Microbiologist Brett Finlay was faced with a scheduling conflict many of his peers would envy. He could fly to Ottawa and be feted as one of Canada's most exceptional health researchers or he could go to Seattle and meet Microsoft billionaire and philanthropist Bill Gates.

Finlay says it didn't take long to decide. He went to Seattle.

It was his first chance to meet Gates, who is using his fortune to exert enormous and growing influence over the biomedical world, and who happens to be Finlay's latest benefactor.

The University of B.C. researcher heads a team that has picked up $10.7 million Cdn as part of the Grand Challenges, a bold new venture by the Bill and Melinda Gates Foundation. The foundation, the world's richest charity with an endowment of close to $29 billion US, now rivals the World Health Organization in efforts to fight disease in poor nations. The foundation has spent $6 billion in the last five years in an effort to improve health in the undeveloped world.

The Grand Challenges adds a techno twist to the foundation's work. Gates has said he was shocked to realize how little research was being done to combat unglamourous diseases such as diarrhea, tuberculosis and malaria, which kill millions each year in poor countries. So he issued a challenge to the research community to come up with "deliverable technologies" to reduce the death toll.

More than 1,500 proposals poured in and the foundation has committed $450 million to the venture. It has approved 43 projects to devise inexpensive and easy-to-use tools, such as needle-free vaccines, and the project leaders were summoned to Seattle in late November for three days of brainstorming and a pep talk from Gates.

"It was fantastic," Finlay says. After Bill and his wife Melinda gave their presentation, Gates stayed on for the scientific sessions and asked lots of questions.

"He knows what a Th2 cell is and all these other things. [Th2 cells are a subset of specialized cells in the immune system.] He's like Joe Scientist," says Finlay, whose team is working on molecules that promise to boost the body's natural ability to fight increasingly lethal microbes.

Finlay has a knack -- and a growing collection of awards -- for putting clever ideas to work.

He devised a vaccine against E. coli 0157:H7, the potentially deadly bacteria that cause hamburger disease and contaminated the drinking water in Walkerton, Ont., in 2000. It eliminates the microbe by vaccinating cattle so they can no longer harbour the human pathogen. The vaccine has been tested in close to 100,000 cattle and is now awaiting approval from the U.S. Food and Drug Administration.

Microbial menaces kill close to 17 million people annually -- millions of them children. Diarrhea kills close to a million people each year, while malaria, pneumonia and tuberculosis kill millions more.

Compounding the problem, Finlay says, is the way pharmaceutical companies have all but abandoned research on new anti-microbial treatments because there is little potential for profit.

Like many scientists, Finlay has been calling for years for concerted action to combat "bad bugs." And he is frustrated by the developed world's fixation with the "splashy" threat of the day -- be it pandemic flu, anthrax in the U.S. or SARS. "More people die in India due to diarrhea in a day than died of SARS," he says.

Some have questioned the technological bent of the Grand Challenges program, suggesting the money might be better spent on cleaning water and improving living conditions. But not Finlay, who says the Gates Foundation has breathed much-needed life into ideas and projects that had been languishing.

Finlay's group has hit upon a number of potent compounds that could lead to "a whole new class of drugs" to prevent and fight infection. "We want to harness the power of the human immune system to stop infections before they start," he says.

Animal experiments underway in Vancouver are providing evidence they could be on to something big. Microbiologist Bob Hancock, also at UBC, discovered proteins that seem to boost the body's ability to fight microbial infection in mice.

He and Finlay went on to create Inimex Pharmaceuticals, a B.C.-based biotechnology company that is working to bring some of the proteins to market.

"Inimex seems to have stumbled into something that has immense implications for treating infections of all shapes and sizes," Finlay says. "That's what Bill Gates wants to harness."