FROM THE ENROLLMENT TO NEW YORK. This time Bill Gates puts aside his usual tact: “It is regrettable that many statements by President Trump have made the research for the vaccine against Covid perceive as a political issue”. Then it rejects the American response to the pandemic because it has been disastrous, and warns that autumn threatens to bring us back to the tragedies of spring if there are not the necessary measures to prevent them. But he is optimistic about the vaccines, predicting that at least three will be authorized by the end of the year, even if we will have to wait until 2022 to see the true end of the virus.
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Gates talks to us from his office, during a video conference with five European media, including The print exclusively for Italy. The occasion is the presentation of the “Goalkeepers report”, that is the report that its Foundation prepares every year on the eve of the UN General Assembly, to monitor the realization in the world of the 17 goals for sustainable development: “Sadly – begins the founder of Microsoft – this year we are not talking about progress, but about the setbacks caused by the pandemic. The impact on health, including the reduction of normal vaccinations, represents a 25-year step back. Inequality has increased and extreme poverty has grown by 7%, affecting 37 million people.
Bill Gates: “100 million dollars for the Covid vaccine. Anyone who needs it must have access”
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The first goal to be set is to stop the pandemic, but to do so we need global collaboration. This includes working together to create a vaccine, conduct trials, manufacture it, and understand how to distribute it, as well as diagnostics and therapies. Access will make a big difference. According to the scenarios studied by Northeastern University, if the first two billion doses go only to rich countries, instead of being distributed on a global basis to health workers and the elderly, we will have double the deaths. It is a sobering perspective, because the world faces the challenge of working together ».
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Are you optimistic or pessimistic about the state of the pandemic?
“I’m pessimistic about how autumn will be in the Northern Hemisphere. If we do not intervene, the death toll, including the US, will return to spring levels. There are a number of predictions, but all roughly point to difficulties for countries that still have many cases pending. This is the bad news. The good news is that we have several vaccines whose initial data are promising, and they could receive emergency use clearance from the FDA or MHRA by the end of this year, certainly early next year. I expect two or three to have it. Some think they have it before November (date of the American presidential elections), but it is not very likely. Pfizer is the only one that could do it by that date, but many more are expected to have test data by early next year. The first vaccine may not be the definitive one – more work will be needed on the secondary ones to see which is most effective. The Gates Foundation is more focused on those that can be produced on a large scale, with a low unit cost of between $ 2 and $ 3 per dose. This includes AstraZeneca Oxford, Novavax, Johnson & Johnson and Sanofi.
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We try to see if one works, and at the same time we build a global production capacity, to reach over one and a half billion doses per year. For these vaccines it should be more possible to hit the target than those made with RNA technology, which is a new process never experienced at similar levels. For example, we work with manufacturers in developing countries, such as the Serum Institute in India, so that for the first time the product made by one company is developed in the factories of another. This makes me optimistic. If they are effective, even with a vaccination level of 60% we should be able to stop the exponential spread of the disease. Next year will be the one in which we will bring down the death toll, and in 2022 the pandemic will end ».
Maraini: “The virus has questioned our well-being. And like all lessons, there are those who improve and those who reject reality”
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Aren’t there the risks associated with “vaccine nationalism”?
“We hoped that the world would prepare itself better for the risk of the pandemic, and in 2015 there were many discussions, but it was not enough. The history of the US is contradictory. In terms of research and development, they gave more money than all other countries combined, multiplied by two; for production in developing countries, on the other hand, they did not move. I still hope that this administration, or one to come, will come forward with strong contributions, and I will spend a lot of time ensuring that that happens. Meanwhile, the Europeans and others have moved. The benefit is huge, billions are spent on saving trillions. The end of the spread of the disease on a global scale brings the added benefit of the end of drastic measures to stop it. Even the countries that responded best, such as Japan and South Korea, have found that avoiding the return of the infection is difficult, if the pandemic does not end on a global basis ».
Will we eventually have more direct deaths, that is, caused by the virus, or indirect, that is, caused by its destructive effects on the health system?
“Direct in rich countries, indirect in poor ones. Deaths will end in 2022, but it will take between 2 and 3 years to heal the damage done to the global health system. For the economic ones, on the other hand, poor countries that do not have the capacity to increase debt will need a decade to return to pre-crisis levels ».
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What does it respond to the antivaxes that attack it?
«I wonder – Gates replies leaning back in his chair – how did people discover my secret plot …».
Seriously.
“This story is so bizarre, you should almost treat it with humor. But it is a very serious problem, because if you accuse us of doing evil things, you limit our work. Then people don’t wear masks or refuse the vaccine. To achieve immunity, at least 60% of the population would need to do so, but 80 or 90% would be better. In the US, however, 40% of the population is not convinced to take it. Ironically, the majority are Republican voters. To overcome the problem we must ensure that the FDA approval process is not politically influenced, we must be super transparent, choose the best vaccine, look at all the side effects. The vaccines are miraculous, they have eliminated diseases like smallpox, measles, now polio. The positive message is not as interesting as fear, which has always existed, but these conspiracy theories are new, because they combine the pandemic with digital media ».
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Can rational arguments prevail?
“What other options do we have? I cannot counter them with alternative follies, I only have the science available. The fact that some politicians are heavily denigrating the media is a frightening phenomenon. Fox News television also helped spread these rumors. Digital media is trying to cut them, but they have not been successful. A crazy video about the alleged cure of Zithromax was seen by over ten million people before it was blocked, at which point the damage is irreversible. I am interested in discussing with the best creatives to understand how to stem the phenomenon ».
You said the solution requires global collaboration, but the US has refused to participate in the World Health Organization’s Covax initiative to work together on a common vaccine.
“US funding of $ 10 billion allowed companies like Johnson & Johnson or AstraZeneca to go full speed, assuring shareholders that they would not make a profit, but would at least break even. The US deserves a good vote on this. Instead, the administration’s willingness to collaborate with the WHO is limited. I have said that I disagree, I consider it a mistake, and I am involved in intense discussions to make sure that the money is there. If this does not happen it will be regrettable, but the rest of the world will have to step forward, because the economic return is enormous. The idea that the investment in a remedy, which costs 6 dollars for the two necessary doses, is blocked because the US is behaving in a singular way makes no sense. Discussions with Europeans have advanced, the vaccine will be financed ».
Coronavirus, WHO: “2 billion vaccine doses by 2021”
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Trump wants it before the election, but the CEOs of nine drug companies have pledged to release it only when it is safe. So isn’t your credibility at risk?
“Only two vaccines have a chance to have data for the end of October, Pfizer and Moderna, and they too are unlikely. Our foundation has invested heavily in rna technology, but for this pandemic the possibility of producing it on a large scale is lower. Therefore we have focused on AstraZeneca Oxford, Novavax, Johnson & Johnson and Sanofi. For at least three of these vaccines, emergency clearance will come by the end of the year, and if they fail we hope others will work, because the level of antibodies we saw in phase 2 of the trials is very good, even for older patients. It is not a political question. It is unfortunate that many of Trump’s statements have made him perceive this way, but the announcement of the nine CEOs of pharmaceutical companies was very appropriate ».
