I would be much happier with your approach if it included broad reforms in research funding agencies -- reforms that would pour a modest fraction of their funds into channels with different performance criteria. Today, most agencies act under incentives that punish surprising failures, with no effective way to offset these by surprising successes. The result is extreme risk aversion precisely where risk can best be tolerated -- by agencies kept afloat by a sea of tax money, and managing a vast, diversified portfolio of research investments.
What I'd like to see is the use of metrics that try to measure the difference between research that produces one unit of benefit and research that produces a million units. I'd then want policies that judge agencies not by their (ideally, many) failures but by the sum of these and their (potentially enormous) successes. Words and ideas I offer here may be used freely and without attribution.
This is the only upside of wealth inequality, that sometimes a part of the immense wealth accumulated at the top is used for patronage of the arts, of science, or for building something lasting.
So, actually, philantropists like the Gatess foundation could pour money into vaccine research, or into orphan diseases, as we know Big Pharma is only interested in treatment, not prevention.
The sad part is that, in more "socialist" times, a worldwide push to eradicate smallpox was successful, and the likelyhood of anything like that being initiated in our neoliberal international climate is next to zero. Those whom the Gods wish to destroy They first make mad. -- Euripides
But if not for the wealthy, who would buy expensive new high-tech junk that doesn't work well -- thereby creating a market that drives design improvement and cost reduction until the masses can buy low-cost working tech-junk? Words and ideas I offer here may be used freely and without attribution.