The X PRIZE Foundation has received a planning grant from the Bill & Melinda Gates Foundation to develop an X PRIZE for effective diagnosis of tuberculosis in the developing world. The overall goal of the prize will be to promote better management of the world’s second most lethal infectious disease. Innovation will need to be tailored for the use in under-developed regions, where over 60% of tuberculosis patients have access to only primitive, peripheral health clinics with scarce resources. A prize in this area would be designed to save millions of lives in the world-wide, among people who need help the most.

The Pandemic

Tuberculosis is caused by the bacteria Mycobacterium tuberculosis. The disease typically affects the lungs, although just about every organ in the body can be affected. There are two types of tuberculosis, which is transmitted primarily through the air: latent and active. Latent tuberculosis occurs when a person is infected with the TB bacteria, but doesn't have any symptoms and can't transmit the disease. The body's immune system is handling the infection. Active TB occurs when the bacteria begin overwhelm the immune system. 75% of the time, active TB manifests itself in the lungs. This is the stage in which the disease is easily transmittable.

In developed countries, people don't often think about tuberculosis, because a cure of antibiotics is readily available, and methods of diagnostics are quick and available. But in 2006 there were more than 9 million new cases of TB world-wide. Around 1.7 million deaths from the disease. There is an antibiotic cure readily available that could put a halt to this world-wide pandemic, but the methods of diagnosis are severely lacking.

Current Diagnoses

The most commonly used diagnostic method (smear microscopy) used in these under-developed regions fails to efficiently and accurately diagnose tuberculosis. Patients must travel at great cost and time to microscopy centers to receive insensitive tests requiring trained technicians and repeated clinic visits. This current “state of the art” has a sensitivity of approximately 40%. As a result of these challenges, many people, especially those who have latent TB, are in the early stages of infection, are co-infected with HIV, or suffer from extrapulmonary TB, are under diagnosed and treated, resulting in significant death, suffering, and the continued spread of disease.

The need for a prize in tuberculosis diagnostics was first recognized by the Advisory Council of the X PRIZE Foundation’s Life Sciences Group. The idea was also independently explored by a classroom of students at the X PRIZE Foundation’s X PRIZE Lab @ MIT. The Lab is a semester long class that focused on Health Care in the Developing World in the spring of 2008. As part of an ongoing project, several students discussed a need for a prize in this area, leading to combined discussions with the Gates Foundation, which resulted in the grant.