The threat of global infectious disease was already a significant humanitarian concern when Ken Stuart set up his independent research lab in 1976. Now known as Seattle Biomedical Research Institute, Stuart’s lab directed the research spotlight on tropical diseases, such as malaria, at a time when few others had shown interest.

Fast-forward more than 30 years later: the Seattle region and Washington State have become known throughout the world as a nexus of global health innovation and entrepreneurship.

Original efforts decades ago by SBRI, PATH and the University of Washington have been joined by Fred Hutchinson Cancer Research Center, the Institute for Systems Biology, the Infectious Disease Research Institute, Seattle Children’s Research Institute and its Global Alliance for the Prevention of Prematurity and Stillbirth program, Battelle/Pacific Northwest National Laboratories, Washington State University and, most significantly, the Bill and Melinda Gates Foundation. These groups together now form a regionally based, yet powerful, alliance in the interest of global health. And as a result of their collaboration, this state has become the symbol of the United States’ compassion and goodwill to millions of people whose lives have been improved or saved.

This is not a statement we make lightly. It takes more than personal anecdotes of success to paint an accurate picture. So, we have created a map—a preliminary but precise accounting for the broad and deep impact that our state’s health research organizations have on global disease.

Researchers and health care workers in Washington state directly run 480 health projects in 92 countries, according to a study commissioned by the Washington Global Health Alliance, which examined nine of the state’s global health institutions.

These organizations are responsible for, among others, 183 different projects focusing on emerging and epidemic diseases and 105 vaccine and immunization programs. They work with 593 unique partners, including 44 foreign government entities, 60 corporate partners and 245 hospitals and universities.

To catalyze more effective and successful collaborations, researchers will leverage this study data to increase efficiencies and create new opportunities in their work. Businesses and philanthropists can see the direct impact of their investments and partnerships. Policymakers can use this information to demonstrate the strength of our state’s global health sector in the face of increasing competition. We will make the case for more federal funding and recruiting new global health researchers and organizations to the state, boosting our economy in the process.

This study measured data from all the organizations mentioned above with the exception of the Gates Foundation, which funds projects, but does not implement programs. Not included in those figures are the significant education and training programs spearheaded by our universities and community colleges, other state research organizations and humanitarian and relief organizations, such as World Vision or Mercy Corps. We expect to broaden the scope in future studies mapping global health efforts.

All told, it is clear the magnitude of Washington State’s impact on infectious disease and suffering is significant and exceptional. Ultimately, we hope this study leads to even greater progress toward our common vision-improving health for people regardless of where they may live. You can see the more detailed survey results at www.wghalliance.org.

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Just came back from the Washington Biotechnology & Biomedical Association’s annual meeting in downtown Seattle, where 500-plus biotechies and distinguished guests (including more than a few local politicians) gathered for a quiche-and-berries breakfast and some keen networking.

The keynote speaker was Elias Zerhouni, the former director of the National Institutes of Health and now a senior fellow at the Bill & Melinda Gates Foundation. Just a few highlights from his talk here:

Zerhouni laid out the top five challenges in public health, as he sees it. Nothing too surprising, but a good way to frame the whole healthcare discussion:

1. The shift from acute to chronic conditions. (“This is a worldwide issue,” he emphasized. “This is the new global health horizon.”)

2. Aging population.

3. Health disparities.

4. Emerging and re-emerging infectious diseases. (Pandemics, for example.)

5. Emerging non-communicable diseases. (Things like obesity and depression, the latter of which the World Health Organization predicts will be the No. 1 cause of disability and dysfunction for people aged 25-44.)

As a world-class radiology researcher, Zerhouni also spoke to the scientific challenges the industry faces. He said the fundamental scientific barrier to doing “translational” research—that which leads to new products like drugs or devices—is the complexity of biological systems involved in diseases. “The explosion of data does not equate to explosion of knowledge,” he said. (This is a common theme across all fields of science and technology.)

On this front, Zerhouni stressed the importance of both external and internal sources of innovation. Meaning, the state of Washington should “find ways of bringing in collaboration on the translation or creation of knowledge.” He pointed out that “building relationships with the Asian Rim is probably your strategic advantage.”

For the politicians in the audience, Zerhouni noted, “Today when you get elected or not elected, the main driver is jobs, jobs, jobs.” He said his dream is that in a few years, biomarkers and healthcare stats will impact political campaigns, to the tune of, “In my district, Body Mass Index has dropped from X to Y.” (Luke previously reported on the issue of jobs being the driver of public support for biotech.)

The last issue Zerhouni addressed was a particularly interesting one: culture wars around science and technology. “Don’t be oblivious to the political, cultural, and moral aspects” of biotech and biomedical work, he said. “Be careful to not assume that everyone in the world believes what you do is holy and good.” Having dealt with the profound issues of evolution vs. creation in Washington DC—most notably in the context of stem cell policy—Zerhouni was sharing some hard-earned wisdom that everyone in the room could take home with them.

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When somebody gets a fever in a poor country, there is no quick or easy way to tell whether it’s a symptom of flu, malaria, a bacterial invader, or some other bug.

And if you don’t what it is, then it’s hard to treat.

So it’s only natural that shrinking modern diagnostic tools into a lightweight box that’s fast, accurate, cheap, and rugged enough for the African bush is one of the big ideas the Bill & Melinda Gates Foundation has supported in the past five years. The instrument is now starting to take shape under the direction of a team at the University of Washington, through what’s called the DxBox, which looks a little like the popular video game console with a similar name. And this particular box is entering a delicate phase in which big decisions are being made about whether it is really ready for a prime time commercial push, in which it could help healthcare workers better diagnose millions of people.

The original Gates grant, worth $15.4 million over five years, went to a diverse collaboration between a pair of bioengineering labs at the University of Washington, global health experts at Seattle-based PATH, and a couple of commercial partners in Redmond, WA-based Micronics and what used to be called Bothell, WA-based Nanogen (now part of ELITech Group). Four years have now passed by since the first check arrived. As the lead scientist on the project, UW bioengineering chair Paul Yager, put it in a recent UW symposium, “it’s put up or shut up time.”

What he really meant is that enough work has been done that it’s time to size up the real-world commercial potential of the product, or maybe spend some more time back at the drawing board. “You have to take what’s in a lab here in Seattle and scrunch it down to that,” Yager said, pointing to a prototype sitting on a shelf in his office, when I followed up recently. “It’s probably about two years away.”

DxBox

So after all of the long hours from 40 UW graduate students and postdocs, another 60 professionals outside the UW, and a lot of trial and error to meet all the demanding requirements of a portable diagnostic, what can this DxBox really do?

It is made to take a pinprick of blood, which a health worker squeezes onto a cartridge that slides into an 8-pound prototype device. All the health worker needs to do is hit “run,” and the pumps and valves inside the little box perform two kinds of automatic diagnostic tests. One is an immunoassay test that uses conventional antibodies, not all that different from a pregnancy test, that are made to bind with certain microbial invaders or antibodies that people produce in response to a certain infection. The other test is a more precise nucleic acid assay, which is supposed to identify microbes at the DNA level. Both tests are made to spit out an answer on an LCD screen in whatever the worker’s native language is, within 30 minutes, to identify the patient’s illness, Yager says. And the machine can run a full day on a laptop battery in places without electricity, Yager says.

The DxBox was designed to screen for six common illnesses that are associated with high fevers—flu, malaria, typhoid, rickettsial infections, measles, and dengue. Even from the start, the machine wasn’t made to be comprehensive, since it doesn’t screen for two of the biggest killers …Next Page »

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In remote villages in Africa, clinics are struggling to deliver timely blood tests to help doctors determine the best way to treat HIV patients. But Bill Rodriguez, a Harvard-trained physician, through his new startup Daktari Diagnostics, is working on a handheld device that could someday perform blood tests for HIV patients virtually anywhere within a few minutes.

Cambridge, MA-based Daktari has generated buzz for its technology and social cause from a bevy of Boston-area backers that have invested a total of $2.8 million to complete its Series A round of financing, says Rodriguez, the co-founder and CEO of startup told me in his first in-depth interview about the company. (We wrote a short story last week that the one-year-old startup had raised $2.5 million, based on regulatory filings, but the firm now says it has raised more money than that.) The Boston-area investors in the startup—a few of which we reported last week—include Norwich Ventures, Partners Innovation Fund, Hub Angels, Mass Medical Angels, Launchpad Venture Group, and Boston Harbor Angels.

Daktari (a Swahili word for doctor or caregiver) has a goal with of producing both social and economic benefits. Rodriguez, who was previously chief medical officer of the William J. Clinton Foundation, said that millions of HIV-positive patients in the world aren’t receiving regular tests that measure the number of blood cells with CD4 markers on their surface—a key indicator of a patient’s immune system strength that can inform a doctor’s decisions on how aggressively to treat HIV. Part of the problem is that the blood tests to get CD4 counts typically must be performed by expensive, bulky instruments called flow cytometers. It’s also difficult to obtain and handle the blood samples because many HIV patients live in remote areas.. Daktari may have a solution: a handheld diagnostic device designed to for use in any setting, without having to manually transfer blood with pipettes or other manual steps.

Some serious players in diagnostics and innovation circles are affiliated with Daktari, including Stan …Next Page »

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PATH, the Seattle-based nonprofit that works to improve health in poor countries, said today it has won the closest thing the humanitarian field has to the Nobel Prize—the $1.5 million cash award known as the Conrad N. Hilton Humanitarian Prize.

The news was delivered at an exuberant press conference this morning with PATH president Christopher Elias, Bill Gates Sr. of the Bill & Melinda Gates Foundation, and officials of the Hilton Foundation. The prize, given annually since 1996, has gone to other big-name health nonprofits in the past like Partners in Health and Doctors Without Borders. The story first appeared on The Seattle Times.

PATH, as I explained in this profile back in February, has such a broad portfolio of projects that it sometimes struggles to explain what it does in a sound bite. But essentially it seeks out clever, affordable technologies, and partnerships with clever entrepreneurs and government agencies, to help improve the health of have-nots around the world. It has developed or played a role in co-developing 85 different technologies being used to improve global health, such as needles designed to curb the spread of infectious diseases, simple diagnostic tests for common diseases, and stickers on vaccine vials that can tell whether the immunization has gone bad. We’ve written a lot about PATH in the past year, including its work to improve the nutritional value of rice, fix broken bones, purify water, and develop new vaccines that can withstand hot and cold temperatures.

“We were absolutely thrilled when we heard,” Elias said during a brief conversation after the press conference. “We’ve been nominated in prior years, but haven’t won.”

The award may not sound like a lot of cash for an organization with 800 employees and a $240 million annual budget, but Elias made it sound like he plans to get major bang for the buck. PATH plans to use the money to expand its field operations in Africa, to scale up big production of existing global health technologies, and to provide seed funding for new technologies.

He gave an example of what he means when he talks about leveraging resources. Five years ago, PATH wanted to compete for grants to improve health in South Africa, but couldn’t be a serious …Next Page »

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One of the big opportunities in biotech over the coming decades may come from neuroscientists who team up with Buddhists. That might sound odd at first, but it’s no joke. This is one of the big ideas on the radar of Bennett Shapiro, the former executive vice president of worldwide basic research at Merck, who lives in Seattle, and serves as a senior partner with Boston’s PureTech Ventures.

Researchers are beginning to get a stronger sense of physiological differences in the brains of Buddhists who have been practicing mind training techniques like meditation for years, as compared to, say, the average brain of a distracted American, Shapiro says. These insights, based partly on brain imaging tools like functional MRI, are sparking new ideas about how to combine meditation techniques with neurological drugs, offering potential to do a better job of treating mental health problems, he says.

“If you want to think about the future in biotechnology, you would want to think about how you can help people regulate their emotions and attention,” Shapiro says. “If one can employ mind training in combination with pharmacologic therapies, one might be able to enhance their efficacy and thereby relieve the suffering of millions of people.”

Shapiro, 70, a longtime Seattleite who I met at a coffee shop near his house in the Magnolia neighborhood, sees these unusual connections between neuroscientists and Buddhists at close range. He serves on the board of the Boulder, CO-based nonprofit Mind & Life Institute, alongside the Dalai Lama himself and top neuroscientists like Richard Davidson of the University of Wisconsin. The Institute is trying to encourage research beyond the current drug regimens, like with selective serotonin reuptake inhibitors such as Prozac, which Shapiro calls “blunt instruments” aimed at treating the most complex, differentiated organ in nature, the brain.

Even though the current drugs don’t work for everybody, and placebos often do remarkably well in clinical trials, these “blunt instruments” still add up to a lucrative market for drug companies. Pfizer alone generated $6 billion last year from neurology drugs, a 17 percent gain from the prior year, making this a faster-growing product category for that company than cardiovascular disease, pain, or cancer treatments. If drugs could be made that were more effective, presumably the market would get a lot bigger. About one out of every four adults in the U.S. suffer a diagnosable mental disorder each year, according to the National Institute of Mental Health.

But what Shapiro is talking about could go a lot further than just diagnosable mental disorders. He’s thinking much more broadly about combinations of mind training and drugs that can help millions of children and adults. He says this sort of mind-training would be self-initiated and driven, not the coercive, frightening stuff from the movies like “A Clockwork Orange.”

If this is done the right way, Shapiro says, “Think about how people who meditate can control their emotions,” as well as their attention spans, Shapiro says. This could transform the educational system, …Next Page »

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Not long ago, drug companies would break out quarterly income streams from the U.S., Europe, Japan, and something called ROW, as in rest-of-world. Investors usually didn’t care about the last numbers, because they were little more than a rounding error.

That’s not the case anymore, as these countries are often called “emerging markets.” They’ve grown enough that Chris Viehbacher, CEO of one of the world’s largest drug companies, Paris-based Sanofi-Aventis (NYSE: SNY), traveled to Seattle this week to curry favor with global health officials at the Pacific Health Summit. The head of a major drug company might have gotten a cold shoulder at a meeting like this a decade ago, but these officials welcomed Viehbacher. Sanofi made headlines at the summit, as it said it plans to donate as many as 100 million doses of flu vaccine to the World Health Organization to help poor countries cope with the swine flu pandemic.

This could all be written off as some kind of public relations exercise, but I wondered if there’s more to the story. The pharmaceutical industry is terrified by a series of patent expirations coming over the next few years, which will allow a flood of cheap generic copies to grab market share away from franchise products that generate an estimated $67 billion in annual sales. Not much has emerged in the industry’s R&D pipeline to replace all these aging blockbusters. Some analysts predict pharma companies will have to continue acquiring and partnering with innovative biotech companies to sustain themselves.

Sanofi has made a couple aggressive moves like this since Viehbacher took over Sanofi in December. Earlier this year, it acquired cancer drugmaker BiPar Sciences for $500 million (giving BiPar investor Paul Allen a big payday), and partnering with South San Francisco-based cancer drug developer Exelixis for a deal possibly worth more than $1 billion.

But Viehbacher also has his sights on making money on low profit-margin, high-volume products in parts of the world that are off the pharma industry’s beaten track. It’s part of a strategy to make Sanofi a more globally diversified company, rather than placing all its chips on the U.S. and Europe—where governments are looking for ways to trim healthcare spending.

Here are edited highlights of a wide-ranging conversation we had about industry trends, the reasons for donating flu vaccine, and how he likes to deal with biotechs.

Xconomy: Why come here to the Pacific Health Summit?

Chris Viehbacher: I laid out a strategy for the company in February, to become a global healthcare company, versus a pharmaceutical company focused on the U.S. and Europe. That means we want to be present in all countries, and therefore, you have to address all diseases in all countries. You can’t just take medicines doing well in the U.S., and try to find people rich enough in other countries to buy them. So, the company is hugely committed to these huge global health issues. We probably, I think, do more than just about anybody. We are very significant in malaria. We are the only company doing things for Sleeping Sickness. We have a new antibiotic coming for tuberculosis, which could cut the treatment time down to four months [from six months], which is huge in the area of TB. We are spending huge amounts of money developing a Dengue Fever vaccine and developing facilities for it. We have partnered with a lot of people in that room, whether it’s the Gates Foundation, GAVI[Global Alliance for Vaccines and Immunization], the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Those are all people we try to work with on a regular basis. It’s very much in line with our strategy. I take a personal interest in these global health issues, and it’s good to meet folks.

X: To what extent does the donation of flu vaccine amplify the company’s global health effort, or show that you’re serious?

CV: The pandemic flu donation is exceptional. I’d normally say donations are not the way to deal with issues of access to medicine. It’s not sustainable. If we were dealing with malaria, or tuberculosis, then I wouldn’t …Next Page »

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Many people thought tuberculosis had gone away. Unfortunately, it has not. Indeed, it is coming back strongly, and in a multidrug resistant form. This has occurred at a time of a vacuum in drug discovery and development for tuberculosis.

Fortunately, government institutions like the National Institutes of Health, non-governmental agencies like the Seattle Biomedical Research Institute, PATH, and even pharmaceutical companies are investing in tuberculosis research.

Interestingly, pharmaceutical companies are doing this for the public good, as it is unlikely that this research could ever be turned into a profitable business for them. Nonprofit organizations like the Global Alliance for TB Drug Development are clinically testing new and more convenient treatments for patients.

Encouragingly, at the Pacific Health Summit, the Global Alliance and Johnson & Johnson’s Tibotec subsidiary announced a novel partnership devoted to the development of an innovative new drug for both drug-sensitive and drug-resistant TB [See Xconomy's earlier coverage].

Much of this work in research and development is being shepherded and supported by the Bill & Melinda Gates Foundation. Scientists follow the money. If the money flows in to support TB, so too will high-quality scientists.

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[Updated: 7:05 pm Eastern]

Wealthy donors like the Bill & Melinda Gates Foundation have helped spark a movement that has almost quadrupled financial support for global health in the past two decades, yet much of the world’s financial support is being spread unevenly, and isn’t always getting to the poorest people in the neediest countries, according to a new study by researchers at the University of Washington and Harvard University.

It might sound surprising, but the people who produced this edgy piece of research, which claims to be the first ever comprehensive look at funding for global health projects, are sponsored by the Gates Foundation. The study, being published in The Lancet, is co-authored by Christopher Murray and six colleagues, including Catherine Michaud of the Harvard Initiative for Global Health. Murray is the former Harvard University professor recruited to the UW two years ago with a $105 million donation by the Gates Foundation to establish the Institute for Health Metrics and Evaluation (IHME).

The report—written without input from the Gates Foundation—is loaded with financial detail, which will certainly be required reading for those who argue that powerful private donors aren’t being transparent enough about what they do. The report found that financial support for global health has climbed from $5.6 billion in 1990 to about $21.8 billion in 2007. This field that attempts to reduce health disparities around the world, used to be primarily the responsibility of international organizations like the World Bank and the United Nations, but now gets almost one-third of its total funding from private sources, according to the study.

Yet even as all this money has flowed in for help, 12 of the 30 countries with the highest burden of disease in the world weren’t getting as much aid as people in healthier, and in some cases, wealthier, countries, according to the study. Angola, Ukraine, and Thailand were among the neediest countries that haven’t been getting their share of health aid.

“The size and scale of it all was surprising,” Murray says. “We all knew the money was going up, but it was much a bigger increase than we thought we’d see. ”

Since no one organization has done a comprehensive analysis of how much money is going to global health, which countries get the money, and which disease categories receive the most, the findings are likely to spark a lot of conversation in global health circles about how to better allocate resources.

“Everyone’s watching,” Murray says.

Some small island nations like Micronesia and the Solomon Islands receive more health aid per capita than countries with higher rates of illness—like Niger and Burkina Faso, according to the study. Mali and Colombia have about the same level of sickness, yet Colombia receives triple the health funding, researchers said. Researchers said they don’t know exactly why that is, although many of the countries with great health needs, and that lack support, are French-speaking former colonies in central and western Africa, Murray says. …Next Page »

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Center stage in Seattle life sciences moved to the waterfront this week, as 250 global movers and shakers in science, global health, and the pharmaceutical business gathered for the Pacific Health Summit.

—The Pacific Health Summit, an invitation-only event of global health stars, in its fifth year, focused this year on multidrug resistant tuberculosis, as I wrote in this preview story. Big names from global health came to brainstorm, including Margaret Chan of the World Health Organization, Anthony Fauci of the National Institutes of Health, and Chris Viehbacher, the CEO of Sanofi-Aventis, the world’s largest vaccine maker. Seattle’s Infectious Disease Research Institute is one of the players in this field, too, through work supported by Eli Lilly.

—Every good conference like the Pacific Health Summit needs power players competing for media attention. This year, we had two pieces of international news. Johnson & Johnson announced a deal to co-develop a new drug with the nonprofit TB Alliance; the deal could lead to the first new drug against tuberculosis in more than 40 years. Sanofi-Aventis also broke some news by announcing it will donate 100 million doses of flu vaccine to the WHO, to help poor countries cope with the swine flu pandemic.

—I profiled Beat Biotherapeutics, a Bellevue, WA-based company that envisions a way of generating stem cells that could perform the function of a cardiac pacemaker, or maybe someday even regenerate heart muscle that’s been damaged by heart attack. This company is built on years of research by UW stem cell scientists Chuck Murry and Michael Laflamme, and is married to bioengineering techniques from Buddy Ratner’s lab at the UW.

—Mukilteo, WA-based CombiMatrix (NASDAQ: CBMX) never captured much of the market for sophisticated gene chips used in modern biotech labs, which is now dominated by Santa Clara, CA-based Affymetrix and San Diego-based Illumina. But now CombiMatrix hopes to carve out an emerging niche by marketing its DNA microarray instruments as a diagnostics service to physicians, who are looking for accurate ways to diagnose the aggressiveness of an individual patient’s form of cancer, and to use genetic screening to catch malignancies earlier.

—MDRNA (NASDAQ: MRNA), the Bothell, WA-based developer of RNA interference drugs, has been working hard to clean up its balance sheet the last few months. It faced a cash crisis earlier in the year, and then raised $7.25 million from Novartis, another $10.5 million from investors, and used some of the proceeds this week to pay off its $5.5 million debt to GE Capital.

—Seattle’s Infectious Disease Research Institute said it is offering up its immune-stimulating compounds known as adjuvants to the world’s major vaccine makers. With the right partnerships in place, these adjuvants have potential to greatly amplify the world’s supply of flu vaccine, says IDRI founder Steve Reed. This may come in especially handy if the swine flu pandemic takes a severe turn for the worse.

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Movers and shakers in global health—including a lot of people not named Bill & Melinda—will be buzzing around the Seattle waterfront this week for what some people like to call the “Davos” of global health.

Like the World Economic Forum in Davos, Switzerland—another picturesque setting with mountains and water nearby—the Pacific Health Summit is an invitation-only annual conference of about 250 world leaders in science, politics, and business. This year, they are gathering to brainstorm about how to put a dent in one of the world’s deadliest infectious diseases: tuberculosis.

The list of power brokers appearing on the docket includes: Margaret Chan, director-general of the World Health Organization; Chris Viehbacher, CEO of drug and vaccine giant Sanofi-Aventis; Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases; and Paul Farmer, founding director of Partners in Health, the famed physician to people in poor countries. Big Pharma will be well-represented by the likes of Merck, GlaxoSmithKline, Johnson & Johnson, Bayer, and others.

The main theme of discussion, TB, rarely captures the attention of the masses, like, say, swine flu does. But it’s at least as worrisome, and it’s not going away. The disease, caused by a bacterial invader that attacks the lungs, is characterized by a chronic cough that makes it especially contagious. There is no vaccine, diagnostics aren’t very accurate, and no new drug has been developed in decades, as Farmer put it in a recent appearance in Seattle. That adds up to a pretty grim outlook for a lot of people. About one in three people on Earth (2 billion cases) are estimated to be infected, and TB kills 1.5 million people a year—ranking it right up there with HIV and malaria as one of the world’s leading killers.

“With TB, there have been no new drugs for 40 years,” says Michael Birt, the executive director of the Pacific Health Summit, and senior vice president for health and society affairs at the National Bureau of Asian Research. “Industry can and should contribute more.”

This field has traditionally been plagued by a classic free market failure. No new drugs get developed …Next Page »

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[[Corrected version May 22]] One of the big ideas for tackling global malnutrition that’s been percolating for years at Seattle-based PATH is showing signs of its first real momentum in the marketplace. More than 60,000 children in India are now getting a daily serving of “Ultra Rice” fortified with iron as part of their school lunch programs, says Dipika Matthias, the project director at PATH.

I first wrote about Ultra Rice in this space back in August, when PATH, the nonprofit organization that works to improve public health in poor countries, had high hopes for it. I got the update on Ultra Rice from Matthias yesterday at PATH’s annual breakfast fundraiser.

PATH obtained the technology from a Bellingham, WA-based food scientist, who invented a way to pack vitamins into a staple food like rice by running it through a process commonly used for making pasta. It didn’t have commercial potential in the U.S., because we get our nutrients from other foods, but since rice is so cheap and widely available around the world, food scientists have long wondered how to turn it into a better vehicle for delivering vitamins and nutrients. To make it practical, it had to be engineered to withstand hot and humid storage conditions, and have a shelf life of as much as six months. Those hurdles are in the past—PATH’s job was to gin up market forces for this healthier brand of rice. The potential payoff for health is big. If millions of people got this on a daily basis, it could help ameliorate the chronic anemia that saps the energy and productivity of millions of people around the world.

“We’re trying to grow the market gradually,” Matthias says. “We’ve shown there’s supply and demand in India. We’re showing real progress.”

A lot of this depends on relationships, to hear Matthias tell the story. PATH made arrangements with the school lunch program in India, which could provide a proven distribution channel and a guaranteed market for the product, to give the Ultra Rice producer an incentive to manufacture it. For the first year, PATH got the Global Alliance for Improved Nutrition to buy the rice, in hopes that a government agency would buy it the next year, Matthias says. [[Eds--the previous story suggested the government agency had committed to buy the Ultra Rice next year, but it hasn't yet.]]

A big part of PATH’s argument was that it could offer good bang for the buck—each kid gets half of his or her recommended daily allowance of iron through the rice, for 75 cents per child per year, Matthias says.

PATH’s commercial partner in India considered this market reasonable enough, and started producing the fortified rice in December, Matthias says. The supplies are going to children in the state of Andhra Pradesh, along the eastern coast of India, she says.

But India is just one of the four markets that PATH plans to crack open for Ultra Rice—the others are Brazil, Colombia, and China. The picture isn’t quite as rosy in Brazil. Back in December, PATH terminated the license with its previous commercial supplier there, who didn’t deliver on the kinds of quantities PATH wanted to produce, Matthias says. That company chose to “de-prioritize” production of Ultra Rice during last fall’s financial crisis, in favor of other products that had higher profit margins, Matthias says.

Now PATH has moved on with another supplier in Brazil, a pasta manufacturer near Sao Paolo called Adorella, which started making production runs earlier this month, she says. About one metric ton of Ultra Rice has been stockpiled in Brazil. Now PATH is working on the demand side of the equation, meeting with influential local officials there who might provide a spark for the product, Matthias says. Some of them may need a little more convincing than others—in the form of clinical trials that prove a public health benefit from eating Ultra Rice, she says.

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You know you’re a global health rock star when you can tease the Bill & Melinda Gates Foundation on its home turf and get away with it.

That was what Paul Farmer did last night as the keynote speaker for the Seattle Biomedical Research Institute’s Passport to Global Health fundraiser. Farmer is best known as the protagonist in Tracy Kidder’s book Mountains Beyond Mountains, which tells the story of how Farmer found his calling as a young doctor at Harvard to treat the serious illnesses of the world’s poorest people. He spoke to a crowd of several hundred people gathered for dinner at the Washington State Convention and Trade Center.

Farmer peppered his talk with lots of side references and jokes. “I like to use levity when I feel emotional,” he said at the beginning.

For people in global health outside of Seattle, the Bill & Melinda Gates Foundation is simply known as “The Foundation,” sort of like how the CIA is known to some as “The Firm,” Farmer said. And even though “The Foundation” is famous for insisting on metrics of progress before they write checks, Farmer resisted using any statistics at all to describe his fight against global scourges like tuberculosis.

Instead, Farmer used an old-fashioned storytelling narrative to show how his work can make a difference. He showed a picture of a young boy in Haiti who came into the clinic looking skeletal, suffering from TB. He was put on “lots of drugs, high doses, never miss a dose,” the tenacious regimen that Farmer and his colleague from Partners In Health, an international healthcare nonprofit, swear by.

Once the drugs went to work, he needed to put on his medical detective hat and find out where the TB came from to cut it off at the roots. Most kids spend their time in two places—school and home. So he investigated, and found out the boy’s father had TB, too, and needed treatment.

After getting to the bottom of this, Farmer said self-deprecatingly, “They get better, I forget about them.” He lost track of the boy after the treatment.

Nine years later, the little boy has grown up into a teenager, and he recently sent a photo to Farmer via e-mail to provide a progress report. The crowd ooohed when Farmer showed the picture of an athletic-looking young man, smiling, wearing a black Air Jordan T-shirt that would make him fit in at any American mall.

All this is happening on what Farmer called “the delivery end” of global health, but he said none of it would be possible without what scientists like those at Seattle Biomedical Research Institute do on the “discovery end.” And he reminded the audience that there’s an enormous amount of work to do on discovery. TB, for one example, hasn’t had any innovative new drugs come along in decades, there’s no vaccine, and diagnostics aren’t very accurate. “I want everybody here in the lab to stay in the lab,” Farmer says.

Farmer, who started out in the global health field 26 years ago, long before it could pull together swanky fundraisers like this one, closed his talk by reminding people how far the field has come.

“This city and a number of institutions here have performed CPR on international health,” Farmer said. “It was not a growing field, it was not drawing young people. It was kind of a hangdog, depressed field.” That’s all changed now, he said. “I think we’re on a path to real progress in global health and reversing epidemics.”

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Seattle has become a major global health hub over the last decade, thanks in no small part to having the Bill & Melinda Gates Foundation, one of the world leaders in funding for global health research, in our own backyard. Now, an emerging and related discipline is also finding an increasing number of connections here—global technology. Researchers around Seattle (and elsewhere) are thinking outside the box to come up with innovative, inexpensive technologies that can be easily implemented in developing countries to improve quality of life there.

“Technology is naturally mixing with global health as there is much low-hanging fruit where a little tech can make a big difference,” Gaetano Borriello, a University of Washington computer science professor, said in an e-mail. “Seattle is a hub for both, so it is a natural place for this new development to be happening.”

This past weekend, the third annual IEEE/ACM International Conference on Information and Communication Technologies and Development took place at Carnegie Mellon University’s Qatar campus in Doha. Seattle-area researchers, specifically from the UW, made quite a showing at the meeting. Several Microsoft projects were presented too, and Bill Gates showed up to give the keynote talk.

Here are some global technology projects underway at the UW and presented at the meeting:

—*bus (or Starbus), a transportation tracking system developed by Borriello and UW technical communication professor Beth Kolko. *bus relies on only GPS and SMS technologies to track any vehicle by cell phone, as long as that vehicle has been equipped with a simple tracking device (*box). The researchers tested the system in Seattle this year and plan to start tests in Bishkek, Kyrgyzstan, soon. In areas with limited transportation and no means of communicating their schedules, a system like this would allow residents of those areas to get the most use possible out of buses and trains.

—MultiMath, a system that uses multiple numerical keyboards to allow students to share a computer in a classroom situation, led by UW computer scientist Richard Anderson and the UW Center for Information and Society’s Joyojeet Pal. The technology would allow a single computer to go farther in resource-poor settings, and allows children more interaction with each other to boot.

—AndroidRosa and JavaRosa, two open-source applications for data sharing on cell phones in the developing world, created by Borriello and his colleagues. The applications are part of the larger open-source cell phone-based data collection project OpenRosa. The idea behind Borriello’s applications is that sharing information such as medical records or tracking disease spread using paper records is slow, but establishing traditional online sharing systems is unrealistic in poor settings where computers, Internet service, and even electricity may be hard to come by. Cell phone usage is common even in poor countries, presenting an intriguing and efficient alternative to paper records.

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PATH, the nonprofit that works to improve health in developing countries, said it is planning to move its headquarters from Seattle’s Ballard neighborhood to larger space in South Lake Union. The organization intends to lease 111,000 square feet on three floors in the 2201 Westlake building being developed by Paul Allen’s Vulcan company. PATH, which has been growing fast since 2000, will move about 300 local employees to the new building in January 2010. Its current space in Ballard has 75,000 square feet.

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Biomedical research funded by Uncle Sam is hot, but publicly traded biotech companies that seek to develop those discoveries in the Northwest are cold. Here’s a recap of the week’s ups and downs in the local life sciences scene:

—President Obama is proposing a whopping $10 billion addition to the National Institutes of Health’s budget as part of his economic stimulus plan, and this has researchers in the Northwest scrambling to turn in their applications. The University of Washington, already the nation’s largest public research center with $1 billion a year in sponsored research, may capture as much as another $300 million in federal stimulus grants, says Linden Rhoads, vice provost of UW TechTransfer. Still, she says that’s no excuse for state lawmakers to start whacking away at the university’s state support.

—Yet even with basic biomedical research on the rise, many public biotech companies are struggling. Based on my review of the quarterly financial filings of the 12 public companies in the Northwest, six were looking pretty vulnerable with less than $20 million in available cash as they headed into 2009.

—Healionics, the Redmond, WA-based company that spun out of the University of Washington bioengineering lab of Buddy Ratner, took its first step this week toward becoming a commercial business. It shipped its first product, a biomaterial coating for shunts that are made to relieve pressure behind the eyes of dogs with glaucoma. If it works by helping allow fluid to pass more easily through the shunt, it could set an important precedent for using the biomaterial in human beings with glaucoma—a more lucrative potential market.

—Halosource, the Bothell, WA-based maker of technology to purify drinking water, won certification from the U.S. Environmental Protection Agency for its technique. This is no big deal in the U.S., where we take clean drinking water for granted, but it’s an important validation to partners Halosource is working with in India, China, Brazil and other parts of the world that are looking at its cheap, gravity-fed system for ridding water of viruses and bacteria. This technology is now providing clean water for 2 million people in India, double the number who were using it nine months ago.

—MDRNA (NASDAQ: MRNA), the Bothell, WA-based developer of RNA interference drug technology, received a bit of a lifeline this week when it received $7.25 million from Novartis in exchange for a non-exclusive worldwide license to its technology. But easy come, easy go. The company has to use $870,000 to write a severance check to its former CEO, Steven Quay.

—Nanostring Technologies CEO Perry Fell has resigned his post, and is being replaced …Next Page »

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The last time I checked in with Bothell, WA-based Halosource in July, it was gaining momentum with a cheap, simple technology for purifying drinking water that was being used by a million people in India. Nine months later, privately held Halosource, a company with just 100 employees, appears to have a hit on its hands. More than 2 million people in India are now getting clean drinking water through its proprietary technique, and now it has its eyes on expanding into new markets in China and Brazil.

Today, Halosource is announcing another milestone to help it hit crack those markets: The U.S. Environmental Protection Agency has certified that its HaloPure system is safe and effective at providing clean drinking water. If all continues to go according to plan, this ought to help the company form more partnerships with distributors like the one in India that has turned HaloPure into a fast-growing product. I heard more about this strategy a few days ago during a phone conversation with chief financial officer James Thompson.

Clean drinking water may not sound like a big deal in this country, but something like a billion people on Earth don’t have enough of it, making this one of the biggest root causes for health disparities in developing countries. The UN estimates that 2.2 million people died from unclean drinking water in 2004. Since many countries lack basic municipal water purifying systems and sewers to keep their water clean, businesses in the developed world have their eyes on consumer products to provide clean drinking water. It’s a market that is worth an estimated $18 billion, and growing at 22 percent annually, according to research firm Frost & Sullivan.

Standard off-the-shelf products aren’t really up to this task: Carbon-filtering systems like Brita can get rid of dirt and sediment particles, but don’t kill viruses or bacteria that make people sick with diarrhea, dysentery, or cholera. Chlorine tablets can do that trick, but who wants water that tastes like that?

Some new technologies for consumers have come along in China and India, like reverse osmosis or ultraviolet lights in water tanks, although those cost $200 to $350 for a home system, and depend on reliable water pressure and electricity. That’s not realistic in many countries, Halosource CEO John Kaestle told me last summer.

Halosource, though, uses a system that depends on a power source that’s reliable everywhere, and costs nothing: gravity. The company makes a yo-yo like cartridge that sits at the bottom of a broad water jug, about the size of a Gatorade cooler. The water flows down by gravity through the Halosource cartridge, which is filled with tiny polystyrene beads coated with bromine, a chemical that kills germs like chlorine does, but without the bad taste.

“We believe HaloPure is the most important non-electric drinking water disinfection technology to reach full commercialization and regulatory approvals in the past decade,” says Andrew Clews, Halosource’s vice president of marketing, in an e-mail.

A small company like Halosource doesn’t have the cash or manpower …Next Page »

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Seattle’s tight-knit global health community is getting a little tighter today. The Seattle Biomedical Research Institute (SBRI) has secured a $2.3 million grant from the PATH Malaria Vaccine Initiative to help sift through a load of discoveries it has made in recent years that researchers say could be critical ingredients in a more effective new vaccine.

The grant will be used to help SBRI scientists whittle down a list of 25 novel proteins on the malaria parasite, to see which ones have the greatest potential to become ingredients of a vaccine that would provoke a strong, protective immune system response. The goal will be to pick two to four of the most promising proteins over the next 18 to 24 months, and then start having serious talks with commercial partners in the biotech and pharmaceutical industry who can develop them further into practical products, says Ashley Birkett, director of preclinical research and development for the PATH Malaria Vaccine Initiative.

Malaria is one of the top priorities of the Seattle-based Bill & Melinda Gates Foundation, because the worst form of the parasite kills an estimated 1 million people a year in the developing world, mainly children. Scientists had reason to cheer late last year when a vaccine candidate from GlaxoSmithKline known as RTS,S was able to protect about 50 percent of the people tested in a large clinical trial, although that’s not nearly good enough to reach the Gates Foundation’s goal of eradicating malaria from the planet. The Glaxo vaccine is built with just one critical protein in the parasite, and by adding more novel proteins on the parasite (known as antigens) from SBRI, the Malaria Vaccine Initiative hopes to create a vaccine that raises the bar to 80 percent protection, Birkitt says.

“We need new targets, and SBRI has new targets,” Birkitt says.

An effective vaccine has eluded scientists for decades, partly because the deadly parasite, plasmodium falciparum, is a complex little organism for a bug, with 5,000 genes. Those numerous genes provide a moving target for scientists. The genes go through fluctuating on-off cycles when the parasite is living in mosquito saliva, and then its gene expression profile morphs when the parasite enters human blood. It goes through another transformation during about a 12-day period when the parasite enters the human liver, before it becomes more virulent in the blood, Birkett says. (SBRI’s Stefan Kappe explained some of the biology of a promising vaccine candidate in this story back in December.)

PATH’s Malaria Vaccine Initiative is one of the leading funnels for research around the world, having secured $168 million from the Gates Foundation in September. The malaria vaccine group, which has offices in Bethesda, MD as well as Seattle, chose to support SBRI’s work because it has assembled multiple scientific collaborators with understanding of genomics, proteomics, and immunology, Birkitt says. Essentially, SBRI has studied the genomic metamorphosis of the parasite so that it has gotten a bead on which genes make the critical antigens at a moment when the malaria parasite is vulnerable, in the liver. It’s possible that a new vaccine made up of a couple of these critical proteins could spark antibodies and killer T cells of the immune system to kill the parasite at that phase, before it makes people deathly ill, Birkitt says.

The research at SBRI involves collaborators at the Walter Reed Army Institute of Research and immunologist David Koelle of the University of Washington. The work has been financed by the Gates Foundation, the U.S. Department of Defense, and the Foundation for the National Institutes of Health/Grand Challenges in Global Health initiative.

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Bill and Melinda Gates don’t give their money away to just anybody who comes along with an impressive resume and a good cause. So why has the world’s largest charitable foundation seen fit to give $1.3 billion of its fortune to a little-known Seattle-based nonprofit called PATH?

PATH, which has raked in the second-largest amount of Gates Foundation grants of any organization behind the vaccine group GAVI, is one of the biggest success stories of the Seattle innovation community in the past decade. Since CEO and president Chris Elias joined in September 2000, PATH has grown from 240 employees to 775. Its annual budget has soared from $41million to $240 million. It has formed partnerships with 60 biotech and pharmaceutical companies, and most public health bodies in the world that count, from the World Health Organization on down.

The organization, formerly known as the Program for Appropriate Technology in Health, sometimes struggles to explain what it does in a tight little Madison Avenue slogan. But essentially it seeks out clever, affordable technologies, and partnerships with clever entrepreneurs, to help improve the health of have-nots around the world. This vision plays itself out in a dizzying number of ways. PATH finances promising vaccine candidates, whether it’s for bird flu or other infectious bugs like pneumococcal disease that kills infants. It is working with entrepreneurs to develop fortified rice to so that people get more nutrition from a staple food. It is developing practical ways to purify water. It is helping ensure doctors get trained in a cheap, simple way to fix broken bones, so that people don’t languish in traction for months. It has pioneered the use of a sticker on vaccine vials that changes color if a vaccine goes bad. It serves as clearinghouse for the Gates Foundation-funded effort to eradicate malaria from the globe.

“We’ve really kind of grown up together with the Gates Foundation,” says Elias, whom I visited in his office. “We’ve grown dramatically.”

PATH got its start in Seattle in 1977 with a grant from the Ford Foundation to try to implement new contraceptive technologies that were developed for rich countries, but weren’t getting where they were needed in poor countries, Elias says. By about 1980, PATH’s founders realized that applying its model—of brokering deals between for-profit companies with innovative ideas and public health agencies with the means to get them to people in need—was a model that might work for expanding the use of diagnostics, drugs, devices, vaccines. Almost two-thirds of its budget comes from foundations, and the next biggest percentage, about 21 percent, comes from the U.S. government.

The people at PATH spend their time thinking about something most people in the U.S. are fortunate enough to never even consider—how to meet basic human health needs that the free market is unable to fulfill.

“The markets are very efficient ways of producing innovation where they work, where there’s a predictable demand and a system for delivery and financing. As imperfect as it is here in the U.S., that exists,” Elias says. “In poor countries, the market often fails. Either the market is unpredictable, or it’s not there. People are too poor. People who live on $1 a day can’t afford to buy products that will make anybody a significant margin.”

So there you have it, one of the world’s biggest fundamental problems, creating an enormous gap between haves and have-nots. Unsolvable, right?

They don’t seem to think so at PATH. In the face …Next Page »

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Bill Gates says he loves his new job at his charitable foundation. The co-founder of Microsoft says so this morning in his first annual letter, posted online, sizing up his nonprofit work.

Gates left his full-time job at Microsoft in June, to devote his full attention to the Bill & Melinda Gates Foundation, the world’s largest charitable foundation. He insists he finds this mission—to wipe out modern global health plagues, boost global economic development, and reduce disparities in U.S. education—to be just as exciting as running one of the world’s most valuable companies.

“Many of my friends were concerned that I wouldn’t find the foundation work as engaging or rewarding as my work at Microsoft,” Gates wrote in the 19-page letter. Even though he reveled in the challenge of leading the software company, “I love the work at the foundation,” Gates wrote.

Now that he has a few months under his belt, friends shouldn’t worry that he’s getting restless, because Gates sees some of the same “magical things” happening at the foundation that he did at Microsoft.

Just like at the company, there is an opportunity for “big breakthroughs.” Like at the company, he can use his skills of “building teams of smart people with different skill sets” to tackle long-term problems. And also like at the company, he’s anything but bored. “I find the intelligence and dedication of the people involved in these issues to be just as im¬pressive as what I have seen before,” Gates wrote. (He discussed these thoughts in a video interview with New York Times columnist Nicholas Kristof over the weekend.)

Like at the company, there’s also plenty to worry about, starting with the economic crisis. The foundation lost about 20 percent of its assets in 2008, which is actually quite a bit better performance than the NASDAQ Composite Index and the S&P 500, which dropped 41 percent and 38 percent on the year, respectively. Even though the foundation lost billions, it will increase spending from $3.3 billion in 2008 to $3.8 billion this year, about 7 percent of total assets. This will drain the foundation’s assets more quickly than the amount it is required to spend annually under federal law, but Gates says that’s not a concern.

“The goal of our foundation is to make investments whose payback to society is very high rather than to pay out the minimum to make the endowment last as long as possible,” Gates wrote.

Here’s what Gates had to say about the three specific areas of the foundation’s interest, global health, global development, and U.S. education:

—The foundation steers about half of its total spending …Next Page »

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