World's richest man's imprint on Africa

Andrew Carnegie once wrote that to die rich was to die in disgrace. Like the 19th-century Pennsylvania steel magnate, Microsoft founder Bill Gates seems determined not to let that happen.

Mr. Gates has promised to give away 95 percent of his personal fortune, currently valued at $46 billion. He has already endowed the Bill and Melinda Gates Foundation, created to help fight disease and improve education worldwide, with $24 billion; since its inception in 2000, the foundation has distributed more than $6.2 billion. And just this week, during his and his wife's three-nation tour of Southern Africa, Gates committed an unprecedented $168 million in private money to fight malaria.

While the Gateses embrace old-style charity, their methods are thoroughly 21st century. Much of their money goes to finding scientific solutions to the world's health problems - like the development of malaria vaccines and new AIDS-prevention techniques. Health workers in Africa say that the world's richest couple are profoundly affecting the direction of research and aid, and creating new hope for tackling some of the most difficult problems here.

"I think it's been quite remarkable the influence they've had in revitalizing and revolutionizing the global health agenda," says Peggy Morrow, vice president of the Program for Appropriate Technology in Health in Seattle, which is working with the Gates Foundation on a variety of issues, including developing a malaria vaccine and developing new screening techniques to prevent cervical cancer in developing countries. "They have changed our priorities, as well as some of the ways in which we work."

Observers say the size and scope of their grants have enabled the Gateses to highlight issues the world has forgotten about. The grant for malaria research, announced Sunday at a rural clinic in Mozambique, is a prime example. Although malaria strikes more than 300 million people every year and kills more than 1.1 million, most of them children and most of them in Africa, it has received just a fraction of the attention and spending of AIDS.

Efforts to create a vaccine have been in development for at least 15 years, but lack of money slowed progress. The Gates Foundation, in partnership with GlaxoSmithKline Biologicals and others, is now funding vaccine trials in rural Manhica, Mozambique, and Gambia. If successful, a malaria vaccine could be available in less than 10 years - still a long way off, but closer than if no Gates funding were provided.

"Even two or three years ago, let alone 15 years ago, we couldn't have imagined that private funding would come available," says Anne Walsh, director of global communications for GlaxoSmithKline Biologicals. "Without the funding, it would have been a lot more difficult and a lot slower."

The development of new prevention methods like vaccines and microbicides hold great appeal to the Gateses, who see them as a long-term investment with potentially high rewards. But they're also working to improve the use of existing technology, and particularly to increase the rate of child immunizations in poor countries.

Despite decades of work by organizations like the World Health Organization (WHO), which helped eradicate smallpox, more than 30 million children around the world still do not receive basic immunizations, and many new vaccinations have yet to reach most of the developing world.

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