The bill gates problem, p.46
The Bill Gates Problem, page 46
“Gavi’s supreme goal”: William Muraskin, “The Global Alliance for Vaccines and Immunization: Is It a New Model for Effective Public–Private Cooperation in International Public Health?,” American Journal of Public Health 94, no. 11 (November 2004): 1922–25.
hold only five seats: Gavi, “Funding”; Gavi, “Gavi Board,” n.d., https://www.gavi.org/our-alliance/governance/gavi-board; Gavi, “Annual Contributions and Proceeds 30 June 2022,” n.d., https://www.gavi.org/investing-gavi/funding. Note: Both donor countries and recipient countries have five board seats. The $35 billion figure comes from pledged donations to Gavi through 2025. Gavi would not respond to detailed questions sent by email about its funding. My calculation tallied up the “grand total” of “Donor governments and the European Commission” for periods 2000–2010, 2022–2015, 2016–2020, and 2021–2025.
40 percent: Village Global, “Bill Gates on Startups, Investing and Solving the World’s Hardest Problems,” Interview by Julia Hartz, 2019, YouTube, 24:00, https://www.youtube.com/watch?v=W5g4sPi1wd4.
billions of dollars for projects related to pneumonia: The Gates Foundation’s public reporting of its charitable grants makes it difficult to pinpoint its precise spending on specific topics. Grants totaling close to $5 billion have gone toward projects that the foundation has categorized as related to pneumonia, though many of these projects are also coded as being directed at other diseases or topics.
stunning array of vaccine developers: Gates’s donations to Genocea, Pfizer, and GSK are not specifically earmarked for work on pneumococcal conjugate vaccines but they nonetheless create financial ties that give the foundation potential avenues of influence. Likewise, the foundation also has provided co-funding, with the U.S. Biomedical Advanced Research and Development Authority, to a project called CARB-X to support other companies that work on pneumonia vaccines, like Vaxcyte and SutroVax, though Gates’s money was not directed at work on pneumonia. “Vaxcyte Announces Expanded CARB-X Award to Advance Development of VAX-A1, a Vaccine to Prevent Group A Streptococcus Infections—Vaxcyte, Inc.,” Press Release, August 5, 2021, https://investors.vaxcyte.com/news-releases/news-release-details/vaxcyte-announces-expanded-carb-x-award-advance-development-vax/; “CARB-X Funds SutroVax to Develop a New Vaccine to Prevent Group A Streptococcal Infections,” News, CARB-X, September 3, 2019, https://carb-x.org/carb-x-news/carb-x-funds-sutrovax-to-develop-a-new-vaccine-to-prevent-group-a-streptococcal-infections/.
“many, many more”: Notably, the Gates Foundation has not publicly disclosed giving money to these companies for work on pneumonia.
seed funding: GSK/Affinivax, “Affinivax Launches Novel Vaccine for Global Impact on Infectious Diseases—Affinivax,” Press Release, October 30, 2014, https://web.archive.org/web/20210921135547/https://affinivax.com/affinivax-launches-novel-vaccine-for-global-impact-on-infectious-diseases/; Affinivax, “Board of Directors—Affinivax,” Affinivax, n.d., https://web.archive.org/web/20150201121843/http://affinivax.com/about/board-of-directors/. Note: The deal actually included milestone payments that could increase the payout to more than $3 billion.
acquired Affinivax: “GSK to Acquire Clinical-Stage Biopharmaceutical Company Affinivax, Inc.,” Press Release, Affinivax, May 31, 2022, https://web.archive.org/web/20221002223521/https://affinivax.com/gsk-to-acquire-clinical-stage-biopharmaceutical-company-affinivax-inc/.
financial windfall: Bill & Melinda Gates Foundation, IRS 990 Filing, Addendum to Part VI-B, Line 5d, Expenditure Responsibility Statement.
philanthrocapitalism: “The Birth of Philanthrocapitalism,” Economist, February 25, 2006, https://www.economist.com/special-report/2006/02/25/the-birth-of-philanthrocapitalism.
My own reporting: Schwab, “Bill Gates Gives to the Rich (Including Himself).”
“deserving charity claimants”: See also Linsey McGoey, No Such Thing as a Free Gift: The Gates Foundation and the Price of Philanthropy (New York: Verso, 2015).
“Its wealth and market power are such”: Lohr, “Where Microsoft Wants to Go Today.” Note: An accompanying chart to the article enumerated a long list of companies Microsoft had invested in or acquired over the previous three years: Hotmail, DreamWorks, NBC, Vermeer Technologies, and dozens more.
spends more money on malaria: PATH, “Bridging the Gaps in Malaria R&D: An Analysis of Funding—From Basic Research and Product Development to Research for Implementation,” PATH, 2018, 8–9, https://www.malariavaccine.org/resources/reports/investigating-second-valley-of-death-malaria-rd.
securing exclusive licenses: “Calibr and Bill & Melinda Gates Medical Research Institute Announce Licensing Agreement for Novel Candidate Tuberculosis Treatment Compound,” Yahoo! Finance, February 15, 2023, https://finance.yahoo.com/news/calibr-bill-melinda-gates-medical-130000099.html; “Merck and the Bill & Melinda Gates Medical Research Institute Announce Licensing Agreement for Novel Tuberculosis Antibiotic Candidates,” BusinessWire, October 18, 2022, https://www.businesswire.com/news/home/20221018005485/en/Merck-and-the-Bill-Melinda-Gates-Medical-Research-Institute-Announce-Licensing-Agreement-for-Novel-Tuberculosis-Antibiotic-Candidates.
spends (slightly) more: “Tuberculosis Research Funding Trends,” Treatment Action Group, December 2022, Figure 10, https://www.treatmentactiongroup.org/resources/tbrd-report/tbrd-report-2022/. Note: The Gates Foundation grant records show $10 million in donations to the NIH and the National Institute of Allergy and Infectious Diseases and $44 million to the Foundation for the NIH, all earmarked for work on tuberculosis.
let slip in a press conference: Tim Schwab, “While the Poor Get Sick, Bill Gates Just Gets Richer,” Nation, October 5, 2020, https://www.thenation.com/article/economy/bill-gates-investments-covid/.
Oxford partnered with pharma giant: Erin Banco, Ashleigh Furlong, and Lennart Pfahler, “How Bill Gates and Partners Used Their Clout to Control the Global Covid Response—with Little Oversight,” Politico, September 14, 2022, https: //www .politico.com/news/2022/09/14/global-covid-pandemic-response-bill-gates -partners-00053969.
“hands-on thing”: Village Global, “Bill Gates on Startups, Investing and Solving the World’s Hardest Problems,” 26:55.
survey instrument: Bill & Melinda Gates Foundation, “Production Economics for Vaccines,” 2016, https://docs.gatesfoundation.org/Documents/PE_Vaccines_Appendix_2016.xlsm.
Iqbal later left the Gates Foundation: Robyn Iqbal, LinkedIn profile, https://www.linkedin.com/in/robyniqbal/.
“locked up”: “WHO Official Criticizes Gates Foundation ‘Cartel’ on Malaria Research,” New York Times, February 18, 2008, https://www.nytimes.com/2008/02/18/health/18iht-gates.1.10134837.html.
second-largest funder: WHO Programme Budget Web Portal, n.d., https://open.who.int/2020–21/contributors/contributor.
forty million dollars: Bill & Melinda Gates Foundation v. PnuVax, United States District Court, Western District of Washington at Seattle, March 12, 2019, IV, A.14 and B.15. Note: While the foundation pledged close to $40 million to Pnuvax, the foundation’s grant records show it only delivered around $12 million.
K&L Gates: Bill & Melinda Gates Foundation v. PnuVax; “K&L Gates Mourns Passing of Longtime Partner and Humanitarian William H. Gates, Sr.,” K&L Gates, September 15, 2020, https://www.klgates.com/KL-Gates-Mourns-Passing-of-Longtime-Partner-and-Humanitarian-William-H-Gates-Sr-9-15-2020.
forty-eight cents: Bill & Melinda Gates Foundation v. PnuVax, Exhibit 2, page 9.
scientific advisory committee: Bill & Melinda Gates Foundation v. PnuVax, Exhibit 2, page 9.
National Post: John Ivison, “Federal Agency Nearly Shut Down Single Largest Canadian Recipient of Gates Funding,” National Post, November 28, 2017, https:// nationalpost.com/news/politics/john-ivison-despite-gates-funding-canadian-startup-nearly-bankrupted-after-nrc-ignored-rent-leniency-pleas.
“failed to comply with the terms”: Bill & Melinda Gates Foundation v. PnuVax, VII.
Global News: Andrew Russell, “Gates Foundation Sues Canadian Company over ‘Misuse’ of $30M Grant to Develop Pneumonia Vaccine,” Global News, November 28, 2017, https://globalnews.ca/news/5035009/gates-foundation-sues-canadian-company-over-misuse-of-30m-grant-to-develop-pneumonia-vaccine/.
Maclean’s: Justin Ling, “Where Did Canada’s Vaccine Effort Actually Go Wrong?,” Maclean’s (blog), May 31, 2021, https://www.macleans.ca/news/canada/where-did-canadas-vaccine-effort-actually-go-wrong/.
Daily Mail: Boer Deng, “Bill Gates Charity Sues Drug Firm,” Times, March 8, 2019, https://www.thetimes.co.uk/article/bill-gates-charity-sues-drug-firm-rf8gnfxq3; Kayla Brantley, “Bill and Melinda Gates Sue Company That Was Awarded a Grant of Up to $30 Million to Develop a Pneumonia Vaccine for Children—But Allegedly Used the Money to Pay Off Its Back Rent and Other Debts It Racked Up,” Daily Mail Online, March 7, 2019, https://www.dailymail.co.uk/news/article-6777959/Bills-Melinda-Gates-sue-company-paid-30million-develop-pneumonia-vaccine.html.
passed over by the Canadian government’s: Marieke Walsh, “Ottawa Passed Over Private Sector Plans to Produce a Covid-19 Vaccine Domestically,” Globe and Mail, December 7, 2020, https://www.theglobeandmail.com/canada/article-feds-passed-over-private-option-with-plans-to-produce-covid-19-vaccine/. Note: Public records show the foundation filing relatively few lawsuits, so there’s no evidence that legal action is a systematic part of how it works with grantees. But we also have to accept that the large majority of companies and other grantees would never get to that point with the foundation; just the threat of a lawsuit would be an extremely powerful motivator to get a partner in line.
working with a number of different companies: The foundation reports extensive grant funding for work on malaria vaccines, including money to companies, universities, and nonprofits: Agenus, Antigen Discovery, Inc., the Broad Institute, CureVac, Duke University, Fraunhofer USA, Inc., GatesMRI, Infectious Disease Research Institute, Kymab Limited, National Institute of Allergy and Infectious Diseases, Sanaria, Seattle Biomedical Research Institute, Stanford University, Tetragenetics, and others. Gates’s financial support for GSK’s malaria vaccine apparently went through PATH; “PATH Welcomes Landmark Financing Agreement for GSK’s Malaria Vaccine,” PATH, August 4, 2021, https://www.path.org/media-center/path-welcomes-landmark-financing-agreement-for-gsks-malaria-vaccine/.
The vaccine’s efficacy was so weak: Jennifer Rigby, Natalie Grover, and Maggie Fick, “Why World’s First Malaria Shot Won’t Reach Millions of Children Who Need It,” Reuters, July 13, 2022, https://www.reuters.com/business/healthcare-pharmaceuticals/why-worlds-first-malaria-shot-wont-reach-millions-children-who-need-it-2022-07-13/.
vaccine developer named Aeras: “IAVI Acquires Aeras TB Vaccine Clinical Programs and Assets,” Press Release, IAVI, October 1, 2018, https://www.iavi.org/news-resources/press-releases/2018/iavi-acquires-aeras-tb-vaccine-clinical-programs-and-assets. Note: Technically, all of Aeras’s work output appeared to be folded into another Gates-funded product developer, IAVI, which, oddly, focuses on HIV/AIDS.
funding for MenAfriVac began: PATH, “Lining Up for Hope—and a Meningitis Vaccine,” PATH, June 15, 2018, https://www.path.org/articles/lining-up-for-hopeand-a-meningitis-vaccine/; PATH, “The Meningitis Vaccine Project: A Groundbreaking Partnership,” June 15, 2015, https://www.path.org/articles/about-meningitis-vaccine-project/.
he continued to remain heavily involved at Microsoft: “Bill Gates Steps Down from Microsoft Board,” Reuters, March 13, 2020, https://www.reuters.com/article/us-microsoft-bill-gates/bill-gates-steps-down-from-microsoft-board-idUSKBN2103BH; Daisuke Wakabayashi, “Bill Gates Bids a Teary Farewell to Microsoft,” Reuters, June 27, 2008, https://www.reuters.com/article/us-microsoft-gates/bill-gates-bids-a-teary-farewell-to-microsoft-idUSN2630130120080628.
“has effectively ended meningitis”: Anita Zaidi, “Geographically Distributed Manufacturing Capacity Is Needed for Improved Global Health Security,” Bill & Melinda Gates Foundation, July 28, 2021, https://www.gatesfoundation.org/ideas/articles/covid19-vaccine-geographic-distribution.
protects against only meningitis serotype A: Katya Fernandez et al., “Meningococcal Meningitis Outbreaks in the African Meningitis Belt After Meningococcal Serogroup A Conjugate Vaccine Introduction, 2011–2017,” Journal of Infectious Diseases 220, no. S4 (October 31, 2019): S225–32, https://doi.org/10.1093/infdis/jiz355.
presumably because they are more expensive: CDC, “About Meningococcal Vaccines,” Centers for Disease Control and Prevention, October 18, 2022, https://www.cdc.gov/vaccines/vpd/mening/hcp/about-vaccine.html. Note: Gavi reports having shipped 22 million doses of the A, C, W, and Y meningococcal vaccines through 2020, compared with 332 million doses of MenAfriVac; Gavi, Annual Progress Report, 2020.
stopped by lawsuits: “Pfizer’s Patent Barrier Foils Korea’s 1st Pneumococcal Conjugate Vaccine,” Korea Biomedical Review, February 20, 2019, https://www.koreabiomed.com/news/articleView.html?idxno=5168.
Cyrus Poonawalla: “About Us,” Serum Institute of India Pvt. Ltd., n.d., https://www.seruminstitute.com/about_us.php; Gavi Staff, “New Collaboration Makes Further 100 Million Doses of Covid-19 Vaccine Available to Low- and Middle-Income Countries,” Gavi, September 29, 2020, https://www.gavi.org/news/media-room/new-collaboration-makes-further-100-million-doses-covid-19-vaccine-available-low.
Gavi for $2: PATH, “Developing a More Affordable Pneumococcal Vaccine,” PATH Case Study, n.d., https://www.path.org/case-studies/developing-more-affordable-pneumococcal-vaccine/.
“a turning point”: Alderson et al., “Development Strategy and Lessons Learned for a 10-Valent Pneumococcal Conjugate Vaccine (PNEUMOSIL®),” 2670–77.
vast majority of the pneumonia vaccines: Gavi, “Supply Agreements,” n.d., https://www.gavi.org/investing-gavi/innovative-financing/pneumococcal-amc/manufacturers/supply-agreements.
seven dollars a dose with bonus payments: UNICEF, “Pneumococcal Conjugate Vaccine (PCV) Price Data,” https://www.unicef.org/supply/documents/pneumococcal-conjugate-vaccine-pcv-price-data.
protects against only ten: Note: Pfizer’s Prevnar 13 covers all ten serotypes covered by Serum’s Pneumosil, including 1, 5, 6A, 6B, 7F, 9V, 14, 19A, 19F, and 23F. See https://pneumosil.com/ and https://prevnar20.pfizerpro.com/.
protects against twenty strains: “Pfizer Announces Positive Top-Line Results from Phase 3 Study of 20-Valent Pneumococcal Conjugate Vaccine in Infants,” Press Release, Pfizer, August 12, 2022, https://www.pfizer.com/news/press-release/press-release-detail/pfizer-announces-positive-top-line-results-phase-3-study-20.
24-valent vaccine: Merck, “U.S. FDA Approves Merck’s VAXNEUVANCETM (Pneumococcal 15-Valent Conjugate Vaccine) for the Prevention of Invasive Pneumococcal Disease in Infants and Children,” Merck.com, https://www.merck.com/news/u-s-fda-approves-mercks-vaxneuvance-pneumococcal-15-valent-conjugate-vaccine-for-the-prevention-of-invasive-pneumococcal-disease-in-infants-and-children/; Affinivax, “GSK to Acquire Clinical-Stage Biopharmaceutical Company Affinivax, Inc.”
cover 90 percent of children: “India Completes National Introduction of Pneumococcal Conjugate Vaccine,” Press Release, Gavi, November 12, 2021, https://www.gavi.org/news/media-room/india-completes-national-introduction-pneumococcal-conjugate-vaccine.
significant impact on global health: WHO and UNICEF estimates show that only 25 percent of Indian children were fully vaccinated in 2021, and it is not clear what portion of the vaccines came from Serum: “Pneumococcal Vaccination Coverage,” World Health Organization, n.d., https://immunizationdata.who.int/pages/coverage/pcv.html?CODE=IND&ANTIGEN=&YEAR=.
announced a massive new project: “Inventprise Announces Investment of up to $90 Million to Advance Its 25 Valent Pneumococcal Conjugate Vaccine Candidate into Proof-of-Concept Clinical Trials,” BusinessWire, November 10, 2021, https://www.businesswire.com/news/home/20211110005245/en/Inventprise-Announces-Investment-of-up-to-90-Million-to-Advance-its-25-Valent-Pneumococcal-Conjugate-Vaccine-Candidate-into-Proof-of-Concept-Clinical-Trials; “Meet Our Leadership Team,” Inventprise, n.d., https://inventprise.com/?page_id=1576.
“convertible debt”: The foundation’s Strategic Investment Fund online database classifies its financing of Inventprise as “convertible debt,” which normally means the debt converts to equity. Gates previously had a convertible debt financing arrangement with Zyomyx, for example, which ended up giving the foundation a 48 percent stake in the company. Bill & Melinda Gates Foundation, “Portfolio,” SIF.gates, n.d., https://sif.gatesfoundation.org/portfolio/; “Inventprise Receives $30M, Appoints New CEO and Expands Corporate Board, “Inventprise,” April 27, 2022, https://webcache.googleusercontent.com/search?q=cache:j_e9JCOLzfIJ:https://inventprise.com/%3Fpage_id%3D19092&cd=1&hl=en&ct=clnk&gl=us&client=firefox-b-1-d; Dennis Price, “Eyes Wide Open: Good Reasons for a Bad Investment in a Low-Cost HIV Test,” in Stanford University with ImpactAlpha, Making Markets Work for the Poor, Supplement, Stanford Social Innovation Review (Summer 2016): 35.
seven “governors”: Query of Washington State Corporations and Charities Filing System, January 31, 2023, https://ccfs.sos.wa.gov/#/. Note: Board members include Donna Ambrosino, a consultant who reports serving on advisory positions at the Gates Foundation and the Gates-founded CEPI (LinkedIn, https://www.linkedin.com/in/donna-ambrosino-m-d-a37b6037/details/experience/); Niranjan Bose, a director at Gates Ventures (LinkedIn, https://www.linkedin.com/in/niranjanbose/details/experience/); Andrew Farnum, who previously held high-profile positions at the foundation and at the Bill & Melinda Gates Medical Research Institute (LinkedIn, https://www.linkedin.com/in/andrew-farnum-4b180a1); Ralf Clemens, a scientific adviser to the Gates Foundation (LinkedIn, https://www.linkedin.com/in/ralf-clemens-75578513/details/organizations/); and Stewart Parker, a Seattle-based consultant who previously ran the Gates-funded Infectious Disease Research Institute (IDRI) (LinkedIn, https://www.linkedin.com/in/stewart-parker-4819975/details/experience/); Julie Emory, “Tech Moves: USAFacts Picks Microsoft and Amazon Vet as CTO; Zillow CMO Departs; and More,” GeekWire, April 8, 2022, https://www.geekwire.com/2022/tech-moves-usafacts-picks-microsoft-and-amazon-vet-as-cto-inventprise-names-ceo-realnetworks-appoints-kontxt-president/.
