News of the WeekPUBLIC HEALTH

Gates Foundation Picks Winners in Grand Challenges in Global Health

Science  01 Jul 2005:
Vol. 309, Issue 5731, pp. 33-35
DOI: 10.1126/science.309.5731.33a

In January 2003, Microsoft billionaire Bill Gates challenged scientists to think big. He asked them to identify critical problems that stand in the way of improving the health of people in developing countries, and he announced that the Bill and Melinda Gates Foundation would bankroll novel research projects aimed at solving them. Last week, after reviewing 1517 letters of intent and then inviting 445 investigators from 75 countries to submit full proposals, the foundation announced the winners: 43 projects that will receive a total of $437 million. “We all recognize that science and technology alone will not solve the health problems of the poor in the developing world,” says Richard Klausner, who runs the foundation's global health program. “What science and technology can and must do, however, is create the possibility of new vaccines, new approaches, and new cures for diseases and health conditions that for too long have been ignored.”

The 5-year grants range from $579,000 to $20 million and address 14 “Grand Challenges in Global Health” that mainly focus on R&D for drugs and vaccines, controlling mosquitoes, genetically engineering improved crops, and developing new tools to gauge the health of individuals and entire populations. Grant recipients come from 33 countries—although more than half live in the United States—and include Nobel laureates and other prominent academics as well as investigators from biotechnology companies and government research institutions.* “These projects truly are on the cutting edge of science, and many of them are taking very important risks that others have shied away from,” says Elias Zerhouni, director of the U.S. National Institutes of Health in Bethesda, Maryland, who serves on the Grand Challenges board that evaluated the ideas.

Klausner, who formerly ran the National Cancer Institute (NCI), said the idea for the Grand Challenges grew out of a meeting he had with Gates in the fall of 2002. Says Klausner: “He asked me an interesting question: 'When you were running NCI, did you have a war room with the 10 most critical questions, and were you monitoring the progress?'” They also discussed German mathematician David Hilbert, who in 1900 famously spelled out 23 problems that he predicted “the leading mathematical spirits of coming generations” would strive to solve.


Richard Klausner (left) and Bill Gates confer at the 2003 World Economic Forum, where the initiative was launched.


Gates announced the Grand Challenges initiative at the World Economic Forum in Davos, Switzerland, in January 2003, committing $200 million from his foundation. More than 1000 scientists suggested ideas that led the initiative's board to select 14 grand challenges (Science, 17 October 2003, p. 398). After sifting through the letters of intent and, subsequently, the full proposals, Gates decided to up the ante: The foundation contributed another $250 million; $27 million more came in from Britain's Wellcome Trust and $4.5 from the Canadian Institutes of Health Research.

Researchers applying for grants had to spell out specific milestones, and they will not receive full funding unless they meet them. “We had lots of pushback from the scientific community, saying you can't have milestones,” says Klausner. “We kept saying try it, try it, try it.” Applicants also had to develop a “global access plan” that explained how poor countries could afford whatever they developed.

Nobel laureate David Baltimore, who won a $13.9 million award to engineer adult stem cells that produce HIV antibodies not found naturally, was one of the scientists who pushed back. “At first, I thought it was overly bureaucratic and unnecessary,” said Baltimore, president of the California Institute of Technology in Pasadena. “But as a discipline, to make sure we knew what we were talking about, it turned out to be interesting. In no other grant do you so precisely lay out what you expect to happen.”

Other grants went to researchers who hope to create vaccines that don't require refrigeration, modify mosquitoes so they die young, and improve bananas, rice, and cassavas. In addition to HIV/AIDS, targeted diseases include malaria, dengue, tuberculosis, pertussis, and hepatitis C. Many of the projects involve far-from-sexy science. “We had this idea we were supposed to be hit by bolts of lightning,” says Klausner. “But this is about solving problems. These things aren't often gee-whiz, they're one area applied to a new area.”

Klausner says this is not a one-shot deal. “We're not being coy with people,” he says. “If they hit all their milestones and it looks spectacular, we would expect them to come back and ask for future funding.”


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