Derek Lowe at In the Pipeline blogs about some shifts at the Bill and Melinda Gates Foundation, where millions of dollars in public health grants haven't necessarily led to the breakthroughs hoped for when the organization began. According to Lowe, the foundation is switching course away from the milestone-specific, highly supervised grants of the past few years to more pie-in-the-sky grants for infectious disease. Lowe says that the big-picture lesson here is that no matter how much money you pour into the field, there just aren't simple solutions for these major health concerns.