But millions of dead have yet to come to poor countries
MILLIONS MAY die before the covid-19 pandemic is over. That’s the strong message from Bill Gates, a co-founder of Microsoft and one of the biggest philanthropists in the world through the Bill & Melinda Gates Foundation, in an interview with Zanny Minton Beddoes, The Economistits editor-in-chief, early August. Most of these deaths, he said, would be caused not by the disease itself, but by the continuing strain on health care systems and economies that are already struggling. He also criticized the politicization of the response to the virus in America, and the proliferation of conspiracy theories – which implied him – both of which have slowed efforts to contain the spread of the disease. But he offered reasons for hope in the medium term, predicting that by the end of 2021 there would be a reasonably effective vaccine in mass production, and a large enough proportion of the world’s population would be immune to the to stop pandemics in their tracks.
Mr. Gates had spent much of his time thinking about viruses and vaccines, long before the new coronavirus was first discovered in Wuhan, Hubei Province, China. The Gates Foundation is central to the global alliance that seeks to eradicate polio by vaccinating everyone and reducing the burden of malaria and counteracting a vaccine. It has been several years since he warned that a new disease causing a global pandemic was a matter of if, not when, and called on the world to keep “Germ Games” in line with the wargames carried out by armies. The foundation has already pledged more than $ 350 million to the covid-19 pandemic response, much of which is aimed at reducing its impact on the developing world. But more is needed. “We all have to spend billions to get the vaccine to save the vibrations that do the economic damage,” he says.
Patchy data make it difficult to assess the true extent of the damage in many poor countries. By August 17, the Africa Centers for Disease Control and Prevention, a body of public health, had recorded more than 1m cases and more than 25,000 deaths in covid-19 in Africa. In India, nearly 52,000 are reported to have died from the disease. The true number in both places is probably much higher. But the coronavirus is not the only lethal force when playing in the developed world with pandemic. The millions of deaths Mr Gates predicts will be caused not only directly by covid-19, but by the knock-on effects. Nearly 90% will be indirect deaths, he says. Lockdowns will reduce access to immunization and medication for other diseases. Deaths from malaria and HIV will rise. Lower agricultural productivity will spread hunger and drop education rates. When it comes to fighting poverty, the virus could wipe out a decade of profits.
To reduce that risk, Mr Gates calls on rich countries to buy vaccines for the poor. This is not entirely altruistic: if some countries remain reservoirs of the disease, it will continue in others. If faxes become high enough in rich countries to cover the fixed costs of production – clinical trials, construction projects, etc. – then the marginal cost of supplying poor countries would be relatively modest: on the order of $ 10 billion-12 billion as a whole. He sees the bulk of that money coming from America, which he also gives “by far the highest class” for research and development for a vaccine, accounting for 80% of the global total. He hopes to see money pledged to buy poverty for the poor world in the next extra bill of Congress.
Whether that happens depends on politics. Congress negotiations on America’s next incentive package have been stalled for weeks. The strong political polarization of the country has complicated its response to the virus, introducing problems that other countries have to deal with. The simple act of wearing a mask has become a political statement, rather than a matter of seeking and then following expert advice, as is the case almost everywhere else. Depressingly, Mr Gates thinks this can not be undone, even if the November election means a change of direction at the top. Once public confidence is lost, and a policy is shifted from the realm of cost-benefit analysis to partisanship, it is not easy to reverse. During a Joe Biden presidency, Mr. Gates thinks, refusing a mask could be a way for Donald Trump supporters to signal their anger and resistance.
Lack of leadership in America has also hindered the response to the pandemic outside the country’s borders. The world’s only superpower has long taken the lead on global public health efforts, and without it, consensus is forging that much harder. And the mood in many countries is one of retreat from multilateralism and cooperation through international institutions. It is hard to see the trend reversing, as the disease is hitting government revenues hard everywhere. Generosity, despite being beneficial to donor as recipient, is in short supply when budgets are squeezed.
It is not enough that there is a vaccine: people must be ready to take it. And here, too, Americans are lagging behind. A recent Gallup poll found that one in three would not agree to receive an FDA-approved vaccine, even if it were free. But here the news is more favorable. The latest research, Mr. Gates explained, suggests that the other coronaviruses in circulation, and a partial immunity provided by vaccines already in use for other diseases, already provide a measure of protection against covid-19. It is also not as contagious as some other diseases. Today’s best estimate is that 30-60% of the world’s population needs an effective vaccine to stop the pandemic. ‘Fortunately, this is not measles. We do not need more than 90% of people to take the vaccine. ”
In 2000, when Mr. Gates resigned as chief executive of Microsoft, the Gates Foundation launched GAVI, a worldwide alliance for the provision of faxes in poor countries. His involvement in polio and measles vaccines has made him an expert in ensuring an equal distribution – especially in poor countries. And this is where Mr. Gates’s view is most positive. He believes the covid-19 vaccine is the fastest ever made. If it is ready for distribution in the time he predicts, it will be by far the fastest vaccine ever to hit the market.
The world is on course to achieve this goal. More than 150 vaccines are being developed worldwide, with six in definitive, large-scale clinical trials. Mr Gates has already donated hundreds of millions to the cause. He is willing to donate much more. But money from private foundations has limits – governments need to take the lead, he thinks, both because it is their healthcare infrastructure that will have to be used for distribution, and to gain public support and trust. To date, they have pledged at least $ 10 billion in global efforts to produce and distribute faxes. This is not enough.
