Strange bedfellows: Bill Gates and Chairman Mao

This headline could be a severe case of six degrees of separation, but bear with me. News recently out of a discussion at the The Royal Society, London, is raising hopes that an effective and affordable cure for malaria is now on the horizon and could be making its way into patients' hands (and mouths) as early as 2010. What's more, this cure for malaria would also mark another milestone in world health, as it would be the first time synthetic biology—collections of synthetic genes that will control the fermentation and growth of yeast—is used to produce a medicine.

This breakthrough is courtesy of a research team led by University of California, Berkeley, Prof. Jay Keasling to insert as many as a dozen genes into yeast microbes that will effectively redesign and allow for growth of these microbes into artemisinin, a well-known cure for malaria. Currently derivatives of artemisinin that are used to produce malaria medicines are extracted from sweet wormwood (Artemisia annua), but the resulting medicine is relatively expensive—especially when we are talking a disease that is predominant in developing countries—at about 2 bucks a dose. Using the synthetic biology approach to production, where all the medicine needed would be produced in one huge 50,000-liter vat, could potentially provide this medicine at pennies on the dollar compared with current treatments.

With an estimated half-billion people afflicted with malaria each year, and as many as 2 million deaths annually—mostly young children—it's pretty easy to see how producing ample, cheap medicine to fight this disease is an important development in improving world health.

What's more, it should be possible, in theory, to continually re-engineer artemisinin, to combat drug resistant strains of malaria.

But what do both Bill Gates and Chairman Mao have to do with this story? Well, plenty, if you follow the thread and history of malaria treatments.

As it turns out, the Chinese have been effectively treating malaria for more than 15 centuries, using Artemisia annua as a natural remedy. More recently the ancient remedy was developed during Mao's Cultural Revolution—it was drunk as tea by the North Vietnamese Army and the Viet Cong­. But world politics being what they were and skepticism about the treatment itself, its spread and adoption by the West and the rest of the world was severely slowed.

Once it got out, though, artemisinin was recognized as the most effective treatment against the disease, and to date, the malaria parasite has not developed resistance to it.

And that is where Bill Gates steps in. His philanthropic organization, The Bill and Melinda Gates Foundation, ponied up more than $40 million to Keasling's Berkeley lab, his company Amyris Biotechnologies and the One World Health Foundation to develop this treatment. It appears that investment is about to pay off.

So there you have it (with apologies to Prof. Keasling): Gates and Mao . . . malaria pioneers.