Sunday, April 13, 2008

A Malaria X-Prize?

In historical terms, almost wiping out a disease isn't much use. It may greatly help a few generations, of course. But almost certainly, absent a total victory over these pathogens, they will incubate, mutate and replicate again, more virulent or resistant than before. So, while we may all pat ourselves on the back for the brilliance of modern medicine, I've always felt we've been fooling ourselves.

Eradicating polio -- which the world almost, almost did -- would be an immense relief. We're not out of the woods yet.You may be surprised to learn that about 2,000 people are still diagnosed with the disease every year. Vaccinations have cut the incidence of polio by about 99 percent, but fewer and fewer of us have had the vaccine.

If polio were truly and finally eradicated, humans could all breathe a collective sigh of relief. No child would ever again be laid low by that disease. We're close, and continuing international programs have a good chance to finish off the poliovirus in our lifetime. It would be only the second disease ever declared eradicated, after smallpox (see Wikipedia for more.)

Similarly, malaria is a disease that we probably COULD eradicate if we had the money and political willpower. There are four strains of malarial parasites which can cause disease in humans. These protozoa still kill about 3 million people a year. And Wikipedia says that as many as 515 million people -- a good percentage of the world's population -- fall ill every year. It may be a chief cause of perpetual poverty in the world's tropical societies.

The big pharmaceutical companies of the world have no incentive to cure these diseases, of course. As Chris Rock astutely points out, the money ain't in the cure, it's in the treatment. Given the truth of that point, maybe the challenge is to put the money back in the cure.

So what if the great health charities, such as the Gates Foundation, were to sponsor a contest. The could raise great piles of money and offer it as a prize to the company which can succesfully eradicate these pathogens worldwide. There could be smaller prizes for partial success, but the big prize comes from permanent victory. We might attack other diseases in similar fashion. Put the profit back into the cure.

The idea of using a prize to spur innovation is nothing new. From the X-prize for a privately-financed spaceship, to the quest for a 100 mpg car, piles of money drive the world's visionaries to put their ideas into practice. The best ideas find risk-tolerant entrepreneurs to back them, and even when they fall short of the final goal, they move the ball forward.

I think that would work with disease. As we pick off diseases, we should be able to devote more and more of our resources on the ones that remain. Let's do it before natural selection produces generations of "superbugs" which overrun the progress we've made.

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