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Saturday, November 25, 2006 - Page updated at 12:00 AM

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Seattle moves to forefront in global fight to save lives

Seattle Times staff reporters

For people seeking money and moral support in the battle against diseases of the poor, an annual trip to the Swiss city of Geneva, home of the World Health Organization, was once considered mandatory.

Today, WHO officials are just as likely to make their own pilgrimages to Seattle, headquarters of the Bill & Melinda Gates Foundation.

Scientists with promising vaccines, medical inventors and the world's top health experts parade through the foundation's modest Lake Union headquarters, hoping for a share of the $1 billion or more it spends each year on global health. And before taking over as WHO's director general in 2003, one of the first things the late Dr. Lee Jong-wook did was visit the foundation, which funds several WHO programs.

After transforming his hometown through a software revolution, Bill Gates, the world's richest man, is now using the fruits of that empire to seed a new kind of industry here. It's one he and his wife, Melinda, hope will reshape the world and save millions of lives.

"Seattle is going to be the epicenter of global health for the 21st century," said Dr. Paul Ramsey, dean of the University of Washington School of Medicine.

Ramsey has reason to be effusive.

In addition to spreading its wealth around the globe, the foundation, since its creation, has funneled more than $1 billion to individual researchers and institutions based in Seattle. The total includes $30 million to launch a Department of Global Health at the UW.

With Gates funding, Seattle scientists are helping lead development of vaccines for malaria, AIDS, pneumonia and a host of other afflictions that ravage Africa, Asia and Latin America. Seattle-based programs are delivering insecticide-treated bed nets and new-generation malaria drugs to people in Zambia; distributing vaccines to rural clinics in Mozambique; and directing street theater in India with a safe-sex theme.

For-profit biotech companies are also lending their expertise to help speed new technologies and drugs to market — and to the people who need them most.

Being based in the same town as their biggest benefactor gives the researchers opportunities to meet, mingle and make plans over coffee, at parties and during informal seminars.

The momentum is sure to grow once the new UW global-health department comes on line next year, with plans to eventually expand to 50 faculty members and up to 500 students.

"There's a synergy that comes from having all these things in the same place," said Dr. Chris Elias, president of PATH.

No local organization has benefited more from a relationship with the Gates Foundation than PATH, the Ballard nonprofit founded nearly 30 years ago with a tiny budget, a staff of eight and an unwieldy name: Program for Appropriate Technology in Health.

Bill and Melinda Gates first met PATH's board of directors at a 1995 dinner in the Columbia Tower in downtown Seattle. The couple wanted to know all about life in the directors' home countries, which included Zimbabwe, Bangladesh, Egypt and India. Melinda asked questions about growing up as a girl in a Muslim nation.

Two weeks later, PATH got a letter announcing a $750,000 grant for the organization's reproductive-health work — the Gateses first foray into global health.

Since then, PATH has received nearly $750 million, more than 10 percent of the foundation's global-health spending. Along the way the organization has grown to more than 500 people in 65 nations and moved into a new headquarters.

PATH's mission has morphed from its initial work developing simple syringes, birthing kits and other health technologies adapted for African villages or illiterate Nepali women. It now coordinates some of the Gates Foundation's most ambitious programs, including getting existing vaccines to children in poor countries and speeding development of new drugs.

PATH's rapid growth has been replicated at other Seattle institutions on the receiving end of Gates grants, creating jobs and providing a modest boost to the local economy.

But the benefits to the region go beyond the financial, said Lee Hartwell, the Nobel Prize-winning geneticist who leads the Fred Hutchinson Cancer Research Center.

"It's moral," Hartwell said. "We are not just a community that enjoys our wealth, but a community that is reaching out to the world and trying to make a difference."

Towering presence

The Gates Foundation, which also has major programs in education and other global-development issues, was already the world's biggest philanthropy before billionaire Warren Buffett announced plans to add an estimated $32 billion of his own fortune to the existing $30 billion pot.

Dr. Jim Kim, a Harvard health expert who formerly led the World Health Organization's AIDS programs, predicts additional donations from Gates will eventually push the foundation's annual health expenditures to $2.5 billion, rivaling the combined spending of European nations.

With such vast sums at play, no other American city can match Seattle's influence on the world of public health, Kim said. Harvard Medical School and Johns Hopkins University still rank higher in prestige than the UW's fledgling global-health program, but that could change as well, he predicted.

"The presence of the Gates Foundation just blows everybody else out of the water," Kim said.

The Seattle tie

Seattle was fertile ground for the foundation's interest in global health to take root, thanks to small organizations such as PATH and a cadre of local scientists studying tropical maladies and parasites long before they were fashionable.

With most U.S. research funding going to cancer and heart disease, money was hard to come by for work on parasitic protozoans and difficult-to-pronounce infections in Africa.

"Frankly, what tropical medicine meant was diseases 'over there,' that weren't our problem," said Ken Stuart, who founded Seattle Biomedical Research Institute (SBRI) in an Issaquah storefront in 1976.

But when Bill Gates Sr. began to scout around on behalf of his son's newly formed foundation, some of the first people he connected with were Dr. Gordon Perkin, PATH's founder, and Dr. William Foege, a Vashon Island resident who led smallpox eradication in the 1970s. A colleague at the elder Gates' law firm served on the board of SBRI.

Both Perkin and Foege helped open the Gateses' eyes to the millions of deaths in the developing world that could be prevented with vaccines and drugs widely available in richer nations. Both men eventually joined the foundation when it was headquartered above a pizza parlor in Redmond, helping influence its early priorities.

"The fact that these groups were here did help shape the foundation," said Dr. Regina Rabinovich, director of the foundation's infectious-disease programs, who also worked at PATH. "It has been shaped by leaders in the field, which includes people in Seattle, but it's not limited to that."

More than half of the foundation's total spending goes to global-health programs. Seattle groups have received about 15 percent of that money.

As the foundation has grown and its reach has become more truly global, any hometown advantage has probably evaporated, said Jack Faris, president of the Washington Biotechnology & Biomedical Association.

"The whole enterprise is the antithesis of parochial, and the Gates Foundation will never be playing home-team favorites," said Faris, who was the foundation's first spokesman.

But proximity still helps personal relationships develop.

In the 1990s, Blaise Judja-Sato and Craig Nakagawa worked together at Teledesic, a satellite communications company funded by Bill Gates and Craig McCaw, when they began talking with people at PATH about their desire to improve health-care delivery in Mozambique. Judja-Sato later founded VillageReach and received support from both the Gates Foundation and McCaw's personal foundation.

World Vision, a Christian relief organization based in Federal Way, has received $3.3 million from the Gates Foundation since 2004, mostly for emergency aid. After a U2 concert at KeyArena last year, World Vision President Richard Stearns had the chance to chat with Bill Gates in person about possible collaborations on clean water and sanitation. The band's lead singer, Bono, introduced them.

Economic catalyst

As an economic engine, the Gates Foundation's local spending is still dwarfed by the $1 billion a year the University of Washington pulls in for research. And much of the money given to local groups is spent elsewhere — as when PATH bought 500,000 mosquito nets last year for malaria control in Zambia.

But Gates-funded nonprofits literally have filled spaces left vacant by failed tech companies. PATH's current headquarters is a high-end building left empty following the dot-com crash. The Infectious Disease Research Institute, a Seattle organization working on products to treat neglected diseases, uses a state-of-the-art lab built by biotech company Corixa before its acquisition by GlaxoSmithKline, and equipment from another biotech firm that went under.

Local biotechs and other businesses are still trying to figure out where they fit into the global-health enterprise and how to make a profit, Faris said. "I think there are very significant business opportunities, but it's not going to be a gold rush."

The foundation rarely gives grants directly to for-profit companies. But with its emphasis on getting new drugs and devices into production as quickly as possible, it recognizes the advantage of involving private enterprise early as "subcontractors."

University of Washington bioengineering professor Paul Yager got a $15.4 million Gates grant by forming a consortium to develop a lab-on-a-card system to quickly diagnose diseases such as dengue and typhoid fever.

Micronics, a Redmond firm that specializes in designing such systems, is part of the group. The company will have the right to market the devices but agreed to make them available at low cost in the developing world, said CEO Karen Hedine.

In a partnership that initially raised doubts, PATH funneled money to GlaxoSmithKline to develop and test a malaria vaccine, said Melinda Moree, director of the PATH project.

"Nonprofit in Seattle funds world's largest vaccine maker," she said with a laugh, imagining a headline about the collaboration.

Gates funding also acts as an economic catalyst by pushing projects out of the lab and into manufacturing and clinical trials, steps that government grants usually don't cover, said Steve Reed, who founded the Infectious Disease Research Institute (IDRI) and heads its research and development.

And the money can help jump-start products that for-profit companies are unwilling to risk on their own because they lack markets in rich countries.

Working with Corixa, the company Reed co-founded, IDRI developed the leading vaccine candidate for leishmaniasis, a parasitic disease caused by the bite of an infected sand fly, and $47 million in Gates funding is supporting its clinical trials in three countries.

"Put us on the map"

The Gates money — and the vote of confidence it represents — has boosted the stature and influence of many Seattle-based groups.

PATH is now able to lure top executives from pharmaceutical companies. The Seattle Biomedical Research Institute, which has received more than $76 million in Gates money, moved into a new building near Lake Union and is now one of the foremost malaria labs in the world.

For VillageReach, Gates Foundation money "put us on the map," said Nakagawa, chief operating officer. The 5-year-old nonprofit, which works to improve the delivery of medicines in Mozambique, received a $3.1 million grant from the foundation in 2003.

"That gave us more credibility to go back to the Ministry of Health and increase our program and also go to other donors," he said. "Any time you talk to a person and say the Gates Foundation is supporting you, they're going to at least look at your application."

The local groups are also having an impact that reaches around the globe.

The Children's Vaccine Program, Gates' first megaproject administered by PATH, has immunized millions of youngsters against infectious diseases. Early successes in the Malaria Vaccine Initiative, also administered by PATH, have changed the minds of skeptics who said such drugs might never be possible. Exciting results in SBRI's malaria research hint at the possibility of even more powerful approaches in the future.

But a widely available, cheap malaria vaccine is still years away. Nor is success guaranteed for the foundation's other, audacious goals.

There's no doubt the Gates Foundation is changing Seattle and the city's place on the world stage. Tangible evidence will rise near Seattle Center over the next several years, as construction proceeds on the foundation's 800,000-square-foot headquarters.

Still unknown is whether the city synonymous with lattes, airplanes and computer software will add another claim to fame: cures.

Sandi Doughton: 206-464-2491 or sdoughton@seattletimes.com; Kristi Heim: 206-46-2718 or kheimseattletimes.com

Copyright © 2006 The Seattle Times Company

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