about our meetings is that they are contentious!" offers Dr. Kim. "We meet face to face and discuss every detail: When should lab tests be done? When should new drugs be given? How will our responsibilities be divided? And we don’t leave the table until we have those problems solved."