Five Years In, Gauging Imp Mr. Gates comes from the software in- stantly doubles. Biology, by compari- Biology also has a greater tendency versy. For example, doing clinical trials which was once cheap and fast but eth- While Dr. Sievers's Gates grant is not the Serum Institute of India -the world's biggest vaccine maker-to test The foundation is still supporting two The first attaches vaccines to nano- rants skin inside the nostrils. Dr. James R ically dubious, has become time-con- By DONALD G. McNEIL Jr. SEATTLE Five years ago, Bill Gates made ards have improved. an extraordinary offer: he invited the world's sci- said it works with hepatitis B and flu vaccine. He won a new grant to test the re ts to submit ideas for tackling the biggest tory authoritles and highly educated po- problems in global health, including the lack of litical and scientific elites may be ner- vaccines for AIDS and malaria, the fact that most yous about being misused by Western vaccines must be kept refrigerated and be deliv scientists and careful about accepting The particles are in what Dr. Baker described as a "proprietary formulation ered by needles, the fact that many tropical crops like cassavas and bananas had little n hew technologies. te on on up to two-thirds of the grants either did not get renewed or may not in the near The vaccine ends up inside the oil parti changes and microbes. The immune No idea was too radical, he said, and what he called the Grand Challenges in Global Health would pursue paths that the National Institutes of Health and other grant makers could not. future, Mr. Gates esti system is "made to eat oil droplets" Dr cases, it was because they were not suc- of political obstacles, or someone else had found a better path. In others, the What follows is sample of the Baker said, because it targets viruses, which are essentially time bombs of ge- netic instructions inside casirigs of fats. posals came in, and the top 43 were so promising that the Bill & Melinda Gates Foundation made $450 million in five-year grants foundation changed the goal.. - more than double what he originally planned to that rats fed the equivalent of two quarts a day had only one side effect weight gain. The emulsion by itself cures viral lesions like cold sores, he Now the five years are up, and the foundation recently brought all the scientists to Seattle to as- sess the results and decide who will get further trate the skin but break up the herpes an interview, Mr. Gates sounded somewhat chastened, saying several times, "We were naive the foundation is still backing is a com eral techniquea werked, but paying for plex one against malaria. It fuses the netic backbone" from vaccines against As an example, he cited the pursuit of vac- for cines that do not need refrigeration. "Back then,ion of dollars thought: 'Wow-we'll have a bunch of thermosta-millions froa the Gabes ble vaccines by 2010: But we're not even close to have been puzred 1nto that. I'd be surprised if we have even one by 2015. distribution of a stozen the Rather than being bottled, the vac- cine can be dried onto a bit of filter pa- reir He underestimated, he said, how long it takesated vaccines to get a new product from the lab to clinical trialsheat-stable ones to low-cost manufacturing to acceptance in third-clinics still need refrigerators per. No malaria vaccine comes close to working 100 percent of the time. Dr. Adrian Hill, of the University of Oxford said his is the "the No. 2 most effective ricity for the rest. In 2007, instead of making more multimillion- dollar grants, he started making hundreds of versity succeeded in splicing tetanus n the w Abraham L. Souenshein of Tufts Uni- ing it with its chief rival, made by Glaxo- ria parasite in the liver, while Glaxos It would be a belt-and-braces ap- hat survives heat or cold and can be ended before he could add diphtheria or Dr. Sonenshein said he was grateful money and now might switch to veteri- like to be able to vaccinate their own hundred grand if you even pretend you can cure That little won't buy a breakthrough, but it lets whooping their existing grants, which saves the foundation a effi- lot of winnowing. "And, he added, "a scientist ina developing country can do a lot with $100,000 to the Gates Foundation Over all, he said: "On drawing attention to ary vaccines. s that lives might be saved through scientific l But I thought some would be saving lives by every time, Several scientists at the conference noted that Colorado chem way now, and it'll be more like in 10 years from now. cows and pigs instead of calling the vet bert E. Sievers, 75, a Unliversity of ist, also reached his chief sugar matrix that can be stored dry and the dried brine shrimp)-did not work, so of a device that vibrates air to send par- ticles into the lungs. That didn't work ei- ther, so he desighed 'a puffer that lofts TARGEr Mosquitoes were the focus of resea the sugar in a tiny plastic bag, creating a sweet cloud that a child inhales.