October 10, 2007

  

  

To: the Scientific Board of the &and Challenges in Global Healt
10/18/07

From: Harold Varmus, Chair of the Board

I am writing to the Scientific Board on my way home from Cape Town to
provide a very brief summary of this week’s excellent meeting of the GCGH
grantees. The report is also intended to encourage all of you to block off
time on your calendars to attend next year’s meeting in Bangkok, scheduled
to be held from October to __,, 2008.

At this third annual meeting, we heard reports of the first two years of work
by all of the grantees. Since there were two or three concurrent sessions
during most of the meeting, no one was able to hear more than about half of
the presentations. But at our Board meeting following the conference, there
was general agreement that the vast majority of the research programs are on
track, that several have exceeded expectations and are producing truly
exciting results, and that only a few are having serious trouble meeting their
milestones. Although we are not yet half way through the funding period
for most grants, the Board emerged with confidence that many of the
objectives of the GCGH initiative will be met----both primary objectives
(the generation of important new knowledge and the delivery of some
potentially useful products) and secondary ones as well (the formation of
effective multi-laboratory collaborations and the enhancement of global
health research in several countries). (A summary of the progress made by
each of the grantees is available in the excellent briefing book prepared for
the Scientific Board and available to all members, whether or not they were
able to travel to Cape Town.)

At its lengthy but invigorating final session, the Board also provided advice
about a number of important questions facing the four agencies that fund the
initiative.

¢ First, we discussed in detail the handful of research programs that have
experienced significant scientific or procedural problems. At least one
Board member has been involved in helping to correct the difficulties with
each of these programs. In addition, the program officers from the BMGF
and the FNIH provided summaries of the problems, both in the briefing
books and orally at our meeting. As a result, we were sufficiently informed
to make recommendations about how each of the less successful grantees
should be managed during the coming year. In one case, an award has
already terminated, and a few grantees have been warned that they may be
subject to budget reductions or termination if they continue to fail to reach
milestones.

* Second, we considered how to respond to complaints that a few speakers
were unwilling to divulge important aspects of their results during the
sessions. These investigators claimed to be constrained because the
information might be subject to patent protection in the future. Several
means to avoid this situation were suggested and will be further evaluated
before next year’s meeting to insure open exchange.

* Third, we talked about some instances in which potentially important
ethical and cultural conflicts have been tackled by Peter Singer and his
Toronto colleagues in consultation with the grantees. (The advantages of
anticipating such conflicts by supporting the Toronto team within the GCGH
initiative were repeatedly displayed during the meeting.)

* Finally, there was considerable conversation about the evolution of the
GCGH initiative. During the meeting, Tachi Yamada announced that the
Gates Foundation would launch an exciting new Innovation Grants program
in 2008, and that this initiative could lead to the definition of new Grand
Challenges. (For a description of this new program, see
http:/Avww.gceh.org/GrandChallenges/GCNewFeature/de fault.htm.)
Although no final decisions were made, it was generally agreed that the
existing GCGH grants would not likely be renewed for an addition term; in
order for teams to continue their projects, they would usually need to seek
alternative sources of funding. But we also proposed that some grantees
might be given one or two year extensions, if there is strong likelihood of
achieving a significant endpoint in a limited amount of additional time.
Such decisions, of course, would be dependent on funds available from the
supporting agencies.

 

We also discussed the question of whether additional members should now
be added to the Board. There is clearly an advantage to working with Board
members who have been involved from the earliest stage of the initiative:
they have a strong sense of what the grants are intended to achieve, and they
are familiar with many of the roughly 44 programs. Moreover, very few
people have left the Board (Rick Klausner, who was replaced by Tachi
Yamada, and, more recently, Julio Frenk, who asked to step down because
he has become a senior advisor to the Gates Foundation.). We also had
fairly good attendance at this meeting. (Thirteen of the 24 members were
present, and nearly all of the thirteen stayed from beginning to end.) So
there may not be a compelling need for additional members. But there was
general agreement that the presence of an even larger cohort at the meetings
is important to promote interactions with the grantees and to guarantee
informed discussion of progress in the many areas of supported research.

We will soon be polling the current SB members to find out whether you
intend to come to the Bangkok meeting, whether you think we should add
new members, and whether you have some specific people to nominate.

We would also like to know if you have suggestions for places to hold the
fifth meeting (in 2009, the year after the already planned Bangkok meeting).
This question was brought up at our concluding dinner, and the
recommendations included a number of cities in South American or Mexico,
other venues in Africa (including East African cities and Alexandria), some
cities in India or China, and a couple of European cities. In other words,
many places are on the table, and now is the time to voice your suggestions.
The sixth (and possibly final) meeting will almost certainly be in Seattle.

Before concluding this memo, I want to insure that all members of the Board
recognize what was very apparent to those of us who attended the meeting in
Cape Town: the program managers have done an extraordinary job of
directing the GCGH initiative. This job means, above all, working with the
grantees, monitoring their progress, identifying problems with intellectual
property and ethical, social, and cultural issues, and providing extra expert
advice when needed. Furthermore, the meeting itself was run superbly
well, with strong scientific sessions, stimulating discussions, and fascinating
external speakers---including Archbishop Emeritus and Nobel Laureate
Desmond Tutu; Njongonkulu Ndungane, the current Archbishop of Cape
Town; Ann Veneman, the Director of UNICEF; and Graca Machel (Nelson
Mandela’s wife and the head of the GAVI Board). In addition, the meeting
was arranged to allow attendance at a Keystone meeting on vaccines, trips to
South African research sites, and workshops on a variety of topics. These
are all reasons to believe that Bangkok will also be superb. Please plan to
come.

Thank you and feel free to contact me or the participating organizations with
any questions or comments.