Making a difference where it’s needed most: Infectious Disease at Wellcome

Around 9.5 million people die from infectious diseases every year. The burden falls overwhelmingly on communities in Africa, South Asia and South-East Asia – places where health systems are stretched and commercial incentives to develop affordable vaccines and treatments are weakest. 

These are diseases of inequity. Tuberculosis, cholera, dengue, schistosomiasis, leishmaniasis – they thrive in the gaps left by underinvestment and neglect. Drug resistance is growing and climate change is pushing the spread of disease into new regions. Yet the tools available to fight many of these diseases are inadequate, inaccessible or, in some cases, over a century old. 

I've spent my career working on these diseases, researching and treating tuberculosis in South Africa. I've seen what happens when the right tools reach the right people – and what happens when they don't. 

That experience reflects a much wider pattern of unmet need and it drives everything we do in Wellcome's Infectious Disease programme.  

We have the independence to back science that others cannot or will not fund. That means strengthening the evidence base on how diseases emerge and spread, accelerating the vaccines and treatments to tackle them, and overcoming the barriers that stop life-saving tools from reaching the people who need them.

Our focus is clear: we support science that leads to vaccines and treatments that make a difference where the burden is greatest. But developing new products is not enough. They must work in the settings where disease hits hardest, be affordable and accessible, and be shaped by the communities who will use them. 

Take tuberculosis. It is preventable and curable, yet it remains the world's biggest infectious disease killer, claiming more than a million lives each year. 

The only licensed vaccine – Bacillus Calmette-Guérin, or BCG – is over 100 years old and offers limited protection for adults and adolescents, who account for most cases. 

But there is real hope. We're supporting a phase 3 trial of M72, a new vaccine candidate, across South Africa, Zambia, Malawi, Kenya and Indonesia. If successful and introduced at scale, it could prevent up to 76 million cases of tuberculosis by 2050. 

Cholera tells a similar story of neglect meeting urgency. Outbreaks are resurging in countries that had not seen significant numbers of cases in years, driven by conflict, natural disasters and climate change. Global vaccine supply cannot keep pace. Through Hilleman Laboratories, we supported the development of HillChol, an oral cholera vaccine approved and launched in India in 2024 by Bharat Biotech. Alongside this, we're funding research to understand where and when outbreaks are most likely to strike, so health systems can act before epidemics take hold. 

Drug-resistant infections pose a different but equally urgent threat. Bacterial antimicrobial resistance is projected to cause 39 million deaths by 2050, yet commercial investment in new antibiotics has collapsed. We’re investing in early-stage discovery through partnerships like CARB-X and the Gram-negative Antibiotics Discovery Innovator (Gr-ADI), launched in 2025 with £50 million in joint funding alongside the Novo Nordisk Foundation and the Gates Foundation. 

Meanwhile, schistosomiasis affects 250 million people, with 90 percent of cases in sub-Saharan Africa. Despite its scale, it remains underfunded and underprioritised. We're funding drug development to replace or complement existing treatments, investigating why current approaches fail to eliminate the disease in some settings, and supporting a pioneering study in Uganda that is accelerating vaccine progress through a human infection model. 

These diseases share the same root causes: high burden in low- and middle-income countries, inadequate tools, limited commercial incentives and persistent barriers to access even when solutions exist. 

Investing in new vaccines and treatments is essential, but it is only the beginning. 

To ensure these innovations reach the people who need them most, we must also shape the policies and systems that determine access and delivery. That means building the delivery infrastructure, financing and uptake needed so that vaccines and treatments don't stall before they reach the communities that stand to benefit. 

Without this work, even the most promising scientific breakthroughs risk never making a real-world difference. 

That's why we tackle the gaps in the research and development ecosystem that slow innovation and limit access to life-saving tools – from strengthening the evidence countries need to make informed decisions, to ensuring infectious disease research is protected, prioritised and positioned to deliver lasting change. 

We're working towards a future where health systems in the highest-burden regions do not just implement solutions designed elsewhere – they drive innovation from within. Where children complete their education free from preventable illness. Where entire communities have the tools, systems and resilience to detect, respond to and overcome infectious disease threats. 

The question is not whether science can deliver the vaccines and treatments the world needs. It's whether we can act with the speed, fairness and ambition required to make sure they reach the people who need them most.