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Published: Monday, 2/9/2009

Bill Gates taps science to rid world's poor of disease

IN 1900, the German mathematician David Hilbert presented 23 unsolved problems to the International Congress of Mathematics. He predicted that research on the problems would result in significant breakthroughs in science, technology, and medicine. He was correct.

The Melinda and Bill Gates Foundation through its Global Health Program has thrown a similar challenge to the scientists of the world. The program funds research to find cures for the most common diseases that afflict the world's poorest of the poor. The challenge is to use human ingenuity and find solutions that defy conventional wisdom.

The disease burden and the resulting disability and deprivation have been overwhelming for developing countries. More than 7 million adults and children die of preventable and treatable diseases, such as respiratory and diarrheal diseases, and tuberculosis and malaria. Another 3 million die infected with HIV. The heaviest toll is on children, as about 9.7 million die of diseases that can easily be treated or prevented.

The economic and human toll of these diseases in poor countries, and the relative lack of research in the diseases of the poor, are startling. Of the $70 billion that is spent every year on medical research and development, only 10 percent is earmarked for diseases that cause 90 percent of the global disease burden. Looking from another angle, in the last 25 years, the U.S. Food and Drug Administration has approved 1,500 new drugs, but only 20 were for diseases that disproportionately affect the developing world.

The innovative approach adopted by the Gates Foundation is called the Grand Challenges in Global Health. It funds interdisciplinary research the world over to find new remedies for age-old maladies. The interesting and fascinating aspect of this funding is that most of the new approaches are unconventional and unorthodox.

There are no precognitions for researchers seeking funding. The foundation funds hundreds of proposals at the initial allocation of $100,000 each. If initial research shows promise, the grant can be renewed or increased. The application is only two pages, and the applicant does not have to have a proven record. A decision to fund is made within three months, a short time compared to how long it takes to have an application reviewed by other funding agencies that require an elaborate and time-consuming peer review process.

The Gates Foundation is funding research to protect against infections, increase understanding, and prevent bacterial resistance to drugs. It also aims to find new ways to prevent or cure HIV, and understand why tuberculosis reactivates after lying dormant for a long time. The foundation will issue new challenges every six months.

The array of research proposals submitted and those approved boggles the mind.

A researcher in the Netherlands would develop antibodies to trick HIV into entering the host cells where the virus could not replicate. In the United Kingdom, a scientist hopes to develop antibiotic-laced living bacteria to prey on the disease-causing organisms.

A Canadian researcher is developing nanoparticles that would "soak up" harmful viruses circulating in the body. An extension of this concept, proposed by another Canadian, would be to capture and remove the cholera toxins from the body. This would open the field to develop drugs against cholera, where none exists.

Perhaps the most intriguing concept being pursued is by a Japanese researcher trying to breed vaccine-laced harmful mosquitoes and to have these flying syringes inoculate populations against certain diseases.

Far-fetched? Outlandish? Yes, but the history of medicine is replete with examples where innovative ideas led to breakthroughs. Take the example of heart surgery.

A story is attributed to the legendary surgeon-researcher Dr. Owen Wangensteen of the University of Minnesota, who directed one of his bright surgery trainees, Dr. Richard DeWall, to go to the lab and not come back until he had found a new way to oxygenate blood during open-heart surgery. And Dr. Wangensteen also told Dr. DeWall to ignore all previous research on the subject and start afresh. Using odds and ends worth $15 and some beer tubing, the young researcher developed the famous DeWall-Lillehei bubble oxygenator in 1955 and ushered in the modern era of open heart surgery.

The United States has been a giant incubator for innovative ideas and spectacular breakthroughs.

After all, it was a young college dropout by the name of Bill Gates who developed a personal computer in his garage and ushered in an era that has taken mankind to discoveries that were unthinkable just 40 years ago.

Now the same man is using his wealth to help the world's most unfortunate people.

Dr. S. Amjad Hussain is a retired Toledo surgeon whose column appears every other week in The Blade.

Contact him at: aghaji@bex.net



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