The bill gates problem, p.61
The Bill Gates Problem, page 61
331 world’s largest vaccine manufacturer: “Up to 100 Million Covid-19 Vaccine Doses to Be Made Available for Low- and Middle-Income Countries as Early as 2021,” Gavi, August 7, 2020, https://www.gavi.org/news/media-room/100-million-covid-19-vaccine-doses-available-low-and-middle-income-countries-2021; Gavi Staff, “New Collaboration Makes Further 100 Million Doses of Covid-19 Vaccine Available to Low- and Middle-Income Countries.”
“the financial risk”: Gates, “These Breakthroughs Will Make 2021 Better than 2020.”
a dynamic duo: Twohey and Kulish, “Bill Gates, the Virus and the Quest to Vaccinate the World.”
Serum drew criticism: Helen Sullivan, “South Africa Paying More than Double EU Price for Oxford Vaccine,” Guardian, January 22, 2021, https://www.theguardian.com/world/2021/jan/22/south-africa-paying-more-than-double-eu-price-for-oxford-astrazeneca-vaccine.
Critics then cried foul: Samanth Subramanian, “Why Is India, the World’s Largest Vaccine Producer, Running Short of Vaccines?,” Quartz, May 6, 2021, https://qz.com/2004650/why-does-india-have-a-covid-19-vaccine-shortage/.
issued an export ban: “Serum Institute of India Gets Nod to Export Covid-19 Vaccines Under the COVAX Programme, Says Source,” Business Insider, November 22, https://www.businessinsider.in/science/health/news/serum-institute-of-india-gets-nod-to-export-covid-19-vaccines-under-the-covax-programme-says-source/articleshow/87852389.cms.
Strive Masiyiwa: “Indian Vaccine Maker Extends Freeze on Export of Covid Jabs,” Financial Times, May 18, 2021, https://www.ft.com/content/63fbbb79-f657-4e6c-b190-cffd0d630593.
joined the board: Schwab, “Will the Gates Foundation’s Board Ever Hold Bill Accountable?”
reliable access to electricity to run freezers: Jon Cohen, “AstraZeneca Lowers Efficacy Claim for Covid-19 Vaccine, a Bit, After Board’s Rebuke,” Science, March 25, 2021, https://www.science.org/content/article/astrazeneca-lowers-efficacy-claim-covid-19-vaccine-bit-after-boards-rebuke.
poor nations began avoiding: Francesco Guarascio, “Poorer Nations Shun AstraZeneca Covid Vaccine—Document,” Reuters, April 14, 2022, https://www.reuters.com/business/healthcare-pharmaceuticals/poorer-nations-shun-astrazeneca-covid-vaccine-document-2022-04-14/.
sitting on an unused stockpile: Angus Liu, “With 200M Unused Doses, AstraZeneca’s Covid Vaccine Partner Serum Institute Halts Production,” Fierce Pharma, April 22, 2022, https://www.fiercepharma.com/pharma/200m-unused-doses-astrazenecas-covid-vaccine-partner-serum-institute-halts-production.
“plagued by missteps”: Cohen, “AstraZeneca Lowers Efficacy Claim for Covid-19 Vaccine, a Bit, After Board’s Rebuke.”
saved more lives: “Oxford Vaccine Saved Most Lives in Its First Year of Rollout,” University of Oxford, July 15, 2022, https://www.ox.ac.uk/news/2022-07-15-oxford-vaccine-saved-most-lives-its-first-year-rollout; “Global Vaccine Market Report: A Shared Understanding for Equitable Access to Vaccines,” World Health Organization, 2022, https://www.who.int/publications/m/item/global-vaccine-market-report-2022.
big vaccine bet, Novavax: Sarah Owermohle, Erin Banco, and Adam Cancryn,“‘They Rushed the Process’: Vaccine Maker’s Woes Hamper Global Inoculation Campaign,” Politico, October 19, 2021, https://www.politico.com/news/2021/10/19/novavax-vaccine-rush-process-global-campaign-516298; Carolyn Y. Johnson, “Maker of Latest Experimental Vaccine Will Not Seek Authorization Until July at the Earliest,” Washington Post, May 10, 2021, https://www.washingtonpost.com/health/2021/05/10/novavax-coronavirus-vaccine/.
another $400 million: Thomas and Twohey, “How a Struggling Company Won $1.6 Billion to Make a Coronavirus Vaccine”; “Our Portfolio,” CEPI, n.d., https://cepi.net/research_dev/our-portfolio/.
the green light from the FDA: Rita Rubin, “Despite Its Fan Base, Newly Authorized ‘Traditional’ Novavax Covid-19 Vaccine Is Having Trouble Gaining a Foothold in the US,” JAMA 328, no. 11 (September 20, 2022): 1026–28, https://doi.org/10.1001/jama.2022.13661; Rebecca Robbins and Carl Zimmer, “F.D.A. Authorizes Novavax’s Covid-19 Vaccine, a Latecomer,” New York Times, July 13, 2022, https://www.nytimes.com/2022/07/13/health/novavax-covid-vaccine-fda-authorization.html.
pool money: “COVAX Explained,” Gavi, September 3, 2020, https://www.gavi.org/vaccineswork/covax-explained.
delivering diagnostics and treatments: “COVAX: The Vaccines Pillar of the Access to Covid-19 Tools (ACT) Accelerator, Structures and Principles,” Gavi, November 9, 2020, https://www.who.int/publications/m/item/covax-the-vaccines-pillar-of-the-access-to-covid-19-tools-(act)-accelerator.
described COVAX as a “Gates operation”: Alexander Zaitchik, “How Bill Gates Impeded Global Access to Covid Vaccines,” New Republic, April 12, 2021, https://newrepublic.com/article/162000/bill-gates-impeded-global-access-covid-vaccines.
no public mandate: Kai Kupferschmidt, “‘Vaccine Nationalism’ Threatens Global Plan to Distribute Covid-19 Shots Fairly,” Science, July 28, 2020, https://www.science.org/content/article/vaccine-nationalism-threatens-global-plan-distribute-covid-19-shots-fairly.
Ecuador’s then health minister: Twohey and Kulish, “Bill Gates, the Virus and the Quest to Vaccinate the World.”
rich and the poor, the winners and losers: Ashley Kirk, Finbarr Sheehy, and Cath Levett, “Canada and UK Among Countries with Most Vaccine Doses Ordered per Person,” Guardian, January 29, 2021, https://www.theguardian.com/world/2021/jan/29/canada-and-uk-among-countries-with-most-vaccine-doses-ordered-per-person.
didn’t alter the logic of the market: Peters, “Inside the Gates Foundation’s Epic Fight Against Covid-19.”
entirely without access: Andrew Gregory, “Only 14% of Promised Covid Vaccine Doses Reach Poorest Nations,” Guardian, October 21, 2021, https://www.theguardian.com/society/2021/oct/21/only-14-of-promised-covid-vaccine-doses-reach-poorest-nations.
twice as many: Maria Cheng and Lori Hinnant, “Rich Nations Dip into COVAX Supply While Poor Wait for Shots,” AP News, August 14, 2021, https://apnews.com/article/joe-biden-middle-east-africa-europe-coronavirus-pandemic-5e57879c6cb22d96b942cbc973b9296c.
the Associated Press reported: Lori Hinnant and Maria Cheng, “Stalled at First Jab: Vaccine Shortages Hit Poor Countries,” AP News, April 20, 2021, https://apnews.com/article/middle-east-coronavirus-pandemic-united-nations-b52bf58e35031e71a5ff85f7a59244f8; Maria Cheng and Aniruddha Ghosal, “Unwilling to Wait, Poorer Countries Seek Their Own Vaccines,” AP News, April 20, 2021, https://apnews.com/article/business-honduras-coronavirus-vaccine-coronavirus-pandemic-central-america-16d7d06f031c89aaf37a4306747b9128.
World Trade Organization: Gabriel Scally, “The World Needs a Patent Waiver on Covid Vaccines. Why Is the UK Blocking It?,” Guardian, April 18, 2021, https://www.theguardian.com/commentisfree/2021/apr/18/patent-waiver-covid-vaccines-uk-variants.
“limited not because of IP rules”: Bill Gates, “Bill Gates: How We Can Close the Vaccine Gap Much Faster Next Time,” CNN, October 13, 2021, https://www.cnn.com/2021/10/13/opinions/closing-vaccine-gap-faster-bill-gates/index.html.
“factory in India”: “Covid-19: Bill Gates Hopeful World ‘Completely Back to Normal’ by End of 2022—and Vaccine Sharing to Ramp Up,” Video, Sky News, 2:45, April 25, 2021, https://news.sky.com/story/covid-19-bill-gates-hopeful-world-completely-back-to-normal-by-end-of-2022-and-vaccine-sharing-to-ramp-up-12285840.
pandemic response effort was succeeding: “Covid-19: Bill Gates Hopeful World ‘Completely Back to Normal’ by End of 2022,” 8:15.
“We have the facilities and equipment”: Stephen Buranyi, “The World Is Desperate for More Covid Vaccines—Patents Shouldn’t Get in the Way,” Guardian, April 24, 2021, https://www.theguardian.com/commentisfree/2021/apr/24/covid-vaccines-patents-pharmaceutical-companies-secrecy.
capable of producing vaccines: Maria Cheng and Lori Hinnant, “Countries Urge Drug Companies to Share Vaccine Know-How,” AP News, March 1, 2021, https://apnews.com/article/drug-companies-called-share-vaccine-info-22d92afbc3ea9ed519be007f8887bcf6; Sharon Lerner, “Factory Owners Around the World Stand Ready to Manufacture Covid-19 Vaccines,” The Intercept, April 29, 2021, https://theintercept.com/2021/04/29/covid-vaccine-factory-production-ip/; Stephanie Nolen, “Here’s Why Developing Countries Can Make mRNA Covid Vaccines,” New York Times, October 22, 2021, https://www.nytimes.com/interactive/2021/10/22/science/developing-country-covid-vaccines.html.
Human Rights Watch: Human Rights Watch, “Experts Identify 100-Plus Firms to Make Covid-19 mRNA Vaccines,” December 15, 2021, https://www.hrw.org/news/2021/12/15/experts-identify-100-plus-firms-make-covid-19-mrna-vaccines.
“Any delay in ensuring”: Joseph E. Stiglitz and Lori Wallach, “Preserving Intellectual Property Barriers to Covid-19 Vaccines Is Morally Wrong and Foolish,” Washington Post, April 26, 2021, https://www.washingtonpost.com/opinions/2021/04/26/preserving-intellectual-property-barriers-covid-19-vaccines-is-morally-wrong-foolish/.
Chelsea Clinton: Chelsea Clinton and Achal Prabhala, “The Vaccine Donations Aren’t Enough,” Atlantic, June 20, 2021, https://www.theatlantic.com/ideas/archive/2021/06/the-vaccine-donations-arent-enough-chelsea-clinton-achal-prabhala/619152/.
“stupidest thing”: Kai Kupferschmidt, “Bill Gates: ‘That’s the Dumbest Thing I’ve Ever Heard,’” Die Zeit, October 27, 2021, https://www.zeit.de/gesundheit/2021–10/bill-gates-corona-impfung-patente-patentrecht-stiftung-verteilung?utm_referrer=https%3A%2F%2Fwww.google.com%2F.
sophisticated manufacturing: Deep in the pandemic, Gates noted on CNN that “we’re supporting the African efforts to build theirs [vaccine capacity] out by 2040,” a much-belated effort. Gates, “How We Can Close the Vaccine Gap Much Faster Next Time.”
“narrow” waiver: Kurt Schlosser, “Gates Foundation Reverses Position on COVID Vaccine Patent Protections After Mounting Pressure,” GeekWire, May 7, 2021, https://www.geekwire.com/2021/gates-foundation-reverses-position-covid-vaccine-patent-protections-mounting-pressure/.
New Republic: Zaitchik, “How Bill Gates Impeded Global Access to Covid Vaccines.”
autopsies of the faceless COVAX: Stephanie Nolen and Rebecca Robbins, “Covid Vaccine Makers Kept $1.4 Billion in Prepayments for Canceled Shots for the World’s Poor,” New York Times, February 1, 2023, https://www.nytimes.com/2023/02/01/health/covid-vaccines-covax-gavi-prepayments.html.
failures of COVAX: Rosa Furneaux, Olivia Goldhill, and Madlen Davies, “How COVAX Failed on Its Promise to Vaccinate the World,” Bureau of Investigative Journalism, October 8, 2021, https://www.thebureauinvestigates.com/stories/2021-10-08/how-covax-failed-on-its-promise-to-vaccinate-the-world.
lives-saved PR: Oliver J. Watson et al., “Global Impact of the First Year of Covid-19 Vaccination: A Mathematical Modelling Study,” Lancet Infectious Diseases 22, no. 9 (September 1, 2022): 1293–302, https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00320-6/fulltext; “Covid-19 Vaccines Have Saved 20 Million Lives So Far, Study Estimates,” Gavi, n.d., https://www.gavi.org/vaccineswork/covid-19-vaccines-have-saved-20-million-lives-so-far-study-estimates; Storeng, Puyvallée, and Stein, “COVAX and the Rise of the ‘Super Public Private Partnership’ for Global Health.”
“crumbling vaccine system”: Peters, “Inside the Gates Foundation’s Epic Fight Against Covid-19.” Note: The foundation’s work on specific diseases and interventions theoretically can also have beneficial spillover effects that enhance public health more broadly. For example, some of the projects Gates supports on HIV/AIDS, polio, and tuberculosis have been reorganized to assist with outbreaks like Ebola and SARS-CoV-2 (Covid-19). However, these programs are often not designed for these cross-cutting purposes and thus offer limited benefits, with researchers describing them as parallel systems that don’t always intersect with government-organized public health systems. Chikwe Ihekweazu, “Lessons from Nigeria’s Adaptation of Global Health Initiatives During the Covid-19 Pandemic,” Emerging Infectious Diseases 28, Suppl. 1 (December 2022): S299–301, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9745227/.
success of Cuba: Sam Meredith, “Why Cuba’s Extraordinary Covid Vaccine Success Could Provide the Best Hope for Low-Income Countries,” CNBC, January 13, 2022, https://www.cnbc.com/2022/01/13/why-cubas-extraordinary-covid-vaccine-success-could-provide-the-best-hope-for-the-global-south.html; Mary Beth Sheridan, “How Cuba Became a Pioneer in Covid-19 Vaccines for Kids,” Washington Post, June 18, 2022, https://www.washingtonpost.com/world/2022/06/18/cuba-coronavirus-vaccine-abdala-soberana/.
U.S. embargo: Bill & Melinda Gates Foundation, “Sample Terms & Conditions, Project Support Grant Agreement,” n.d., https://docs.gatesfoundation.org/documents/sample-terms-and-conditions.pdf.
less expensive than other vaccines: “Doctor on Developing Global Covid-19 Vaccine: ‘We Got Zero Help from the U.S. Government,’” Yahoo! News, February 8, 2022, https://news.yahoo.com/covid-vaccines-policymakers-never-really-211439188.html. Note: UNICEF’s records show that Corbevax is the lowest-priced vaccine, at under two dollars per dose, compared to the Oxford-AstraZeneca-Serum vaccine, which sold, at its lowest price, for three dollars. Covid-19 Market Dashboard, UNICEF, n.d., https://www.unicef.org/supply/covid-19-market-dashboard.
IndoVac: “Indonesia’s Bio Farma Ready to Produce IndoVac Covid-19 Vaccines,” Bloomberg, September 11, 2022, https://www.bloomberg.com/press-releases/2022-09-11/indonesia-s-bio-farma-ready-to-produce-indovac-covid-19-vaccines.
Gates’s top-pick vaccine manufacturer: Thomas and Twohey, “How a Struggling Company Won $1.6 Billion to Make a Coronavirus Vaccine”; “Our Portfolio,” CEPI.
can be quickly scaled up: Peter J. Hotez and Maria Elena Bottazzi, “A Covid Vaccine for All,” Scientific American, December 30, 2021, https://www.scientificamerican.com/article/a-covid-vaccine-for-all/.
“capacity building”: During the pandemic, as poor nations and public health experts widely called for local and regional manufacturing of Covid-19 vaccines, the foundation began presenting itself as a champion of working with “developing country vaccine manufacturers,” or DCVMs. “Over the past two decades, our foundation has given US$1 billion in support to DCVMs and related grantees and has worked with 19 DCVMS across 11 countries to bring 17 vaccines to market,” the foundation boasted. “These collaborations have made a tremendous difference all over the world.” The foundation, notably, does not name all 17 of these vaccines. And the few examples it gives of “developing country” partners include projects based in South Korea, a highly advanced economy. The foundation also points to its work with the Serum Institute of India, the largest vaccine manufacturer in the world and, arguably, part of Big Pharma. Zaidi, “Geographically Distributed Manufacturing Capacity Is Needed for Improved Global Health Security.”
notable about Peter Hotez: “Gates Foundation Commits Nearly $70 Million to Help Fight Neglected Tropical Diseases,” Bill & Melinda Gates Foundation, n.d., https://www.gatesfoundation.org/ideas/media-center/press-releases/2006/09/$70-million-to-help-fight-neglected-tropical-diseases; “Albert B. Sabin Vaccine Institute Signs Agreement with GW Medical Center for Collaboration on $18 Million Bill & Melinda Gates Foundation Research Grant,” Bill & Melinda Gates Foundation, n.d., https://www.gatesfoundation.org/ideas/media-center/press-releases/2000/08/hookworm-vaccine-research.
George Washington University: “Albert B. Sabin Vaccine Institute Signs Agreement with GW Medical Center for Collaboration on $18 Million Bill & Melinda Gates Foundation Research Grant.”
“funding the diseases”: Fratangelo, “How Gates Changes Global Public Health.”
Preventing the Next Pandemic: Peter J. Hotez, Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-Science (Baltimore: Johns Hopkins University Press, 2021); Bill Gates, How to Prevent the Next Pandemic (New York: Alfred A. Knopf, 2022).
“ten to the seven dollars”: By this, Hotez means 10 to the seventh power, or $10,000,000 in this case, vs. 10 to the fifth power, which is $100,000.
new malaria vaccine that the pharma giant GSK rolled out: Abdi Latif Dahir, “Africans Welcome New Malaria Vaccine. But Is It a ‘Game Changer’?,” New York Times, October 7, 2021, https://www.nytimes.com/2021/10/07/world/africa/malaria-vaccine-africa.html; Amy Maxmen, “Scientists Hail Historic Malaria Vaccine Approval—but Point to Challenges Ahead,” Nature, October 8, 2021, https://www.nature.com/articles/d41586-021-02755-5.
publicly distanced itself: Carmen Paun and Daniel Payne, “How the Gates Foundation Plans to Beat Malaria Without the Vaccine,” Politico, August 4, 2022, https://www.politico.com/newsletters/global-pulse/2022/07/07/moving-on-from-malaria-vaccine-00044349. Note: One caveat is that the Gates-funded Gavi put $155 million into the malaria vaccine’s rollout, a decision the Gates Foundation publicly supported, as reported by Politico.
college dropout: Gates, “My Annual Letter: Vaccine Miracles.”
eradicate malaria: “Malaria Forum,” Bill & Melinda Gates Foundation, October 7, 2007, https://www.gatesfoundation.org/ideas/speeches/2007/10/melinda-french-gates-malaria-forum.
“good vaccine for malaria”: Moyers, “A Conversation with Bill Gates: Making a Healthier World for Children and Future Generations.”
forward-looking claims: Nicholas Kristof, “A Conversation with Bill Gates,” New York Times, January 24, 2009, https://www.nytimes.com/video/opinion/1231546145505/a-conversation-with-bill-gates.html.
“involved in bed-nets”: Andy Beckett, “Inside the Bill and Melinda Gates Foundation,” Guardian, July 12, 2010, https://www.theguardian.com/world/2010/jul/12/bill-and-melinda-gates-foundation.
Global Fund: S. Bhatt et al., “The Effect of Malaria Control on Plasmodium falciparum in Africa Between 2000 and 2015,” Nature 526, no. 7572 (October 2015): 207–11, https://doi.org/10.1038/nature15535; The Global Fund, Annex 1, Results Report 2022, September 7, 2022, https://www.theglobalfund.org/media/12261/corporate_2022resultsreport_annex_en.pdf.
progress against malaria has leveled off: World Health Organization, World Malaria Report 2020: 20 Years of Global Progress and Challenges, 2020, vii.
