Interview: Bill Gates talks to Recode about his new book, philanthropy, public health

WHO estimates Covid-19 pandemic has killed nearly 15 million people Globally – not only from the virus, but also as an indirect result of the crisis, such as the inability to access other types of care due to overburdened hospital systems. But it doesn’t have to be so catastrophic.Experts say its impact is compounded by a number of factors: the world’s ill-preparedness for the pandemic, slow progress in developing and delivering Covid-19 tests in many countries, and economic inequality make everything worse.

Low- and middle-income countries are still struggling to obtain life-saving vaccines, putting these populations at continued risk of contracting the virus.In the United States, a preprint Working-class Americans were found to be five times more likely to die from Covid-19 than college-educated Americans.In general, the epidemic has also Global income inequality widensin part because rich countries can Provide more financial relief For their residents, poorer countries have far fewer tools to recover.

Two years after declaring the Covid-19 pandemic, Bill Gates writes How to prevent the next pandemicthe book outlines how the Bill & Melinda Gates Foundation co-founder and global health expert believes the world should prepare for future health crises — including how we can address the enduring problem of economic inequality, which Problems put already vulnerable people at greater risk. In the US, Poverty rate falls in 2021 Because of pandemic relief spending, such as stimulus checks and the expanded child tax credit. But since then, Poverty is rising againand Child poverty has risen sharply Many parents will receive monthly cash benefits between July and December 2021 after the expanded child tax credit expires.

Here are five ideas Gates explored via email via Recode on how to consider economic inequality when preparing for the next pandemic. The interview has been lightly edited for clarity.

Wizkin

In your book, you mention how people are wary of the outsize influence of wealthy philanthropists today — while also acknowledging that many governments did not act adequately when the pandemic hit.

How can we make sure the government can step up next time? Do you think it’s mostly about funding the right institutions (and requiring higher taxes)? Is it a matter of political will? Is it something else?

Bill Gates

I hope that after the past two years – millions of lives lost and trillions of dollars in economic impact – now every country understands that they need to do more at the government level. Philanthropy can test new ideas and mobilize resources faster than governments, but epidemic prevention requires long-term funding and support, and global cooperation. The world cannot and should not rely on philanthropy to lead this.

In my book, I write that governments need to prepare for outbreaks and prevent epidemics in the same way they fund fire and earthquake prevention measures and practices. To end preventable diseases and prevent emerging diseases from becoming pandemics, governments will need to increase investment in vaccine and therapeutic development, comprehensive disease surveillance, and well-funded multilateral organizations such as the World Health Organization (WHO). They also need to make greater investments to improve primary health care in all countries.

The natural place for government funding is the World Health Organization, as it was created to coordinate the global response to health problems. Philanthropy cannot be a voting member of WHO. It is up to each member state that WHO needs to focus on pandemic prevention. But at the moment, WHO does not have the funds to do much of the work on the pandemic. It does not have a large number of full-time employees. It does not require states to conduct exercises. That needs to change if the world is to get serious about making Covid the last pandemic.

Wizkin

Do you think there will always be a need and space for private philanthropy to coexist with government? What, if any, needs to change in the relationship between the private and public sectors? How do we get there? Who needs to change it?

Bill Gates

Governments play the most critical role in protecting people from infectious diseases and other serious health risks. But I do believe that philanthropy has a role to play – for example, we can fund initiatives that governments or the private sector cannot or won’t. Most global health problems, such as malaria, need to be addressed outside of traditional market-based systems because they will never be profitable for the private sector.During the Covid pandemic, scientists, philanthropists and global health agencies such as ACT Accelerator) to develop, test and deploy safe and effective vaccines faster than ever before. This is a great example of how the three departments can work together to solve these big problems.

Wizkin

How might public policy need to change so that we are better prepared for the next pandemic, and what role do you think billionaires/other wealthy philanthropists play in that?

Bill Gates

One of the greatest tragedies the world has learned from Covid is that governments are not investing enough in the tools they need to effectively prepare for a pandemic. Countries need to strengthen and develop policies and invest more in strengthening disease surveillance, funding research and development, and strengthening health systems. What I’m trying to do, and what the foundation is doing, is to help catalyze new ideas, especially those that help to give people in low-income countries equitable access to life-saving tools, who often come as new health innovations emerge. left behind in the market. We also play a role in attracting the private sector, helping companies secure financing to produce tests, treatments and vaccines for low- and middle-income countries.

Wizkin

The public discourse surrounding Covid-19 has become extremely polarized and politicized. What are your thoughts on the role of misinformation versus good, reliable information in public health outcomes?

Bill Gates

I worry about the spread of misinformation and conspiracy theories about public health because it leads people to question their doctors and question the science. It’s understandable that people are looking for easy answers because it’s been a pretty scary two years. And I think most people are worried about their health and the health of their families and loved ones. They came from the right place, but they were pulled in by false information.

Wizkin

What role do you think economic inequality plays in disease outcomes? It’s hindering access to vaccines and medicines in low- and middle-income countries, but we’re seeing even in the United States that black and brown communities are the hardest hit by Covid-19.

How can we ensure that economic inequality is not a major factor in surviving the next pandemic?

Bill Gates

Melinda and I started the Gates Foundation more than two decades ago because we were alarmed by health inequities around the world. Significant progress has been made since then, but even today, children born in Nigeria are about 28 times more likely to die before the age of 5 than those born in the United States.

When Covid came along, these existing health inequalities helped it become a global catastrophe. In my book, I propose a plan that includes three key measures.First, we need to strengthen disease surveillance by establishing early warning systems to coordinate across borders to catch new viruses and outbreaks, the world needs to stand up GERM teama paid full-time team dedicated to pandemic prevention. [Editor’s note: The Global Epidemic Response and Mobilization team is a permanent disease outbreak watchdog group that Gates’s book proposes we create.]

The second is to increase investment in the research and development of next-generation vaccines and effective therapies to ensure production capacity in various regions of the world. We must strengthen global health systems, especially in low- and middle-income countries, and in low-income communities in rich countries, by investing in primary health care.

Some programs focus on equitable health outcomes, such as the Global Fund and the Global Polio Eradication Initiative, Gavi, the Global Financing Facility, and CEPI. Fully funding these organizations would have a major impact on health equity around the world. [Editor’s note: These are all global health programs that the Gates Foundation has funded. The Global Fund is a public-private partnership that finances the fight against AIDS, tuberculosis, and malaria. The Global Polio Eradication Initiative is a WHO-led public-private partnership that seeks to immunize all children at risk for polio. Gavi is a public-private partnership that strives to improve vaccine access in low-income countries. The Global Financing Facility is a World Bank-led public-private partnership that focuses on promoting the health and nutrition of women and children. And CEPI, the Coalition for Epidemic Preparedness Innovations, is a public-private partnership that invests in vaccine research.]

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