List of unsolved problems in medicine

Evidence-based medicine (EBM) has become the central paradigm in medical practice and research. However, debate continues around EBM and about how results obtained from large samples of patients can be applied to the individual.[1][2][3][4]

There are numerous diseases for which causes are not known. There are others for which the etiology is fully or partially understood, but for which effective treatments are not yet available. It is safe to say that no disease is completely understood.

Idiopathic is a descriptive term used in medicine to denote diseases with an unknown cause or mechanism of apparent spontaneous origin.[5] Examples of idiopathic diseases include: Idiopathic pulmonary fibrosis, Idiopathic intracranial hypertension, and Idiopathic pulmonary haemosiderosis.

On 26 January 2003, Bill & Melinda Gates Foundation made available $200 million for a medical research initiative on "Grand Challenges in Global Health". The initial list were:[6]

To improve childhood vaccines:

• GC 1: Create effective single-dose vaccines that can be used soon after birth;
• GC 2: Prepare vaccines that do not require refrigeration;
• GC 3: Develop needle-free delivery systems for vaccines.

To create new vaccines:

• GC 4: Devise reliable tests in model systems to evaluate live attenuated vaccines;
• GC 5: Solve how to design antigens for effective, protective immunity;
• GC 6: Learn which immunological responses provide protective immunity.

To control insects that transmit agents of disease:

• GC 7: Develop a genetic strategy to deplete or incapacitate a disease-transmitting insect population;
• GC 8: Develop a chemical strategy to deplete or incapacitate a disease-transmitting insect population.

To improve nutrition to promote health:

• GC 9: Create a full range of optimal bioavailable nutrients in a single staple plant species.

To improve drug treatment of infectious diseases:

• GC 10: Discover drugs and delivery systems that minimize the likelihood of drug-resistant microorganisms.

To cure latent and chronic infections:

• GC 11: Create therapies that can cure latent infections;
• GC 12: Create immunological methods that can cure chronic infections.

To measure disease and health status accurately and economically in poor countries:

• GC 13: Develop technologies that permit quantitative assessment of population health status;
• GC 14: Develop technologies that allow assessment of individuals for multiple conditions or pathogens at point-of-care.