Feature Profile

Pipe dreamer

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a2236 (Published 12 November 2008) Cite this as: BMJ 2008;337:a2236
  1. Faisal Islam, economics correspondent
  1. 1Channel 4 News, London
  1. faisal.islam{at}itn.co.uk

    Tachi Yamada, president of the Gates Foundation global health programme, talks to Faisal Islam about his efforts to redirect drug research

    Pipelines are often controversial constructs. They crisscross land and sea gushing with dirty black gold, and wars are routinely fought over their politics. But the world’s most important pipeline isn’t visible. It is the pipeline of drugs that should save and improve the lives of billions of people. But until now this pipeline has been routed entirely to maximise return for the shareholders of large drug companies rather than to save as many lives as possible.

    Tachi Yamada may hold the key to a historic re-routing of this pipeline. As president of the global health programme at the Bill and Melinda Gates Foundation he has the financial firepower of the world’s first and third richest men behind him, and the experience of creating one of the world’s biggest pipelines at GlaxoSmithKline. Two years after joining the Gates Foundation, he has just embarked on an epic struggle with tobacco companies, is seeking to turn one of the basic norms of scientific research on its head (see box), and still talks a lot about pipelines.

    Yamada on peer review and awarding grants

    Not content with altering the drugs industry’s own process of Darwinism, Yamada is challenging one of the sacred cows of scientific research—peer review.

    “I think by and large peer review is a very important process and for the vast majority of science, it’s a form of scientific due diligence,” he says. “But there have to be also mechanisms that allow for really novel and paradigm-shifting ideas to come to the surface, and for that peer review can be a hindrance.”

    He is offering $100m for “non-peer reviewed, high risk, but potentially high reward” ideas through a programme called grand challenges explorations. The results of the …

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