CAN ONE FOUNDATION CHANGE LIFE ON EARTH?

IT’s JUST a routine checkup, standard for participants in a clinical trial, but when Alice, a South African shop clerk in her forties, visits the Be Part Yoluntu Centre for research, she wears her best outfit: trousers, a blouse, and short heels.

- BY ALEXA MIKHAIL

She wants to be “presentable,” she tells Fortune, because the clinic in Mbekweni, a township northeast of Cape Town, is a special place to her: “What I've seen is that your health matters more when you come here.”

For Alice and the other participants in a global clinical trial for a new tuberculosis vaccine, it’s “not just an injection of IV,” explains Dr. Ronald Kapp, a physician and investigator at the center. “It’s also an injection of dignity.”

In this TB hotspot, with its high unemployment rates and poverty, almost everyone has a friend, neighbor, or relative who has been sick or died from the bacterial lung disease. It’s an awful death: Once known as “consumption,” the world’s deadliest infectious disease appears to consume the human body from within, sometimes filling sufferers’ lungs with fluid. Alice (a pseudonym used to protect her identity and the integrity of the clinical trial), a mother of three, says she is proud to participate in the Phase III trial of what could be the first new tuberculosis vaccine in a century—which health researchers hope will eventually eradicate TB worldwide. Efforts like this one, funded by the Gates Foundation in faraway Seattle, alongside Wellcome, are “going to save the world,” Alice tells Fortune.

A preventable disease that nevertheless killed 1.25 million people in 2023 is a tragedy that to the philanthropist Bill Gates is also an opportunity: “It’s amazing how little work has been done on any tools for TB—TB diagnostics, drugs, and vaccines,” the Microsoft cofounder noted. “TB gets ignored because it’s only in poor countries.” Speaking like the methodical tech pioneer he famously is, Gates explained that the foundation intends to change that, pulling off “breakthroughs in all three of those areas.”

And as Gates told