Grand challenges issued

Ten months after Microsoft founder Bill Gates announced his "Grand Challenges in Global Health" research initiative in Davos, Switzerland, a hand-picked panel of international scientists has drafted a list of 14 challenges, whose solutions could lead to important healthcare advances for the developing world. The list appears in today's issue of the journal Science.The 14 challenges include controlling infectious disease through new and improved vaccines and better management and eradication of the insects that transmit agents of disease. Others call for improved nutrition and better disease measurement in both individuals and populations. Each challenge will receive grants of up to $20 million over 5 years or less. The Bill and Melinda Gates Foundation is funding this $200 million project, which is administered by the Foundation for the National Institutes of Health.A description of deliberations that led to selection of the 14 global health challenges and an outline of steps to apply for funding to address one or more of them are included in a "policy forum" article by Grand Challenges Panel Chairman Harold Varmus and colleagues.The aim of the Grand Challenges is to guide researchers to specific scientific or technical breakthroughs that overcome barriers and find solutions to one or more significant health problems, one of the article's authors, Peter Singer, director of the Joint Centre for Bioethics at University of Toronto, told The Scientist. "We often talk about the 10/90 gap, where 90% of health research resources are devoted to the problems of 10% of the world's population. Here is an initiative that is turning the tide on the 10/90 gap, both through the investment of substantial financial resources, but ultimately, and perhaps more importantly, through capturing the imagination of and engaging the global scientific community to focus on the scientific and technological challenges of five billion people in the world," said Singer, who is also a member of the Grand Challenges Scientific Advisory Board.Gates' Grand Challenges effort joins a growing list of similar initiatives and scientific forums that are forming to tackle the world's most daunting problems. In July, the United Nations Development Programme published the Human Development Report 2003 proposing a series of international forums be created to help set the research priorities required to meet the technological needs of the developing world. In the same month, The Millennium Project, an international think tank with more than 1500 participants, released its 2003 State of the Future report, detailing global views on the challenges facing humanity today. The Millennium Project has also set its own 15 global challenges. It's still too early to tell if these global challenges and research initiatives are going to work in the long run, said Kevin Frost, vice president of clinical research and prevention programs at the American Foundation for AIDS Research in New York City, which works with the National Institutes of Health to fund more avant garde research projects. "It's a gamble, but these challenges make us realize that we do have the resources to make a difference and improve peoples' lives."So far, some of the earliest initiatives, such as the Global Fund, founded by United Nations Secretary-General Kofi Annan to fight AIDS, tuberculosis, and malaria, have not made much headway. Part of the problem is funding, said Frost. Despite a commitment of $1.2 billion, the Fund estimates that it needs between $7 and $10 billion annually in order to turn tide on those epidemics.Still, the global effort to fight AIDS in sub-Saharan Africa gives hope. Five years ago, nobody was talking about the HIV problem in Africa, even though millions were infected, and today we are starting to roll out medicine in Africa, where they are receiving triple-combination drugs, said Frost. "The numbers are small, but it's a beginning. But if you even raised the idea 5 years ago at an AIDS meeting you would have been laughed at."There is early evidence that the Grand Challenges in Global Health initiative has captured the attention of the global scientific community. More than a thousand submissions came from all over the world in response to the call for ideas, said Singer. "Ultimately, if the best scientific minds focus on the problems affecting five billion people in the world, the initiative will be a success," he predicted.Jerome Glenn, director of the Millennium Project, agrees and believes that in the coming years international forums will be increasingly important to share insights, such as the recent lessons learned from the international response to severe acute respiratory syndrome. "These [insights] are being shared, studied, and taken more seriously," he said.According to Frost, whether research questions are answered in the context of these programs is in some way almost secondary. "I know that's why they are formed—to catalyze research in a certain area—but it's the inspiration of it that's almost the greater good because it inspires humanity to aspire to achieve great things."What's most important ultimately is the application of the research, said Singer. "If and when a 'Grand Challenge' is solved, that scientific or technological solution will still have to be implemented appropriately and on a widespread basis, to benefit the global poor," he noted. And that may require an entire new set of Grand Challenges.

Grand challenges issued

Gates initiative joins growing number of urgent research to-do lists

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