Conway studied zoology and then agriculture at Cambridge University. He lived for six years in Borneo, where he was in charge of agricultural pest control. Having earned his doctorate in systems ecology, he spent 15 years at Britain¹s Imperial College, where he taught and set up the Centre for Environmental Technology. He worked as a consultant, mostly for the Ford Foundation, in Asia and Africa, lived for a year in Thailand, and then worked for the International Institute for Environmental Development, a nongovernmental organization in London, developing ideas of sustainable agriculture.

He resumed his globetrotting to run the Ford Foundation¹s program in New Delhi for five years, and then returned to Britain as vice chancellor of the University of Sussex, whence he was poached by the Rockefeller Foundation. He now shuttles between two homes, in New York and London. Having adapted to the transatlantic lifestyle, his wife Susan, a professor of art history and an expert in Southeast Asian art and design, now teaches at the Parsons School of Design and the New School University in New York and the British Museum in London.

Conway speaks with pride of the Rockefeller Foundation. Created in 1913, it has long been interested in health isssues. An early focus was the eradication of hookworm, and in the 1920s the foundation helped create what was then called the Peking Medical College in China. It participated in the creation of the yellow fever vaccine, an achievement that involved a number of the foundation staff directly as they were doing research and risking--and, in some cases, losing--their lives. The foundation also funded work on molecular biology in the 1940s, work that served as the basis for much of the later research into DNA.

The foundation focuses on four major themes, one of which is health equity. It deals with diseases like HIV/Aids, tuberculosis and malaria. Another theme is food security, defined as the effort to provide enough food for the poor but also help them develop food sources and get cash from selling agricultural crops. The third theme is working communities in the United States, and involves inner city development, housing, economic development, school reform and race and ethnicity. The fourth theme is referred to as creativity and culture, and focuses on the arts and humanities in the 21st century, in particular their link to both minority cultures in the US and indigenous cultures in Africa and Asia.

Global inclusion is a separate cross-theme relating to the dialogues and negotiations that are taking place internationally that affect the poor, for example on intellectual property rights or biotechnology.

Conway describes these themes with the help of the image of a shuttlecock. Health equity, food seurity, working communities and creativity & culture are the shuttlecock¹s four feathers. The two binders are global inclusion and regional programs. And the white at the bottom represents the poor and excluded people. "You have to work at the global imagery," Conway said, "because a lot of decisions are taken in Washington or Geneva that can have devastating effects on the poor."

The foundation spends about $150 million a year on grants, some 70 percent of that directed toward developing countries. It represents the highest proportion of foundation money going to the developing world. The foundation invests a small amount of its money in start-up financing; for example it has invested in one small company in the US which is producing a microbicide. The investment is made not with the expectation of a substantial return but to get the company going and attract other investors. In Africa the foundation invests in some small seed and fertilizer companies.

The foundation identifies itself as a knowledge-based global foundation with a commitment to enrich and sustain the lives and livelihoods of poor and excluded people throughout the world. "Often, mission statements are pretty vacuous," Conway said. "But this is quite important. We focus on the poor and excluded people, and our grants have to demonstrate that that¹s who¹s getting them," he added. "We provide grants for what are, in a sense, experiments, to see if we can find a way of improving things. And then, if that works, we try to do it on a much larger scale."

Conway sees globalization as having the two faces of the god Janus. "The dark side of the project is when the rich get richer and the poor get poorer. Then there¹s a light side to Janus, when everybody benefits. But there¹s nothing inevitable about these options, and it¹s up to us to determine which option we want and to elaborate policies and create institutions and regulations to ensure that globalization goes to the benefit of all, and to motivate the private sector to see that it can profit."

Public/private partnerships have had some bad press recently, but Conway stressed that the free-market system does not necessarily provide public goods for the poor. "The pharmaceutical industry hasn¹t provided any drugs for TB for 20 years. It¹s not really working on vaccines for AIDS in Africa, it¹s not doing any work on microbicides except on a very small scale. The problem with multinationals and all large companies is that shareholders want a quick return, so companies will want to invest in what brings a quick return, drugs for aging, Alzheimer¹s disease, cardiac problems. There¹s not enough of a market for the diseases of the poor."

The Rockefeller Foundation is also trying to create an entity in which biotech companies will donate some of their intellectual property for agriculture in Africa. Such companies have patented formulations, many of which they will never use. The foundation is trying to convince the companies that by donating these dormant patents they may gain understanding of how their formulations will work in the field and also earn the good will of the community.

Funded by a mixture of private and public money, the international AIDS vaccine initiative, created in 1996 by the foundation. is developing vaccines for Africa. One vaccine now being tested in Nairobi is doing well and is soon going into third-phase trials. Conway said that there are eight or more vaccines appropriate for Africa in the pipeline. (The HIV virus is constantly mutating so that one vaccine would not be able to target all strains.) "We may have to deal with the virus the way we deal with influenza, a different vaccine for each new strain, and that will be a hell of a challenge," Conway said.

"The AIDS epidemic will surpass the plague, the Black Death of the Middle Ages; it will be the worst epidemic the world has ever seen,"Conway said. "There are about 50 million people infected over all--about 25 million in sub-Saharan Africa, though that figure is probably a low estimate. The average life expectancy in many countries has fallen by a decade. Countries in southern Africa have enormously high rates of infection. Some countries really worked on sexual behavior and curbed the spread of the disease. For example, in Uganda the age of first sexual intercourse has increased, mostly because the leadership has been outspoken about the dangers of HIV infection."

The effects of the AIDS epidemic are devastating to the fabric of Africa. A large proportion of the teachers in Kwa Zulu Natal has died of AIDS. The epidemic has created a large number of orphans, and grandparents are forced to look after their children¹s children. The argument that this was just a product of poverty is descredited by the fact that the rich in Africa are suffering just as much as the poor from AIDS. In recent years there has been a large increase in infection of women, in particular wives infected by their husbands, because men often resist using condoms with their wives. The infection is frequently passed on to infants. "And that¹s, I think, the most obscene inequity in the world today," Conway said. "You¹ve got one infant being born every minute of the day with HIV. We¹ve been talking for an hour. Two hundred women have been infected with HIV while we¹ve been talking, and 60 children have been born with HIV." The infection is transmitted during birth or through breastfeeding. The drug nevirapine, given to the mother during labor and to the child after birth, can be 80 percent effective in stopping transmission of the virus during birth for a cost of $4. "When Kofi Annan launched a global fund for HIV/AIDS, malaria and TB, we decided among the foundations that we would try to do something that would be complementary to the fund, in some sense show the way forward,"Conway said. That step would be to start treating the mothers to prevent infection of the children.

"We¹ve started a program called pMTCT-Plus to prevent transmission from mother to child. The little Op¹ stands for prevention, OMTCT¹ is mother-to-child transmission, and the OPlus¹ is also treating the mothers." Foundations including the Bill and Melinda Gates Foundation, the Packard Foundation, the Hewlett Foundation, the MacArthur Foundation, the Kaiser Family Foundation and the Robert Wood Johnson Foundation have raised approximately $60 million and committed to a total of $100 million over the next five years.

More than 100 sites currently offer pMTCT in Africa. Some are administered by Unicef, others by the Elizabeth Glaser Pediatric AIDS Foundation. In recent years, AIDS initiatives have increasingly focused on prevention rather than just care. Most of the work of the Rockefeller Foundation for the last 10 years has been on prevention. "But in this last year we decided we needed to work on care as well, partly because the extent of the epidemic is such that you can¹t just walk away. But also because we realized that the lack of care was affecting the way in which poor people see health care services generally. Given that this is the biggest illness all around in poor communities, the fact that the health care system couldn¹t do anything much more brings the whole question of health care into disrepute and undermines every attempt to improve health generally," Conway said.

The Rockefeller Foundation is also funding research into a new method of administering AIDS treatment that involves giving anti-retroviral drugs for three months and then suspending them for three months. There is evidence from studies in Europe and the United States that this method may work as well as, if not better than, continuous treatment. Nobody quite knows precisely why, but it entails fewer side effects. It is possible that during the off-treatment months the virus may lose some of the resistance it might have been building to the drugs.

Conway sees microbicides--compounds that would kill the pathogens of sexually transmitted diseases and also the HIV virus--as a very important element of fighting the spread of AIDS. Because the use of condoms is largely controlled by men, that means that women, particularly wives, are left exposed. A microbicide would return the initiative to women and might be used as a gel or a foam or an impregnated pessary. There are several promising candidates, Conway said, one of them being produced by the Population Council in New York and derived from seaweed. But the early microbicides will be only partially effective, he warned, and the pharmaceutical companies of the West will be interested in microbicides for Western women only if they¹re very effective and can be had over the counter. That is still several years away, he said.

The Rockefeller Foundation has created an international partnership for microbicides (IPM). That¹s a partnership of government, academics, private-sector companies (biotech and pharmaceutical) and representatives of nongovernmental organizations (NGOs) to promote the production of microbicides. A long testing period is needed to verify the efficacy of preventative medicines and clinical trials are difficult to set up. The foundation intends to sponsor new compounds and make sure that if a compound passes the trials it will be available cheaply or free of charge. "That¹s critical," Conway said. "I think that¹s the key."

People¹s reactions to AIDS programs largely fall into two categories. While the success of some anti-retroviral drugs in the United States led to the "Lazarus Effect" -the emptying of AIDS hospital wards as patients improved dramatically, and then to apathy--others are overwhelmed by the extent of the epidemic. "I think it¹s important to say that there are things one can do," Conway stressed. He mentioned Brazil, Uganda, Thailand and Senegal as among the countries that have done a good job of dealing with the AIDS epidemic, but acknowledged that countries like India, Indonesia, Vietnam and China have been very slow to accept that they have a serious problem.

The Rockefeller Foundation funds its projects from the proceeds of an endowment of approximately $3.1 billion invested in the stock market. About $190 million, all derived from income, is spent every year. Conway said the foundation is keen to see the principal grow to maintain the real value of the endowment. The money is divided more or less equally among the four feathers of the shuttlecock. The apportionment of the money is decided by the foundation and approved by its board of directors.

"We like to think of the pMTCT-Plus program as a piece of research,² Conway said. ³We are trying to demonstrate how we can effectively treat adults in Africa. If we can show the way, then the Global Fund of the United Nations will put some money to expand what we¹re doing. The analogy I have is that we are a small icebreaker going through the Northwest Passage and there¹s this great fleet under Admiral Annan behind us, following our lead through the ice."

Breaking through the ice may take a while in a climate where so many claims are made on available funding. But the Rockefeller Foundation has been in the vanguard of health initiatives for almost a century, and Gordon Conway is a patient man. One of his hobbies is growing orchids.