$450 million in Gates grants aims to help poor nations fight disease

British researchers plan to alter the genes of disease-causing mosquitoes, a Nobel laureate in California wants to use stem cell injections to replace vaccines and a Seattle bioengineer hopes to see his hand-held diagnostic device soon at work in remote Africa.

It's all because of a $450 million initiative started by Bill Gates, and co-managed by the Foundation for the National Institutes of Health, called Grand Challenges in Global Health.


		Gilbert W. Arias / P-I
	Paul Yager, a UW professor of bioengineering, received $15.4 million to work on a blood analyzer that will quickly diagnose diseases in poor communities.

Yesterday, the Bill & Melinda Gates Foundation and the NIH announced the recipients of $437 million in competitive grants that were awarded to 43 scientific teams in 33 countries. The project is aimed at enlisting the best and brightest in science to address some of the most critical technical obstacles to improving health throughout much of the developing world.

Nearly $50 million will go to Seattle organizations already playing leading roles in global health.

Two malaria researchers at Seattle Biomedical Research Institute, Dr. Patrick Duffy and Stefan Kappe, received $19 million and $13.5 million, respectively, to continue their efforts aimed at finding an effective vaccine against the parasite that causes the disease.

"This will allow us to put together a much more comprehensive program," said Duffy, who spoke from Tanzania where he and his colleagues are studying malaria in pregnant women. Duffy came to Seattle Biomedical in 2001 because of a $5 million Gates grant that helped create what is now one of the largest malaria research programs in the nation.

Paul Yager, a University of Washington professor of bioengineering, received $15.4 million. Yager plans to develop a blood-testing device that will immediately diagnose diseases in poor communities lacking basic laboratory and medical equipment.

"You can manufacture these things for pennies," said Yager, holding up a prototype of the credit-card-sized blood analyzer he will develop in collaboration with other Seattle partners -- PATH, an international health organization, Micronics, a medical device company in Redmond, and Nanogen, a Bothell-based subsidiary of a San Diego diagnostics firm.

The Grand Challenges initiative, first announced by Gates at the World Economic Forum in 2003, was created because much of science neglects Third World problems.

"Unfortunately, the scientific efforts at creating modern medicine have largely ignored the diseases (of poor countries)," said Dr. Richard Klausner, director of the global health program at the Seattle philanthropy.

"There are 27 million children in the world who fail to receive appropriate immunizations every year and that's largely because of deficiencies in the current immunization programs," said Dr. Harold Varmus, president of Memorial Sloan-Kettering Cancer Center and head of the initiative's scientific advisory board.

Asking scientists to fix these deficiencies -- by combining many vaccines into a single dose that can be given soon after birth, by developing vaccines that don't require refrigeration or finding alternatives to needle delivery -- was a top priority.

Discovering new vaccines against scourges such as HIV, malaria and tuberculosis was another. Although there has been a considerable amount of work done in the search for an AIDS vaccine, much less attention had been given to the search for a malaria vaccine before the Gates Foundation invested more than $150 million in the effort.

"Yet malaria kills at least a million people every year," noted Kappe.

Although Duffy and his colleagues are looking for vaccine targets by analyzing natural immunity among Tanzanian women and children, Kappe is genetically altering the parasites to see if a mutant form of the bug might be useful as a vaccine.

"We find that when we disrupt some genes, the parasite becomes attenuated (slightly disabled) and cannot cause infection," he said. But in experiments on mice, it does appear to stimulate immunity to further infections, Kappe said.

The Gates grant, he said, will allow Seattle Biomedical researchers to expand their search of the 5,000 or so genes in the malaria parasite to find the best ones to disrupt for a mouse malaria vaccine.

"Once we identify this in the rodent model, we will go to humans," Kappe said.

Other top priorities for the Grand Challenges initiative include improving the nutritional values of staple foods such as rice, cassava, bananas and sorghum, short-circuiting the disease-spreading nature of mosquitoes and improving drug therapies for chronic infections. One grant recipient, Nobel Prize winner David Baltimore at the California Institute of Technology, received $13.9 million to explore using genetically engineering stem cells to boost immunity in people with HIV. If Baltimore's approach works for HIV, perhaps a patient's stem cells could be "pre-programmed" to protect against any infectious disease.

"It's an extremely interesting idea ... that literally proposes to replace vaccines entirely," Klausner said.

But Baltimore's project also sounds especially speculative and unlikely to produce anything that will, in the near term, help the millions of people dying now from mundane diseases such as diarrhea or fever.

A number of public health experts have expressed concern that the Gates Foundation is becoming too enamored of "upstream" scientific projects and is moving away from its original emphasis of expanding the use of health tools already available -- such as basic vaccines or drug therapies -- to prevent disease and save lives now.

Klausner rejected such criticism, noting that the $450 million for Grand Challenges amounts to only about 8 percent of the philanthropy's total projected global health budget for the next five years.

"We don't see this as a sign of our walking away from the commitment to solving problems of global health as quickly as possible," said Klausner, noting that the foundation has given $1.5 billion to the Global Alliance for Vaccines and Immunization to greatly expand the number of children getting basic immunizations.

"We have a broad range of activities that run from delivering health tools now ... to investing to create health tools that are needed but we don't have now," he said.

Also yesterday, the Wellcome Trust in Britain said it would contribute $27 million and the Canadian Institutes of Health Research promised $4.5 million to the Grand Challenges, which still had $13 million left after recipients were announced yesterday. Klausner said it is likely there will be another round of grants, perhaps with more emphasis this time on funding projects run by scientists in developing countries.

P-I reporter Tom Paulson can be reached at 206-448-8318 or tompaulson@seattlepi.com