Flying Syringes and Other Bold Ideas

Bill Gates, co-founder of the Bill & Melinda Gates Foundation gives a baby an oral Polio vaccine at the Shadnagar community health clinic in Andhra Pradesh, India, November 14, 2002. Gates is wrapping up his trip to India where learned about the country's health system.    (AP Photo/Jeff Christensen,Reuters)
Bill Gates, co-founder of the Bill & Melinda Gates Foundation gives a baby an oral Polio vaccine at the Shadnagar community health clinic in Andhra Pradesh, India, November 14, 2002. Gates is wrapping up his trip to India where learned about the country's health system. (AP Photo/Jeff Christensen,Reuters)

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By Tim Johnston
Washington Post Foreign Service
Thursday, October 23, 2008

BANGKOK, Oct. 22 -- The charitable foundation founded by Microsoft Corp. Chairman Bill Gates has awarded 104 grants, each for $100,000, in a bid to inject entrepreneurial boldness and risk-taking into the often staid world of medical research.

Announced in Bangkok, the grants are the first stage of a $100 million, five-year project the Bill and Melinda Gates Foundation hopes will encourage research into innovative medical ideas that it feels now have little chance of development, largely because of how funding is distributed.

In making its picks, the foundation has rejected the widespread practice of peer review -- assigning other specialists in a field to evaluate research -- because, in the words of Tadataka Yamada, the foundation's director of global health, "peer review -- by definition almost -- excludes innovation because innovation has no peers."

Yamada cited Australian researchers Robin Warren and Barry Marshall as among his inspirations. When the two suggested that peptic ulcers were caused by a bacterium rather than stomach acid, Yamada, a gastroenterologist, was among what he calls the "acid mafia" who rejected the seemingly eccentric claims out of hand.

To prove his point, Marshall drank the bacteria, making himself severely ill before he was cured with antibiotics. The mafia was wrong, and the two Australians won the 2005 Nobel Prize in medicine.

"For me it was a revelation. I resolved . . . that I would always try to look for the new ideas and foster the notion that the most outlandish ideas could be transformative to the field," Yamada said.

The winning grants offer a bewildering array of ideas from a bewildering array of researchers. Hiroyuki Matsuoka of Jichi Medical University in Japan wants to turn mosquitoes into flying syringes to deliver vaccines rather than illness.

Nobel laureate Andrew Fire is going to look at whether turning off single genes by a technique called "RNA interference" can be used to fight viral infections.

"Really it's just opening the world up to a broader array of ideas, rather than placing our bets on just a few horses that might not ever succeed," Yamada said.

In this first phase of the Gates Foundation project, applicants for the Grand Challenges Explorations grants were asked to concentrate on some of the biggest killers in the developing world: HIV-AIDS, malaria, tuberculosis and other infectious diseases.

In applications, the foundation asks only for the outline of a hypothesis and a way of testing it: It does not require applicants to provide data to support their theory, a requirement that puts many researchers, especially those from the developing world, in a chicken-and-egg situation.

"It's usually very difficult," said Pattamaporn Kittayapong of Thailand's Mahidol University, who has won a grant to study ways of preventing the transmission of dengue fever. "Usually they are looking for an idea that has some kind of backup before you get funding."

The simplicity of the application process -- a two-page form -- has opened the door to ideas and researchers who were previously out in the cold. "I think that has helped a lot because we usually have a lot of problems going for grants because English is not our first language," Pattamaporn said.

About 15 percent of the applications and grantees come from developing countries.

The proposals were evaluated by an internal foundation board and an external panel whose members were picked for their entrepreneurial and innovative record rather than their medical expertise.

If the grants show that the ideas have merit, the foundation is offering secondary funding of $1 million over two years to take them further.

Grant winners are asked to sign contracts specifying that if any significant breakthroughs result, they will be made available at affordable prices in the developing world.


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