Bill Gates puts his money to work in the developing world

On Sunday, Bill Gates gave a talk that barely mentioned computing. Instead, he spent his time discussing his new passion, medicine for the developing world, which fit nicely into the theme of his venue: this year’s Lindau Nobel Laureates meeting, which is focused on the future of medicine. Gates was at the gathering of past Noble Prize winners because he was named to the board of the Lindau Foundation, which runs the annual gathering; he both gave a short talk of his own and appeared in a panel discussion.

Gates did set up his talk by referring to what he called “the miracle of the microprocessor.” He felt that it took an entire generation of change before everyone fully appreciated the power microprocessors had, but that power was ultimately transformative. He sees similar potential for transformation in fields such as materials science, agriculture, energy, and health. These days, his foundation is using his wealth to try to transform the last of these, primarily by funding medicine for the poorest inhabitants of our planet. As Gates put it, if diseases of the poor attracted talent based on human impact of their solutions, they’d have five times the people working on them as they have now.

Market failures with research aren’t limited to the health issues of the poorest. Gates mentioned that antibiotic resistance pointed to a rich-world failure, where market pressures promote the overuse of antibiotics, while the small profits involved have historically limited commercial investments in the development of new ones.

Gates talked a bit about the role of foundations in this process. For the most part, he said, the funding structure in the US worked pretty well: the government funded basic research, and the commercial sector took some of those ideas and developed products and services out of them. This doesn’t work for diseases of the poor, though, because there’s not a market to pay for the results (he also made a quip about contrasting it with the amount of funding given for commercial development of baldness cures). Gates feels that foundations can take the place of companies when it comes to some of the development costs in this area.

The Gates foundation has also chosen to fund some of the research that appears riskier than most governments are likely to fund. That’s a role that Gates sees as being increasingly important as budget constraints are forcing science budgets to flatline around the world. That will almost certainly cause funding agencies to increase their conservatism, focusing on established labs and projects that are highly likely to produce information. Without foundations, younger investigators and high-risk projects are likely to be passed by. The Gates Foundation’s funding evaluation process ensures that the people evaluating applications for scientific merit don’t see the records of the people who are doing the proposing, so there’s going to be less of a bias towards funding large, established labs.

Where does he specifically see promise? Gates mentioned two areas. One was the development of new insecticides, which can help control the spread of mosquitos that spread many diseases in the developing world. Because their annoyance extends to the developed world, any results from this area of study would seem to be ripe for commercial follow-up, although this wasn’t mentioned by Gates. The other area that received attention is basic study of the immune system. Here, riskier projects are easier to justify, because immune function is essential for the control of so many diseases—major results can have an impact well beyond their immediate area of focus.