Transformations in Research: Gates Foundation Pledges Millions to Global Health

This is the fourth installment in a 2004 series of columns highlighting new methodologies, approaches, and technological innovations in academic research.

By Whitney L.J. Howell

The words "computer" and "software" are synonymous with Bill Gates. But the Microsoft mogul has now linked his name with one of the most ambitious plans for global health in recent history.

Microsoft co-founder Bill Gates pledged $200 million to kickstart a global health initiative that will provide valuable research and healthcare services to areas in greatest need.

Introduced at the start of 2003 and set to launch by October 2004, the Grand Challenges in Global Health Initiative is designed to facilitate healthcare research that will break the cycle of diseases that plagues much of the world's population, says Elke Jordan, Ph.D., Foundation for National Institute of Health (FNIH) assistant director for scientific initiatives and Grand Challenges grant manager.

"Our scientists will strive to create innovative ideas to solve the intractable problems in global health," Dr. Jordan said.

When Gates announced his health brainchild last year, he pledged $200 million through the Bill & Melinda Gates Foundation. He touted it as a marriage of two disciplines that could open the door to worldwide health.

"There is great potential for science and technology to solve persistent global health challenges, but far greater resources are needed," Gates said. "This initiative is about discovery and invention. It is about finding specific solutions to the hardest problems. By accelerating research to overcome scientific obstacles in AIDS, malaria, and other diseases, millions of lives could be saved."

Successful project proposals are expected to tackle serious impediments to healthcare advancement that have not already been researched. They must also provide creative solutions to the problem that could be implemented in less-developed nations. Some disciplines likely to be included in the initiative are immunology, cellular biology and evolutionary biology, according to a description of the program written by Harold Varmus, M.D., panel leader and president of Memorial Sloan-Kettering Cancer Center, and other panel members.

Last summer, a "call for ideas" brought in more than 1,000 submissions to be considered as grand challenges. Although the topics range from nutrition to controlling disease-bearing insects, the majority of the goals revolve around infectious diseases, Dr. Jordan said.

"It just sort of happened," Dr. Jordan said. "It was natural and logical because infectious diseases are a major health problem in the developing world, and we would like to know a lot more about managing these diseases."

According to Carol Dahl, Ph.D., associate director for Global Health Technologies at the Gates Foundation, roughly $70 billion is spent each year throughout the scientific community on medical research and development, but only 10 percent of the money is allocated to diseases responsible for nearly 90 percent of global health challenges.

"The Grand Challenges in Global Health Initiative is helping to address this problem by identifying critical scientific and technological problems that, if solved, could lead to important advances against diseases in the developing world, and engaging the scientific community in developing solutions to these challenges," Dr. Dahl said.

To get Grand Challenges on its feet, a group of 20 scientists and public health experts from 13 countries was assembled to serve as a selection panel. The Gates Foundation does not manage Global Challenges, but two of its employees serve on the panel. Richard Klausner, executive director of the foundation's Global Health program, and William Foege, a foundation senior fellow, are panel members.

The panel accepted applications for project funding through January 2004, including a description of the projects methodology and future applications of any research and findings. The proposals are currently under review, and promising applicants will be asked to submit full applications with more detailed information by June.

If selected, a project could receive a maximum of $20 million over the next five years to conduct research. The amount of money awarded depends upon which aspects of the project fit into the mold the panel has created for the program.

"A chosen project has to have a brilliant new idea for solving a scientific problem with a big impact that can be applied in a developing world country," Dr. Jordan says. "It must be able to deal with the problems prevalent there."

Dr. Jordan says the panel is scheduled to complete deliberations over the projects and announce the winners this October. In addition, she says, the panel is expected to invite another round of project ideas for future awards. Future funding from the Gates Foundation has not been discussed.

Scientists and researchers in charge of selected projects will have the opportunity to negotiate with the panel for more funding based upon the project's goals and potential experimental procedures. After the research is underway, Dr. Jordan says the panel will require regular reports from each venture and will occasionally make site visits to assess the rate of progress and level of accomplishment.

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