The Path Forward, According to Bill and Melinda Gates

June 26, 2020

Takeaways

A discussion moderated by Suzanne Clark
The coronavirus pandemic has changed the world in many ways. It has altered nearly every facet of our lives – the way we work, travel, learn, and more. As we learn how to navigate life in a pandemic, global leadership across all sectors – public, private, and philanthropic – has never been more important.
 
Bill and Melinda Gates have dedicated their lives to advancing science and improving public health. A few years ago, Bill brought attention to the risks of a deadly global pandemic. His warning is now our reality. He and Melinda have devoted themselves and their organization to finding a solution. The Bill and Melinda Gates Foundation has committed more than 300 million dollars to the global COVID-19 response.
 
In a special episode of our Path Forward series, we had a chance to learn more about their thoughts on the importance of a coordinated international response to the pandemic, the lasting changes we might see coming out of the crisis, how to ensure equitable access to COVID-19 treatment and vaccines, and much more.

The Panelists
 
Suzanne Clark, President, U.S. Chamber of Commerce
Bill Gates, Co-chair and trustee, Bill and Melinda Gates Foundation
Melinda Gates, Co-chair and trustee, Bill and Melinda Gates Foundation

Prioritizing the Fight
 
Suzanne Clark: What is the Gates Foundation doing to fight the coronavirus, and why is it such a priority for you? 
 
Bill Gates: Our Foundation has a big focus on infectious diseases that kill millions of people, primarily in developing countries. Our understanding about how you design a vaccine, we’ve funded a lot of new vaccines. We're a partner in Gavi, The Vaccine Alliance, which actually buys vaccines for developing countries. And we have a lot of the expertise that's not in the private sector to pick which of these we should build factories for and how we coordinate all this activity. It's become a huge focus for us. The benefit of getting the vaccine, even three or four months earlier, would be very dramatic in terms of ending both these awful economic effects as well as the death and disease.
 
Suzanne Clark: Do you think we'll see a vaccine at scale? And what can we do to make distribution equitable?
 
Melinda Gates: Yes. I think we all believe that just seeing the various vaccine candidates that are coming through the pipeline, there are three that are looking quite promising, luckily. And I think we all believe that by 2021, we will have a vaccine. We're working ahead of time with the manufacturers, with the pharmaceutical companies, to try to have manufacturing capability ready to go. So as soon as those trials are finished, the vaccine can go immediately into manufacturing.
 
The whole reason we got involved in this vaccine was to make sure there's equitable distribution. The last thing you want is a bidding war between countries for this vaccine. We know there are 60 million health care workers around the world who are keeping everybody safe. They deserve to get this vaccine first. And from there, you want to do tiering in various countries to make sure your most vulnerable populations get it. In our country, that would be Blacks and Native Americans, people with underlying health conditions, and the elderly.
 
We need to look at as a globe and we're involved with many European leaders and African leaders and others in Southeast Asia to make sure there's a purchasing fund that can pull that vaccine through when it's available and get it out in wide-scale distribution.
 

This won't be the last pandemic that we face.  

 
Predicting the Future
 
Suzanne Clark: Bill, you got widespread attention for a prediction you made in 2015 about the dangers of the global pandemic. And you, sadly for the world, did predict the future. What are you concerned about now?
 
 
 
Bill Gates: This won't be the last pandemic that we face. Pandemics can come from natural causes, which is largely coming across from other species. A flu, for example, is still a very big risk. We'll have to invest in making sure that we catch the disease sooner and that we have platforms to make diagnostics, therapeutics, and vaccines very quickly.
 
Very little was invested, even though there were these calls by a lot of people, including our Foundation. One group that was funded, the Coalition for Epidemic Preparedness Innovations (CEPI), is helping out here. We're better off than if that hadn't happened. 
 
People trust government to think through these things. This was a failure to get ready, and the cost would have been tiny compared to what we spend on being ready for war. We didn't actually do the simulation to think about nursing homes, getting factories ready, the testing regime. In fact, the testing was ramped up very quickly in a few countries that have almost avoided the epidemic entirely like Taiwan, New Zealand, and Australia. They took their experience, prepared, and moved a lot faster. We'll have to prepare for the next one. That will get attention this time.
 
Suzanne Clark: What do you think is different about the vaccine development this time that makes us think the development will happen? Is it this global coordination?
 
Melinda Gates: It's the pharmaceutical companies working together with scientists from all over the globe in a very coordinated fashion. We have never seen the companies come together in this way and to be thinking ahead about manufacturing – not just for their own country or their own region, but for other places in the world. What makes us optimistic is the many conversations we’re having, the way we're seeing the scientists move forward with the data as soon as they get it, and also seeing global leaders come together. The European Commission did a huge pledging event for this vaccine alliance that we've been part of so that when the vaccine is ready to go, we can purchase that vaccine for the rest of the world.
 
Suzanne Clark: Is the same thing true on therapeutics and testing? Will this get us to where we need to be on the other side?
 
Bill Gates: Well, people are caught a little bit flat footed in that usually, the U.S. is very well organized. This new drug that got proven out, that's a trial network we've funded with others like the Wellcome Trust in the U.K. Usually, you expect the U.S. to do good coordinated trials and to pick drugs for their scientific merit. The world has had a little bit of a hard time when the U.S. testing went in the wrong direction, when it hasn't been a federal notion of how you prioritize things. But I have to say, the Europeans are filling that vacuum, particularly in terms of caring for the entire world. Their generosity has been quite good. 
 
People hope that the U.S. comes back, although withdrawing from the WHO is a step in the opposite direction. But historically, the U.S. did smallpox eradication, the Rotary has been behind the polio progress that we've made, and there's still a chance for the U.S. to contribute on this. 
 

COVID-19 anywhere is COVID-19 everywhere. 

 
An Invisible Threat
 
Suzanne Clark: If you were talking to a small business person in the middle of the country somewhere who might not understand that, explain why it’s so important that we reach beyond our borders and help control this virus.
 
Melinda Gates: COVID-19 anywhere is COVID-19 everywhere.  For a small business owner, the supplies that come in that help you run your business don’t necessarily come from the United States. And your customers probably aren’t necessarily just U.S. customers. If we want to have global trade and a global supply chain and global manufacturing, we have to get the whole world coordinated in its response to this disease because it’s not going to be able to be contained in one or two places.
 
Bill Gates: To put it in perspective, the U.S. has spent trillions of dollars to try to deal with the problem here. We’re only talking about less than a few percent of that that would need to be spent in helping get rid of the disease in the entire world. It’s not like there’s some gigantic tradeoff. Just like the WHO is 500M a year for things like reproductive health, vaccines, polio, it covers a lot of different areas. Its not competing budget-wise with the large-scale resources.
 

It is up to us to rebuild the world we want. 

 
Suzanne Clark: How is the world changing in a broader sense as a result of this virus? What do you think we’re going to see as some lasting changes as a result of this health and economic crisis?
 
Melinda Gates: That is yet to come, and it is up to us as citizens to help rebuild the world that we want. This crisis has exposed some gaps around the world, and particularly in the United States.  One of those is the gender and racial inequities that exist. Women do 2.5X more work at home than men do. That’s the unpaid labor – taking care of the kids, making the lunch, making sure they’re online learning.  It’s way past time that the United States has a paid family medical leave policy, We’re the only industrialized nation that doesn’t, and if we want to put people back to work safely and keep their families from getting sick, we need to have paid family medical leave.  Congress, in its wisdom, started to address that in two of the stimulus bills. We need a long-term solution.  
 
I would also add that not only has COVID-19 exposed the gaps in the system, it has also shown us opportunities, like the fact that kids can jump online and start learning. Unfortunately, it’s not all kids, because many kids didn’t have access to a computer or good digital literacy online or teachers who knew how to teach online.  But we know now that it’s possible. Now we will make sure that technology is spread equitably and those great lesson plans and advising can happen.  
 
In the developing world, there are many people who do digital banking on their phone.  That was already at scale in a number of countries, but all of a sudden, people really saw the benefit in not needing to stand in lines where they might get sick.  In just Pakistan alone, in 48 hours, 40 million additional people signed up for a digital bank account. That is an opportunity we can use to reach low-income families and women on that phone with all kinds of things like cash transfers, more information, and health services. Some of those digital opportunities are hitting in ways we didn’t expect quicker than we thought they would.
 
Our New Normal
 
Suzanne Clark: What have you learned about yourselves in this time and what has changed about the way that you are working?
 
Bill Gates: It’s impressive that, for office work, you can do quite well. In our Foundation, nobody has been in the office for over three months now, but our work is going on full speed.  Because I’m involved with software, I think about how we can make these platforms even better, but it has been decent enough to allow a lot to happen.  It’s certainly going to accelerate the questions of whether we need to travel as much and how good can we make online education and telemedicine. It’s like 10 years of progress on those things have been compressed into a couple of years.
 
Melinda Gates: Our lives, like everybody here in the U.S., have changed substantially.  We’re lucky to not be struggling to put a meal on the table, but working from home was not something we did as much of before. We’re using a lot of Microsoft Teams and Zoom. When I go back to work, I’ll be wearing my tennis shoes. And I’m not going to travel as much. There will be meetings I travel for, and there will be reasons to go to Africa and Southeast Asia, but conferences can be changed and we’re doing them online now. Traveling less will give me more time to enjoy life and step outside a little bit more.
 
Watch the conversation