Bill Gates 2.0
Traditional methods of scientific research have not produced the medical breakthroughs he expected. Now he's going to use his money, through the Gates Foundation, to challenge old ways. The man is breathtaking.
Having departed Microsoft, Bill Gates will now concentrate his full and formidable attention on the Bill and Melinda Gates Foundation and the intractable problems of global health. Being Bill Gates, he plans to solve them completely and permanently. In this effort, he will be overthrowing some traditional research practices and deploying some methods learned at Microsoft in trying to solve long-standing scientific challenges. Can he do it?
I used to think that given enough money and enough top scientists, time, and a fierce persistence, we would solve these health riddles. Now I worry: Maybe not. Gates does, too, which is why he is going at these challenges in some quite different ways that may dramatically shake up the way we do science.
Consider, for instance, the AIDS vaccine effort. After an unprecedented, quarter-century scientific offensive, it has failed badly. None of more than 30 vaccines tested have worked or provided insight into what might. The most recent candidate seemed to increase the risk of HIV infection. DNA sequencing technology and its scientific offspring, genomics, have not led to a breakthrough. Today's "rational drug design" has yet to break free from the trial-and-error methods of the past. The new model, wrote a Gates-funded researcher in tuberculosis, "completely collapses beneath the complexities and peculiarities of the disease."
Meanwhile, TB is pulling away. More than 400,000 people a year contract a strain resistant to multiple antibiotics; XDR or extensively drug-resistant cases are on the rise and essentially untreatable. Malaria, even with each of 5,300 genes laid bare, is currently "setting records" for fatalities, an incredulous Gates has observed.
Gates moves into his full-time role at his foundation following a decade's invovlement with unleashing the full potenital of science and technology on global health. First, Gates ended the neglect of diseases of the developing world. "The real missing element," he said years ago, "is applying biology to the diseases of the developing world. That's where the market mechanism doesn't work." Market forces, Gates added, put curing baldness ahead of curing malaria. Some $37 billion in assets and a bit of ingenuity later, the Gates Foundation has rectified this market imperfection to an admirable degree, through public-private partnerships and by creating an artificial demand curve to entice pharmaceutical companies into the field.
Initially, when it came to the specifics of applying biology, the foundation and Gates were hands-off. In 2000, with a minuscule staff of six, the foundation picked the best organization for a given disease and issued big blocks of cash, which others carved into grants and projects. But Gates was also looking to contribute in "clever ways," as he said, "so that it's not just writing checks."
Those munificent checks bulked up global health research capacity. Next, Gates gave it direction. In 2003, he handed down an agenda at the World Economic Forum in Davos, Switzerland, in the form of Grand Challenges that identified the 14 most critical scientific obstacles to global health. Gates drew inspiration from David Hilbert, who, at the dawn of the 20th century, put forth a set of ambitious mathematics problems which he hoped "the leading mathematical spirits of coming generations" might strive to solve.
Gates' Grand Challenges dangled nearly half a billion dollars before researchers. Further enhancing the engine of innovation — and ruffling feathers in the research community — the Gates Foundation required applicants to specify milestones, timelines, and deliverables. "In no other grant," said Nobel laureate David Baltimore, who got one, "do you so precisely lay out what you expect to happen."
Gates expected breakthroughs as he handed out 43 such grants in 2005. He had practically engineered a new stage in the evolution of scientific progress, assembling the best minds in science, equipped with technology of unprecedented power, and working toward starkly-defined objectives on a schedule.
But the breakthroughs are stubbornly failing to appear. More recently, a worried Gates has hedged his bets, not only against his own Grand Challenge projects but against how science has been conducted in health research for much of the last century. Among Gates' first tasks in his new job will be sorting through grant applications for his new Grand Challenges Explorations, a search for completely new ideas in global health.
In an invitation/indictment recently appearing in the New England Journal of Medicine, the foundation faulted the research establishment for its "unchallenged dogma" and "traditional thinking," noting the failed AIDS vaccines and timid research in AIDS, malaria, and tuberculosis that has produced only "incremental innovation."
The Explorations reflect Gates' decade-long, top-to-bottom reform of global health. Gates has now bored down practically to the lab bench as, simultaneously, he arrives to take a direct hand at his foundation. He's squeezing the elements of innovation together, trying to generate and capture "transformative innovation" on a remarkable scale that recalls the discovery of vaccination itself.
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Comments:
Posted Mon, Jun 30, 7:10 a.m. inappropriate
The Explorations Model Works for Others: There is a case to be made that scientists do their truly creative work before the age of 35 or 40. There is certainly some empirical evidence that this is the case. The best example of this is the fascinating history of Research Corporation, the second oldest philanthropic foundation in the US. Now 95 years old, Research Corporation is very small. The dollar total grants they make are less than UW researchers spill on paper clips in any given year, and half of that small amount is to promote science education rather than research. The research grants they make are small, about $100,000, and are restricted to scientists in the third year of their first tenure track appointment. Another unusual characteristic of Research Corporation is that all officers, directors and advisory board members are scientist. There are no MBAs, lawyers, developers, philanthropists, politicians, socialites, pundits, policy wonks or other assorted twits at the foundation. So what are the results? Over 95 years, with a tiny endowment, Research Corporation has financed or helped finance the research of 30 American Nobel Prize winners, including some of the biggies. It is probably a good thing that they don't have Gates Foundation type of money; they would get distracted by modern management practices and end up with a big goose egg.
Posted Mon, Jun 30, 9:41 a.m. inappropriate
'Crowdsourcing'?: New words emerge from decades of 'borrowing' and buying other's research and product ideas. With estate and gift tax avoidance, the challenge is on for the Gates and Buffett money to be spent wisely. Maybe some DDT and some behavioral changes will help alleviate the scourges of malaria and HIV/AIDS. Here's to a successful Gates research spending spree!.
Posted Mon, Jun 30, 10:11 a.m. inappropriate
After Gates re-invents science, maybe he can stop climate change.: You say Gates is trying to find solutions for why "science isn't working." Huh? Who says science isn't working? Yes, the Gates Foundation is doing great things. But the philanthropy is hardly challenging the fundamentals of the scientific method. He is just trying to redirect some specific aims by tweaking the incentives. It's a good thing, but let's not get hysterical here.
Posted Mon, Jun 30, 2:54 p.m. inappropriate
A safer bet is that, like the pioneering Rockefeller Foundation and more recently the World Health Organization, the Gates foundation will apply the technology of the moment and a host of other measures with tremendous success to global health.
I do believe there is a disparity between our belief in the inevitability and rapidity of scientific and technological progress and the actuality. The severe difficulties of the AIDS vaccine effort (well-funded and technologically ultra-modern) are a case in point. We fought a 25-year battle with a new foe (well, the virus is actually quite ancient) and lost in a rout.
No one's questioning the scientific method although I think even slight aspersions on peer review are pretty stunning. I really recommend reading Tadataka Yamada's piece (the "invitation/indictment" link in the article). I find it surprisingly piercing particularly since there doesn't seem to be anything to prevent applying his criticisms to the giant catalog of uncured diseases of the developed world.
I'm with you on not getting hysterical. The Explorations are a small (just a $100 million!) part of overall foundation spending of billions. They continue to fund the original Grand Challenges grantees and vastly more besides.
But if we were already on a trajectory to a 21st century of diseaseless immortality--a real break with the preceding century and even the late 19th century--there would be no Explorations.
Posted Mon, Jun 30, 10:23 p.m. inappropriate
The foundation's record on education is a cause for concern: The foundation came at the problem of improving public education with a similar attitude of trying to create a "new paradigm." The results have been mixed at best. Have they learned from their experience in education? Their approach seems eerily familiar.
Posted Tue, Jul 1, 9:53 a.m. inappropriate
RE: After Gates re-invents science, maybe he can stop climate change.: Science would work better on Linux. Heh, heh, heh...
Posted Tue, Jul 1, 12:56 p.m. inappropriate
Transformative innovation - priceless?: It's a little odd to see Gates leading the charge to inject innovation and creativity into the health sciences when he utterly failed to pull that off at Microsoft, despite all the billions burned on R&D.;
No one questions Gates's success and skills as an business leader, but few in the software world would call him or Microsoft a source "transformative innovation". Remarkably, none of the big inventions in computing (PCs, the graphical user interface, spreadsheets, the web, managed programming languages, online music, handheld computers, etc.) came from Redmond. Microsoft's success was entirely the result of tough and shrewd business tactics and good execution. Creativity happened at other companies.
Hopefully, his efforts will more successful this time around.
Posted Tue, Jul 8, 10:23 a.m. inappropriate
crowdsource, engineering: Applying engineering principles that are successful in electronics/automotive industry to biology fail - ask any pharmaceutical executive. I may not understand the blue screen of death messages, but someone, somewhere does, as it is all designed by humans. Cells/biology are a black box. Spending more money/applying more FTEs will not yield linear gains.
As far as crowdsourcing, easy to do with software where everyone has a computer/mainframe in their garage. Biomedical research makes use of toxic chemicals, dangerous biologics, ultracentrifuges etc. which people do not have in their garage. Good luck Bill.