With a $45.7 million grant from the National Institutes of Health, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College will collaborate on research aimed at improving tuberculosis treatments and stopping the deadly infection from spreading.

NIH has awarded Weill Cornell Medical College more than $6.2 million in first-year funding to support research collaboration among six institutions in close alliance with voluntary pharmaceutical partners.

TB-causing bacteria are increasingly becoming resistant to the most commonly used treatments, presenting a growing problem in a globalized world, TB Research Unit principal investigator Carl Nathan, chair of the Department of Microbiology and Immunology at Weill Cornell, said in a press statement.

For patients who don't respond to those drugs, the infection can require more than two years of therapy with multiple, toxic and expensive alternatives, which often fail. When TB, which is spread through the air, is not effectively treated, it is usually lethal.

"Neither academia nor pharma can solve this problem working alone," Nathan said. "We have to work together to improve treatment of tuberculosis, or it will continue to spread and become even more resistant to treatment than it is today.

Nathan, is also director of the Abby and Howard P. Milstein Program in Translational Medicine.

Michael Glickman, MD, an infectious disease specialist and Alfred Sloan Chair at Memorial Sloan Kettering Cancer Center, serves as the TB Research Unit's co-principal investigator.

TB is the single leading cause of death from a bacterial infection, and the second leading cause of death from any pathogen, Glickman notes in a news release. One in three people are infected with the bacteria that cause TB. Of those people, between 5 and 10 percent eventually develop the active disease.

Each person with an active case of untreated TB may go on to infect 10 or 20 additional people, said Glickman.

There are millions of infections and deaths each year from TB. In 2013, an estimated 9 million new cases were reported and 1.5 million people died, according to the World Health Organization.

"The incredible concentration of TB expertise in the Tri-Institutional community, which includes investigators studying human genetics of TB susceptibility, microbiology, and immunology, constitutes a formidable research team to contribute to tackling these problems," Glickman said.

The TB Research Unit is designed to help address significant gaps in understanding how TB bacteria establish and maintain infection in the human body as well as how agents might attack vulnerabilities in the bacteria.

The translational research in initiatives like this one is underpinned by health information technology to help collect, sort and analyze relevant data.

The most common form of TB is distinctive in that humans are its only natural host. Because the TB bacterium has co-evolved with humans for tens of thousands of years, it "has learned enough about our immune systems to survive our efforts to eliminate it," Nathan said.

Two issues have plagued those efforts: persistence, the ability of TB bacteria to enter a drug-tolerant state, and latency, the capacity of the bacteria to hide within a person for decades before resuming growth and causing disease.

Current TB drugs take months to treat latent and persistent disease, according to Nathan. The drug isoniazid was first tested in the United States in 1952 by a Cornell physician and remains a mainstay. "Most of today's TB drugs are old and would likely not pass federal approval if introduced today," Nathan said.