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The aim is to save many of the millions of lives lost each year to malaria, tuberculosis, malnutrition and other pressing health problems, Mr. [Gates] said in announcing the grant yesterday at the World Economic Forum meeting in Davos, Switzerland. In speaking there, Mr. Gates, the founder of Microsoft, underscored the effects of poor health in stifling the economies of developing countries. In creating the grant, Mr. Gates said he had been inspired by the success of a German, David Hilbert, who challenged his fellow mathematicians in 1900 to solve 23 problems over the next century. Dr. Hilbert's challenge led to mathematical breakthroughs, opened up fields of study and contributed to the development of computers. Mr. Gates said he hoped ''to draw in a lot of talent that hasn't been aware of what could make a huge difference in terms of world health.'' For example, he said, ''even scientists who work in different realms will now see that things like preventing mosquitoes from being a delivery vector'' for diseases like malaria, dengue and West Nile fever ''would be a phenomenal thing.''

The aim is to save many of the millions of lives lost each year to malaria, tuberculosis, malnutrition and other pressing health problems, Bill Gates said in announcing the grant yesterday at the World Economic Forum meeting in Davos, Switzerland. In speaking there, Gates, the founder of Microsoft, underscored the effects of poor health in stifling the economies of developing countries. Gates said he hoped 'to draw in a lot of talent that hasn't been aware of what could make a huge difference in terms of world health.' For example, he said, 'even scientists who work in different realms will now see that things like preventing mosquitoes from being a delivery vector' for diseases like malaria, dengue and West Nile fever 'would be a phenomenal thing.' 1 PIC; Bill Gates, Microsoft founder and co-founder of the Bill and Melinda Gates Foundation, said he hopes a $200 million grant will help eliminate many causes of death in poorer nations.; Credit: Michel Euler / Associated Press

In recent years, many expert panels have warned that budget cuts were causing the public health system in the United States to crumble. On top of traditional services for mothers and children, health departments have had to apply more sophisticated laboratory techniques and newer methods to counter the resurgence of tuberculosis and to keep other infectious diseases in check. The latest demands involve a vaccine that few practicing doctors have ever given because the United States abandoned it as a routine in 1972, eight years before smallpox was eradicated from the world. Now health departments must train workers in how to use two-pronged needles to administer the vaccine and recognize its many complications, some of which are rare but potentially lethal. The vaccine, which is made from a live virus that is a cousin to smallpox, is the most dangerous human immunization. Experts have predicted that some recipients will have sore arms and suffer flulike symptoms that will keep them home from work and that a few will have much more serious reactions. Some people are advised to forgo vaccination unless there is a terrorist attack. Among them are those with weakened immune systems or a history of eczema or atopic dermatitis, two common skin conditions. Dr. Elizabeth McNeill, the chief medical officer of the Pima County Health Department in Tucson, Arizona, said she had a hard time justifying putting so many resources into smallpox vaccinations. I don't see a tangible benefit, she said. In other words, there is no case of smallpox out there

WASHINGTON _ Many local health departments across the nation say they will have to curtail an array of services, including cancer and tuberculosis screening and children's dental examinations, to meet the needs of President [Bush]'s federal smallpox vaccination program. The Bush administration has requested that health departments administer smallpox vaccine to health care workers on a voluntary basis. Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health care and emergency workers will be vaccinated. In the second, up to 10 million health care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine. The latest demands involve a vaccine that few practicing doctors have ever given because the United States abandoned it as a routine in 1972, eight years before smallpox was eradicated from the world. Now health departments must train workers how to use two-pronged needles to administer the vaccine and recognize its many complications, some rare but potentially lethal

The [Bush] administration has requested that health departments administer smallpox vaccine to health care workers on a voluntary basis. Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health care and emergency workers will be vaccinated. In the second, up to 10 million health care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine. Dr. Thomas R. Frieden, the New York City health commissioner, said he expected the impact to be severe. ''While we appreciate the federal government's support for bioterrorism preparedness, the vaccination drive will be extraordinarily disruptive to our day-to-day work of protecting the public's health,'' Dr. Frieden said. ''This is the unfortunate price we are paying for the level of preparedness it appears we need.'' The latest demands involve a vaccine that few practicing doctors have ever given because the United States abandoned it as a routine in 1972, eight years before smallpox was eradicated from the world. Now health departments must train workers how to use two-pronged needles to administer the vaccine and recognize its many complications, some rare but potentially lethal

Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health- care and emergency workers will be vaccinated. In the second, up to 10 million health-care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine