It’s hard … even if you have money

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The other day there was a great NYT article about the difficulties the Gates Foundation is having generating vaccines quickly.

For instance, after spending half a billion on a limited number (43) of selected projects, they have not (yet) produced a result.

In 2007, instead of making more multimillion-dollar grants, he started making hundreds of $100,000 ones.

“Now,” he said, only half-kidding, “you get a hundred grand if you even pretend you can cure AIDS.”

That little won’t buy a breakthrough, but it lets scientists “moonlight” by adding new goals to their existing grants, which saves the foundation a lot of winnowing. “And,” he added, “a scientist in a developing country can do a lot with $100,000.”

So they have tipped towards diversity rather than review and deep funding. Of course, the latter is how most government health research organisations operate.

Another insight:

Biology also has a greater tendency to create progress-hindering controversy. For example, doing clinical trials on illiterate subjects in poor countries, which was once cheap and fast but ethically dubious, has become time-consuming and expensive as ethical standards have improved.

This should give us pause. I often wonder what the ethical oversight is buying us. If it delays a vaccine by a year or more, how many lives is that? I’m not suggesting unregulated experimentation but I’d like to know more about what the trade-offs are for a marginal increase in ethical review.

On the other hand, this story seems to exemplify the point of what the Gates Foundation should be doing:

Another grant is ending because it attracted so much commercial backing. Rafi Ahmed, an Emory University immunologist, studies why the immune system’s T-cells get “exhausted” during a long battle against some viruses like H.I.V. or hepatitis C. Eventually, he discovered, the cells start growing “inhibitory receptors” on their surfaces as a self-protection measure. 

Because T-cells fight many diseases, including cancerGenentech, Bristol-Myers Squibb and the National Institutes of Health are all offering him money.

“Without Gates, we wouldn’t have been able to put together the team we did,” Dr. Ahmed said. “The money, and the fantastic vision of a grand challenge — that’s been one of the best things.”

And this is encouraging but I also wonder if it is working the wrong way around.

The fastest-moving project is that of Scott O’Neill, a biologist at the University of Queensland, Australia.

Five years ago, Dr. O’Neill got $7 million to try to infect mosquitoes with a strain of wolbachia bacteria that didn’t kill mosquitoes outright, but made them die before they got old. 

The Gates Foundation is still supporting his work, and the Australian government is now contributing as well, he said. “And if the field trials are successful, worrying about financing isn’t going to keep me awake at night.”

That is, why is the Australian government now interested when it wasn’t before?

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