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founders' deaths, the Gates Foundation has been programmed to dole out all its cash and wind itself up 20 years after their deaths. The instinct to shake up the complacent and challenge the intellectually lazy doesn't always win Gates friends. Putting his personal money and reputation on the line to eradicate a disease has also risked accusations of vanity --a case of the "ego philanthropy" that can distort goals when the super-rich get involved. Wiping out a disease has only happened once before, when the World Health Organisation declared in 1980 that smallpox had been eliminated. Helping to finance and organise a second eradication would cap the Gates Foundation's emergence as the most significant private charity in the world of global health. It would also set the stage for the next items on the list of diseases it hopes eventually to wipe out, starting with malaria. << OLE Object: Picture (Device Independent Bitmap) >> OAP Gates with his wife Melinda, at a meeting in 2011 with members of the Mushar community in Jamsot, near Patna, India Gates brushes off questions about the merits of the eradication effort and whether other initiatives might be a better investment in terms of the immediate number of lives saved. "Eradications are special," he says. "Zero is a magic number. You either do what it takes to get to zero and you're glad you did it; or you get close, give up and it goes back to where it was before, in which case you wasted all that credibility, activity, money that could have been applied to other things." Since he threw his organisation behind the effort, polio has been eradicated in India. But it remains rooted in Afghanistan, Nigeria and Pakistan, spilling over sporadically into their neighbours. That these three countries remain among the world's most difficult to operate in -- in Pakistan, the Taliban has taken to bombing vaccination teams, accusing them of being in cahoots with the CIA -- provides a clue about why, nearly 30 years after the eradication campaign began, polio persists. Eradication has little to do with making advances in science and technology -- though work on new vaccines targeted more directly at the strains of the disease that remain has helped in the fight. Take one of the biggest challenges to managing immunisation campaigns against polio and other diseases in the developing world: getting vaccines to where they're required while keeping their temperature in a narrow 2C-8C range to prevent them spoiling. Running the so-called "cold chain" needed for this to happen -- from big refrigerators in regional distribution centres to the cases vaccinators carry into the field -- requires painstaking logistical organisation. Often, kerosene or other fuels used in refrigeration are in short supply or antiquated