Washington Editor

WASHINGTON - Developing countries that lack adequate healthcare for even the most basic diseases often face insurmountable obstacles in their quest to become economically stable and independent.

Facing this, Elias Zerhouni, director of the National Institutes of Health, said the key to changing the downward spiral experienced by many poor countries is adequate leadership.

"Take Uganda, for example. If you look at their AIDS statistics, they're good. They have reduced AIDS, so I asked the ambassador what made the difference - was it NIH funding?" Zerhouni said. "I hope the NIH funding helped, but the answer is understanding and nurturing leadership."

Zerhouni spoke Wednesday here at the Global Health Forum 2002 hosted by the Washington-based Biotechnology Industry Organization and the Seattle-based Bill & Melinda Gates Foundation. The forum, attended by some 400 industry leaders, brought together potential financers and international health experts to examine how biotechnology can improve global health and address many of the neglected diseases plaguing Third World countries.

While Zerhouni said success lies in leadership, the Algerian-born radiologist said global health is both a national and international issue and failing to handle the crisis places everyone at risk.

"But there are fundamental obstacles that we need to overcome," he said. "I am from a developing country and there is a cycle of health, economics and politics. You cannot look at this as a biotech or healthcare worker, [instead] you need to look at the entire system to understand what keeps [some countries] from succeeding."

And even though Zerhouni clearly advocates NIH-backed research, he suggested that partnerships between companies and foundations might have a greater impact because they are not limited by government controls.

Last year about $500 million in NIH money was dedicated to global healthcare programs, including $300 million for AIDS research.

"It's not that we are not making an effort, but the question is whether we are effective," said Zerhouni, who believes an effective plan for combating global healthcare rests in a coordinated approach between biotechnology organizations, foundations and the government.

From the foundation standpoint, Patty Stonesifer, co-founder and president of the Bill & Melinda Gates Foundation, addressed via video the lunchtime crowd referencing the plight of developing countries.

The organization's global health program focuses on infectious diseases, HIV/AIDS, tuberculosis, and reproductive and child health. To date, the foundation has awarded $2.5 billion in global health grants to organizations worldwide.

In her brief remarks, Stonesifer said she's optimistic about harnessing advances in biotechnology to improve health concerns. "We have the best minds in the biotech industry and we cannot quit until we figure out how to save millions of children and their families," she said. "Failure is not an option; too many lives depend on it."

She pointed out that in the past 25 years, the FDA has approved 1,500 new drugs, but only 15 of those drugs increase longevity of life. Furthermore, she said $70 billion is spent on research each year worldwide, but only 10 percent of that money goes toward diseases that impact the largest populations.