Last week a young man named Onekalit turned up with a nasty cough to a health center we operate in a youth prison in Gulu, Northern Uganda. The dry cough wore him down for over a month, but last week he managed to cough a bit of sputum into a small plastic container. The incredible Gates-Foundation-funded GeneXpert test confimed our fears – Tuberculosis
But Onekalit will be OK – after 6-9 months of gruelling treatment, the TB will be cured. He will not become one of the 1.5 million people that TB kills every year, more than double that of malaria. After covid subsided TB has now regained the dubious honour of the world’s deadliest infectious disease.
The Gates Foundation helped bring the amazing GeneXpert diagnostic test to places like rural Uganda, but Bill and co. are now going a step further making their biggest ever 400 million dollar bet on a vaccine that initial trials show may be 50% effective in stopping TB progress from latent infection to deadly lung disease.
The first new effective TB vaccine in over 100 years.
Surprisingly this vaccine has been sitting around (in a form) doing nothing much for around 20 years. GlaxoSmithKline (GSK) bought the patent almost 20 years ago, before publishing a trial which showed it was actually quite good and could save millions of lives, then decided they couldn’t make money from the vaccine so shelved it...
Unfortunately, our economic system is not set up to bring a vaccine which could save hundreds of millions of future lives to market. Fortunately our economic system does allow people like Effective Altruists and Bill Gates to donate their own stacks of cash towards life saving endeavours that the market has failed to bring to fruition.
This mind bogglingly expensive 550million dollar trail is necessary because TB is a slow disease. Slow to divide, slow to spread, slow to treat. Tracking and follow up TB takes far longer than for your average infectious disease. For malaria, within a year we can start to see whether a vaccine works. For TB it will take at least 5 times as long – 5 years or more before we know whether we are onto a winner.
If the vaccine really is 50% effective, it could save around 10 million lives in the next 25 years, not to mention helping prevent the terrifying Antimicrobial Resistance (AMR) that TB has already partly achieved.
500 million died from Smallpox (“but not a single one more”) – over 1 billion have died from TB. We remain far a from “not a single one more” in the case of TB – but this could be a spectacular step in the right direction.
Not his real name
https://www.who.int/news/item/27-10-2022-tuberculosis-deaths-and-disease-increase-during-the-covid-19-pandemic - Although from an effective altruism perspective the suffering caused by malaria is worse, because malaria kills mostly young children, whereas TB kills people of all ages.