Time - USA (2020-08-17)

100 Time August 17/August 24, 2020

6 Questions

‘

OUR R&D RESPONSE—

FUNDING VACCINES

AND THERAPEUTICS—

HAS BEEN THE BEST

IN THE WORLD

’

we did with hydroxy chloroquine and

give it emergency use, when there was

no serious data to suggest there was any-

thing there. It was purely political. Sort

of like a wives’-tale type thing. We really

can’t do that with the vaccine.

Are you confident that the fall won’t

be as disastrous as this summer?

Strangely, the death rate this summer

has not gotten up to the peak death rate,

and that’s partly because we do have

remdesivir and dexamethasone. There

are things the medical profession with

lots of heroes and great thinking does to

reduce the death rate. So the fall is a mix

for me, where the innovation track is the

good news that could bring things down,

but a lack of social distancing —that one

hangs in the balance.

How confident are you that vaccine

manufacturing and distribution

will provide a vaccine to everyone

who needs one? As yet, the U.S. hasn’t

spoken up on its willingness to help the

developing countries here, like the U.S.

has done in every other global health

thing. I’m hopeful that the supplemental

bill, like 1% of it, will go to people like

Gavi and Global Fund, who bring us that

health equity.

Are you optimistic about how we will

manage this pandemic? I think the

U.S. response will improve. I think

the innovation will come along. I think

U.S. generosity will show up to help

the world on this. I mean, it’s a huge

setback. The only good thing that will

come out of this is we’ll advance some

technologies that will help us be

ready for a future pandemic, and will

help us with other diseases. But I was

one of the voices that said we should

be ready for this. We weren’t ready for

it, and the price of that will be very high.

But we will get past it. —Alice PArk

Adapted from a TIME 100 Talk.

Watch the full interview with Gates

at time.com/gates-interview

T

his pandemic seems a little dif-

ferent in that the U.S. doesn’t

seem to be serving as a model

for how to best respond. What has

been responsible for that? If you

score the U.S., our domestic response

has been weak but can improve. Our

R&D response—funding vaccines and

therapeutics— has been the best in the

world. And then in the third category,

making those tools available to the

world, we’re hoping this supplemen-

tal bill—1% to the resources—would be

enough to have a pretty dramatic effect

and get other countries to give. So that

one’s incomplete still.

How do you think government leaders

can better work with public-health

leaders to learn from the lessons of

Ebola, HIV and previous influenza

outbreaks? Well, it is amazing, the

contrast to Ebola—the U.S. allocated

money and went and helped out, even

though the threat of that to the U.S. itself

was very, very minor. Here we haven’t yet

shown up in the international forums,

where the money to get these tools out to

countries is being discussed. That still

absolutely can be fixed. The private

sector [left] all by itself would simply

charge the highest price and only

give to the very wealthy. When you

use the private sector, which is where

the deep expertise is, you have to use

them in the right way. And that’s not

being done. It can’t just be

a pure market-driven thing.

The Gates Foundation is one of the

largest funders of vaccine research

around the world. How can we ensure

that vaccine trials are successful? The

political pressure to move quickly is not

a perfect thing—even calling the thing

[Operation] Warp Speed, talking about

going around certain Food and Drug

Administration guidelines. So far, the

staff, the nonpolitical staff, has held the

line that we really have to prove effi-

cacy and have the full safety database

and that we’re not going to go off like

Bill Gates The tech magnate turned

philanthropist on the U.S. response to COVID-

19, prospects for a vaccine and how to share it

JEFF PACHOUD—AFP/GETTY IMAGES