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When you hear scientists talking about the "Gates challenge" nowadays, they aren't talking about installing a new version of Windows. They're talking about the health of the planet's population.

More precisely, they're reflecting on what could be done to combat menacing diseases around the world, particularly in the developing regions where modern medicine and public health policies haven't been widely established.

The Bill & Melinda Gates Foundation wants to encourage such reflections, and is urging the global scientific community to articulate some "grand challenges" facing research for coping with "the most critical health problems in the developing world."

In collaboration with the U.S. National Institutes of Health and the NIH's foundation, the Gates foundation has committed $200 million to a "Grand Challenges in Global Health" initiative. The goal is to inspire and support new science and technology for addressing the world's major health issues.

"Our aim is to identify 10 to 15 critical scientific and/or technical challenges, which, if solved, could lead to important advances against diseases and improve health," Harold Varmus, chair of the initiative's science board, wrote in a recent e-mail distributed to researchers in the medical community.

It's easy enough to list the biggest global health threats. Tuberculosis, malaria and AIDS come to mind immediately. There's also smoking, other substance abuse disorders and mental-health afflictions (for instance, trauma or post-traumatic stress disorder caused by war, other violence, abuse and terrorism). Even some mainly Western world disorders, such as cancer and heart disease, aren't entirely absent from the developing world. And don't forget the generic problem of new diseases, such as SARS.

But the Gates challenge is not about identifying the problems, it's about suggesting ways to find solutions.

"A Grand Challenge is a call for a specific scientific or technological innovation that would remove a critical barrier to solving an important health problem in the developing world with a high likelihood of global impact and feasibility," the initiative's Web site explains (www.grandchallenges gh.org).

The idea is to pursue some discovery or invention that would "break through the roadblock that stands between where we are now and where we would like to be in science, medicine, and public health."

So you can't just say "find a cure for malaria," for example. You would have to propose something like designing water-loving microrobots programmed to identify mosquito larvae and zap them with powerful nanolasers.

Recommendations for Grand Challenges are being accepted until June 15 (you can find the form at www.grandchallengesgh.org/submissions.html). Submissions will be evaluated by a scientific board to identify the Top 10 or so; the initiative will then publish requests for proposals to be funded. (Anybody can apply for funding to do research on one of the final set of challenges there's no preference to those who suggested the idea.) And even if the Gates foundation can't fund everything, the process itself should call attention to many aspects of global health in need of serious study.

No doubt the world's health researchers will submit plenty of recommendations for the expert panel to screen. But just in case they miss some, how about:

- A cheap and easy test for water quality, something like throwaway sensors that would glow in colors that differed depending on whether water was safe or hazardous. (Poor water quality is a major factor in many Third-World diseases.)

- Better mathematical methods for tracking and predicting the spread of infectious diseases. More specifically, perhaps, better math for identifying optimum vaccination strategies. Today experts argue about the best approach for smallpox vaccination, for example.

- Obtaining a complete inventory of the genes involved in the neurobiology of addiction and elucidating the math describing the interactions among them. Curing or preventing substance abuse will no doubt require a deeper understanding of the neurobiological circuitry underlying the motivation for self-destructive behavior.

- More information on the precise changes induced in children's brains by violence, abuse, famine or other trauma, in order to suggest interventions to ameliorate the repercussions persisting into adulthood.

- And on the social science side, figuring out a way for more intelligent interaction between the legal and medical systems. More of the world's seriously mentally ill people are homeless or in jail than in facilities providing medical care. (In this respect, the United States does qualify as a Third-World nation.)

- Finally, how about an innovative system for transferring new research knowledge from the lab to the clinic, and from scientists to the public. Some new mix of media and proper medical expertise is needed to part the flood of research data and impart the relevant and important information to practitioners and patients in an accessible form.

Of course, making any of this happen will require more than scientific and technological discovery and innovation. Doing the research is one thing, distributing the benefits of the research around the world is another. Orchestrating the international cooperation necessary for success will be another grand challenge in itself.

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