The money for malaria is one arm of a much broader, multibillion-dollar global health initiative that Gates helped launch last year aimed at achieving major reductions in disease in poor countries. Vaccines are the weapons of choice.
"It's a lot of money, but it's not just the money that's driving this," said Regina Rabinovich, director of the Malaria Vaccine Initiative based in Washington, D.C., who was in Seattle last week.
Gates' investment in fighting Third World diseases has galvanized the worldwide community, Rabinovich said. The purpose of her organization is to "fill in the gaps" for industry and the public sector to get promising vaccines out into development.
"Gates is challenging us, telling us this is doable, so let's get on with it," Rabinovich said. "The world should have a sense of impatience rather than a sense of resignation."
In that spirit, children in Gambia last week received an experimental malaria vaccine as part of a new clinical trial Rabinovich helped set up with Britain's Medical Research Council. MRC scientists have worked in this tiny West African nation for years.
The vaccine, developed by scientists at Walter Reed and GlaxoSmithKline, had been tested in adults and shown to provide temporary immunity. But industry had shown little interest in carrying it any further.
"It was the first time we had evidence you could succeed against malaria with a vaccine," noted Duffy. "But we still don't really know why it worked or why it didn't last."
It's possible that children may achieve more lasting immunity from the vaccine, something the Gambia trial will test. But even if the vaccine doesn't last, Rabinovich said, it might help some children avoid the infection when they are most vulnerable to the parasite.
Thousands of people, mostly children, die every day from malaria, she said. What can seem like a mild case of flu in the morning can kill by nightfall, Rabinovich said. At least a million children die every year, and the drugs used to combat the parasite appear to be losing effectiveness.
Malaria "Getting Worse in the Tropics"
"The malaria situation is getting worse in most parts of the tropics," said Brian Greenwood, director of the malaria research program at the London School of Hygiene & Tropical Medicine, citing drug resistance combined with increased poverty as factors. Greenwood, who ran the MRC lab in Gambia before moving to the London School, leads one of the top malaria research teams in the world.
Until Gates' investment in malaria research, Duffy said, it was hard to find funding for studying the disease, let alone developing a vaccine.
As Gordon Perkin, director of global health strategy for the Gates Foundation, explained: "Malaria is a disease that primarily affects developing nations. This is not a very profitable market in the eyes of some companies."
Earlier this month, an anonymous donor promised U.S. $100 million over 10 years to establish a malaria research institute at Johns Hopkins University's Bloomsberg School of Public Health. The United Nations recently called for a new global fund dedicated to fighting AIDS, malaria and tuberculosis.
Developing an effective vaccine against malaria is the top priority of the Gates Foundation, Perkin said.
Rabinovich and her colleagues have been given the task of pushing forward the most promising vaccines available. Duffy and the gang at Seattle Biomedical, working with Leroy Hood's Institute for Systems Biology, will be working more "upstream"—using powerful computers to study the genetics of malaria to look for new vaccine targets.
The world community has tried repeatedly to rid itself of this parasite with a bloodlust for humanity. There have been global malaria eradication and disease-control campaigns, which have failed or stalled for lack of resources. The World Health Organization estimates it will take U.S. $10 billion to rid the planet of malaria by 2010, noting that the economic benefit of eliminating the disease would make up the cost within a year.
The fight against malaria is on many fronts, Perkin said, with the ultimate goal of reducing poverty by reducing the burden of disease.
Duffy is just one of the new recruits in the ever-expanding, disease-fighting battalion enlisted by Gates. More will come, he predicted, as Seattle continues to evolve into one of the international epicenters for global health.
"We're going to take this to a different level," Duffy said.
(c) 2001 Seattle Post-Intelligencer
