How Seattle became a world leader in global health and development

Scientists at the global health giant PATH look at diagnostic tests for onchocerciasis (river blindness) at the nonprofit's laboratory in Seattle. (PATH photo)

SEATTLE, United States — In schools across India this week, schoolchildren are eating pasta disguised as rice kernels and boosted with extra nutrients. At a health clinic in Honduras, a nurse is sterilizing medical instruments with chlorine made from an easy-to-use portable kit. In Kenya, thirsty workers will come home from long days on the job and drink water from reliable, low-cost filters.

All of these innovations are aimed at solving the world’s pressing development challenges. And they all were born in an R&D lab in a glassy office building above a high-end furniture store in Seattle. The lab belongs to PATH, a global health powerhouse whose scientists and engineers churn out vaccines, drugs and diagnostic tools aimed at improving the health and livelihoods of the world’s poorest people.

What PATH does is a long way from shipping timber — the economic activity that first put this port city on the map. It’s also pretty different from the work of global brands that more recently became synonymous with Seattle: Amazon, Boeing, Microsoft. But it’s at the heart of new economic clusters that Seattle is building around the growing industries of global health and international development.

In addition to PATH, the city boasts the Bill & Melinda Gates FoundationPATH’s biggest funder — as well as 650 companies, nonprofits, universities and other foundations engaged in health research, education, poverty and other work in the developing world. How the city became a global leader in these fields is a case study not only in innovation around life-saving ideas, but also how city leaders, businesses and the philanthropic community have nurtured significant new industries. More than 12,600 people here work in the global health sector alone, generating USD 5.8 billion in direct economic impact.

“It’s the world epicenter for setting the global health agenda,” says Tom Paulson, founder of Humanosphere, a nonprofit media outlet based here that covers global poverty and inequality. He puts Washington State’s largest city ahead of other hubs such as Geneva (home of the World Health Organization), Atlanta (Centers for Disease Control and Prevention), Boston (Harvard University and MIT) and Washington, D. C.(National Institutes of Health).

It’s easy to point to the Gates Foundation, the world’s largest charity and a major player in U. N. development circles, as the reason behind Seattle’s global prominence. The foundation plays a vital role to be sure, but Seattle’s story is broader than that. Corporate executives, state and local government officials and other philanthropists also have been making concerted efforts to connect dots between industry players, pull in investment dollars and talented people, and get them all to see themselves as part of something bigger. It’s a story any city in the world can learn from, whether or not they have a billionaire in their backyard.

PATH breaking

PATH’s story sounds straight out of tech-startup-in-a-garage lore. Forty years ago, a trio of researchers began working on family-planning innovations, in hopes of getting contraceptives into the hands of people in the developing world. They parlayed a USD 92,000 Ford Foundation grant and a donated office with orange shag carpeting into a global health behemoth. (Disclosure: The Ford Foundation is a funder of Citiscope.)

From its initial focus on contraception, PATH expanded into many other areas of public health, such as fighting malaria. Its signature invention — developed and deployed with several partners and manufactured by Serum Institute of India — is MenAfriVac, a vaccine for meningitis A that has reached more than 270 million people in 26 African countries. PATH frequently collaborates with local partners on global issues. Outdoor products manufacturer Mountain Safety Research is a partner on PATH’s portable chlorine kit for drinking water. And a joint effort with Seattle Children’s Hospital and the University of Washington School of Dentistry produced a special cup designed for feeding breastmilk or formula to sick and low birthweight infants. PATH now pulls in revenues of almost USD 300 million a year.

In 2010, PATH moved into a state-of-the-art headquarters building in South Lake Union. I recently visited the R&D lab there, a high-tech machine shop where industrial-grade drill bits carve out precision pieces of plastic and devices test products’ durability by shaking them in a vice-like grip. A battered travel case still bore luggage tags marked Entebbe airport from a recent trip to Uganda, where PATH employees lugged vaccine coolers for field tests. Staff from the World Health Organization’s Geneva headquarters were due in the following week to see some of PATH’s innovations firsthand.

PATH’s signature invention, a vaccine for meningitis A called MenAfriVac, has reached more than 270 million people in 26 African countries. (PATH photo) 

PATH’s headquarters are in a Seattle neighbourhood called South Lake Union. It’s a lakeside district on the edge of downtown Seattle, home to dry docks, marinas and a seaplane operation. Starting in the 1990s, many biotech companies began moving in, finding affordable warehouses to set up laboratories. The now booming area boasts research centers for cancer, brain science and cell science, as well as a number of pharmaceutical companies and the University of Washington’s School of Medicine.

Ten years ago, a group of doctors, health researchers and entrepreneurs, most of them representing institutions based in South Lake Union, found that they were increasingly working in a similar corner of the life-sciences field focused on solving global health challenges. They approached PATH and Gates about the idea of starting an alliance that could both promote the industry externally and play matchmaker internally for organizations in need of partners. The Washington Global Health Alliance was born. It would provide some of the glue needed to bind a lot of disparate organizations into something that identifies itself as an economic cluster.

A first step was to work with the local chamber of commerce to make the region’s global health industry the focus of the chamber’s annual retreat — an event that attracts the likes of Seattle’s mayor, Washington State’s governor and the state’s two U. S. senators. Another step was to partner with the City of Seattle’s Office of Economic Development to map the work done by the alliance’s nine members. The results showed 480 global health projects underway in 92 countries.

In 2011, the state Department of Commerce kicked in USD 55,000 for a follow-up mapping study with data from 59 organizations. Those results were even more impressive, finding 2,500 projects underway in 156 countries.

The data helped the alliance net a USD 1.2-million fund from the Washington State legislature to spur commercialization of global-health technology. Those initial state funds have dried up, but they produced big results. “We have seeded hundreds of partnerships,” says Lisa Cohen, the alliance’s founding executive director, who recently retired.

For example, the alliance was a driving force behind a new coalition to tackle anti-microbial resistance, which the U. N. fingered as a major global health priority last year. Cohen also points to Global to Local, an effort to apply global-health methodologies to local health care, starting in some of Seattle’s underserved communities. With such successes, the Washington group even authored a guidebook for how other regions can start health alliances.

‘We do development differently’

Around the same time the Alliance started coming together, local philanthropist Bill Clapp began making some connections of his own.

In the 1990s, Clapp used his stake in the Weyerhaeuser timber fortune to endow a pair of local institutions focused on impact investing and grantmaking to alleviate poverty. He could see that individual charities and NGOs all across the Seattle region were working overseas — not just on global health but also on development issues such as poverty, education and land access. For example, the Christian philanthropy World Vision International relocated from California to the Seattle suburbs in the mid-1990s. The University of Washington had birthed Landesa, an internationally renowned NGO focused on land rights for the rural poor, back in 1967.

To bring these many groups together, Clapp founded Global Washington. It’s an organization that aims to do for the region’s global-development sector many of the same things that the Alliance does for the region’s global-health sector. There’s some crossover between the two advocacy groups, but Global Washington’s umbrella is a bit broader. Executive Director Kristen Dailey describes Clapp’s revelation as “astounding” that “this small town … was more globally-minded than anybody knew.”

Global Washington Executive Director Kristen Dailey addresses the organization’s December conference, which brought together players in the region’s global-development industry. (Global Washington)

Dailey points to a number of nonprofits that have moved to Seattle, opened local offices or relocated staff here. She rattles off bike donor World Bicycle Relief, the U. S. branch of Oxfam International, humanitarian relief organization Mercy Corps, microcredit specialist Grameen Foundation, urban water access provider Splash, and ambitious disease fighter Malaria No More.

At Global Washington’s annual conference last December, founders of small NGOs were able to corner bigwig funders for an elevator pitch and exchange of business cards. Aid professionals geeked out about the finer points of competing water filters. And there was much talk about shifting political winds in what everybody called “the other Washington”. Would Donald Trump cut U. S. aid budgets? Would global-development talent flee uncertainty in the nation’s capital for growing opportunities across the country in Seattle?

“As the business community has done, the global development community has to do — we have to go out and brand ourselves,” Dailey says. In her view, Seattle’s location 2,300 miles from the other Washington is more an asset than a liability. “We do development differently here because we have a tech-minded, forward-thinking, innovative culture,” she argues. “We’re not like the [Washington, D. C.] groups stuck on USAID contracts.”

Gates’ impact

Seattle’s global health and development communities do have their own centre of gravity, however: the Gates Foundation.

In 1997, Microsoft co-founder Bill Gates and his wife Melinda read an article in The New York Times about how a lack of clean water killed poor children in India. That news report struck a chord with the couple. Three years later, the world’s richest man endowed the Bill & Melinda Gates Foundation with nearly USD 2 billion, a sum that has since grown to USD 40 billion.

The foundation operates from a sleek pair of buildings on the edge of South Lake Union in the shadow of Seattle’s iconic Space Needle. Humanosphere’s Paulson calls the Gates Foundation the “8,000 pound gorilla”, one with strong opinions on everything from U. S. foreign policy to the Sustainable Development Goals countries agreed to at the U. N. two years ago.

“When Bill opened the Gates Foundation, it was a seminal moment, a line in the sand,” says Katharine Kreis, Director of Strategic Initiatives for PATH. Lisa Cohen calls the Gates factor “absolutely catalytic”, although not the sole reason for Seattle’s success. “It has certainly helped grow the sector here,” she says.

Bill Gates takes a sip of water produced by a machine that boils human waste to produce potable water. The machine was designed by a Seattle-area firm and piloted in Senegal. (Gates Notes) 

The Gates Foundation’s infusion of billions of dollars — numbers that can compete with the foreign aid budgets of industrialized countries — definitely kicked the global health and development sectors into high gear. PATH’s move to South Lake Union? That was partly financed in part with a Gates-backed loan. PATH’s new vaccine innovation centre? Initial funding came from Gates. The University of Washington’s Department of Global Health? Gates endowed it.

The Gates Foundation doesn’t like to take too much credit locally — Communications Director Josh Lozman, was quick to point out to me in an email that “the city itself was primed for growth long before the foundation started investing.” But Lozman also used the word “catalytic” to characterize Gates’ role.

“Foundation investments in organizations like PATH for vaccine development, and in the University of Washington for data analysis, have accelerated the global health sector’s growth, elevating the issues and attracting both talent and innovations,” Lozman wrote. “Once that happens, there’s a snowball effect — talent follows talent and innovation follows innovation.”

Increasingly, Seattle’s global health and development sectors are mixing in productive ways with its tech sector.

For example, Microsoft is backing NetHope, a consortium of more than 50 international nonprofits working in humanitarian aid. Providing relief in a war zone or after a disaster requires complex IT logistics that nonprofits often can’t afford. NetHope finds affordable tech solutions for its members — often by brokering discounts from tech companies, or sharing resources. PATH, for example, is using data visualization software produced by Seattle-based Tableau to pilot its strategy for malaria eradication in Zambia.

Recently, Tableau offered Global Washington’s nonprofit members a free three-hour training on its data-analysis tools. It’s the kind of service that underlines the benefits of proximity, the core principle of an economic cluster. “Face-to-face is never going to go away,” says Dailey.

Together time

Even as the Seattle region’s global health and development clusters grow, there are challenges ahead.

Some of those challenges are spatial. Much of the activity in these industries happens within Seattle proper. However, Microsoft is headquartered in suburban Redmond and many tech companies call neighbouring Bellevue home. Owing to Seattle’s bad traffic congestion and insufficient transit connections, someone at Microsoft Philanthropies, for example, is unlikely to trek over to the Gates Foundation for a lunch talk.

Soaring rents in South Lake Union may only make the problem worse. As Amazon rapidly expands its office space in the neighbourhood, it’s getting harder for the small nonprofits and startups that fuel a lot of the new thinking in global health and development to locate or expand there.

Soaring rents in Seattle’s booming South Lake Union neighbourhood are forcing smaller players in the city’s global health and development industries to look elsewhere for office space. (AP photo/Ted S. Warren)

Other challenges are more social in nature. While high-tech’s start-up culture relies on networking events as a way to match entrepreneurs and investors, and Washington, D. C.’s policy and think-tank crowds hop from one happy hour to the next, the same is not true in Seattle. “I don’t know we’ll ever have the buzz of New York or D. C.,” Dailey says. “People have their heads down working really hard.”

Cohen thinks there could be scope for municipal or state investment in a bricks-and-mortar project that could address these problems: an incubator that could house multiple small NGOs in one place. Incubators and “accelerators” are nothing new in the tech startup world — there are 21 in Seattle alone — but it would be new for the global-health and development sectors in Seattle.

“That would be a visionary way to approach this if we want to keep this intellectual firepower and tremendous global influence here in Seattle,” Cohen says. Despite all the Boeing airplanes, Microsoft software and Amazon Kindles the region produces, she insists, “to me, global health is the greatest export this state has to offer because it’s saving tens of millions of lives.”

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Gregory Scruggs is a senior correspondent for Citiscope. Full bio


  • Government, business, philanthropy and the NGO sectors have gradually built economic clusters focused on global health and development.
  • This growth was aided by formation of industry associations that connect dots between players, pull in investment and people and get everyone involved to see themselves as part of something bigger.
  • Being home to the world’s largest charity — the Bill & Melinda Gates Foundation — has helped Seattle’s growth, but it’s not the only factor. 

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