Bill Gates on Coronavirus, Vaccines and Global Health

That will not happen soon, Mr. Gates conceded. The Trump administration has publicly refused to join the international collaborative agreement known as Covax, under which the World Health Organization; GAVI, the Vaccine Alliance; and the Coalition for Epidemic Preparedness Innovations have joined forces to make sure both rich and poor countries receive new coronavirus vaccines simultaneously.

Instead, Operation Warp Speed, the Trump administration’s unilateral effort to fast-track vaccine development, has paid out $11 billion to six vaccine companies in return for ensuring that at least 100 million doses from each company, and options for millions more, are exclusively earmarked for the United States.

Although that position “looks selfish,” Mr. Gates said, he did not feel it was unjustified. Realistically, he said, “You’re not going to succeed in getting the U.S. to treat itself as just a random 5 percent of the world’s population.” American taxpayers, he noted, have paid two-thirds of the costs of the clinical trials and of manufacturing doses even before the trials end.

Absent that money, the only available vaccines would be those from Russia or China, which Mr. Gates considered untested and potentially weak. “You can’t call up Johnson & Johnson or AstraZeneca and say, ‘Hey, here’s a chance to lose $500 million.”

If just three of the several vaccines that the United States is backing succeed, he said, the country would have more doses than it could use, and the rest could be shared with the world.

Also, Mr. Gates said he expected that by early next year, regardless of who wins the presidential election, the United States would come around to paying much of the estimated $4 billion needed to get vaccines to all the world’s poor.

He noted that Congress had repeatedly kept funds for AIDS, malaria and childhood vaccines in the foreign aid budget, despite numerous attempts by the White House over the past decade to slash those items; the programs are popular both with liberals and Christian conservatives.

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