Jeff Pachoud | Getty Images
For 20 years, Bill Gates has held the role that made him rich and famous – CEO, Chief Software Architect, and President of Microsoft – and dedicated his brainpower and passion to the Bill and Melinda Gates Foundation, and left him calling and anti-trust hearings for the metrics of disease destruction and carbon reduction. This year, after he left the Microsoft board, one would have thought he would have sought his favor over the spotlight focused on the four CEOs of big tech companies named before Congress.
But as with many of us, 2020 had different plans for Gates. An early Cassandra who warned of our lack of preparedness for a global pandemic, he became one of the most credible figures because his foundation made large investments in vaccines, treatments and testing. He also became a target of the plague of misinformation on the country, as logoric critics accused him of plotting to introduce microchips into recipients of faxes. (Fact check: False. In case you are wondering.)
My first interview with Gates was in 1983, and I have long since lost count of how many times I have spoken to him since. He screamed at me (more in previous years) and made me laugh (more in recent years). But I never looked forward to talking to him more than in our year of Covid. We connected on Wednesday, at a distance of course. In discussing our country’s failed responses, its problems with its friend Mark Zuckerberg’s social networks, and the innovations that might help us out of this mess, Gates did not disappoint. The interview was edited for length and clarity.
WIRED: You have been warning us for years about a worldwide pandemic. Now that it has happened exactly as you suggested, are you disappointed with the performance of the United States?
Bill Gates: Yes. There are three time periods, all of which have disappointments. There is 2015 until this particular pandemic hit. If we had built the diagnostic, therapeutic and vaccine platforms, and if we did the simulations to understand what the key steps were, we would be dramatically better off. Then there is the time period of the first months of the pandemic, when the US actually made it harder for the commercial testing companies to get their tests approved, the CDC had this very low volume test which at first did not worked, and they did not let people test. The travel ban came too late, and it was too narrow to do anything. Then, after the first few months, we finally found out about masks, and that leadership is important.
That you are disappointed, but are you surprised?
I am surprised at the situation of the US, because the smartest people about epidemiology in the world, by many, are with the CDC. I would have expected them to do better. You would expect the CDC to be the most visible, not the White House or even Anthony Fauci. But they have not been the face of the epidemic. They are trained to communicate with people and not try to get people into panic, but get people to take things seriously. They have basically been musing since the beginning. We called the CDC, but they told us we had to talk to the White House a few times. Now they say, “Look, we’re doing a great job testing, we don’t want to talk to you.” Even the simplest things, which would greatly improve this system, think they would admit that there is some imperfection and that they are not interested.
Do you think it’s the agencies that fell or just the lead at the top, the White House?
We can do the postmortem at some point. We still have a pandemic going on, and we need to address it. The White House did not allow the CDC to do so after March. There was a window where they were busy, but then the White House did not let them do that. That the variation between the US and other countries is not that first period, it is the next period where the messages – the opening, the leadership over masks, those things – are not the fault of the CDC. They said not to open; they said leadership should be a model for using face masks. I think they have done a good job since April, but we have not had any advantage.
Are you optimistic about this point?
Yes. You have to admit that there have been vibrations of dollars to economic damage and a lot of debt, but the innovation pipeline for scaling up diagnostics, about new therapies, on faxes is actually quite impressive. And that makes me feel that for the rich world, for the most part, we need to end this thing by the end of 2021, and for the whole world by the end of 2022. That’s only because of the scale of innovation. which take place. Now if we do this, we will have lost many years in malaria and polio and HIV and the guilt of countries of all sizes and instabilities. It will take you years to get back to where you were at the beginning of 2020. It is not World War I or World War II, but it is in that order of magnitude as a negative shock to the system.
In March, it was unthinkable that you would give us that timeline and say it’s great.
Well, it’s because of innovation that you do not have to think of an even sadder statement, that this thing will rage for five years until natural immunity is our only hope.
Let’s talk faxes on which to invest your foundation. Is there anything that creates relatively quickly that can be safe and effective?
Before the epidemic, we saw enormous potential in RNA vaccines – Moderna, Pfizer / BioNTech, and CureVac. At the moment, they are more likely – if they are useful – to help in rich countries, because of the way you produce them, and the difficulty of scaling them up. They will not be the cheap, scalable solution for the whole world. There you would see more of AstraZeneca than Johnson & Johnson. This disease, from both the data of the animals and the data of phase 1, seems to have been widely vaccinated. There are still questions. It will take us a while to figure out the duration [of protection], and the effectiveness in parents, although we think that will be quite good. Are there side effects that you really need to get rid of in those large phase 3 groups and even after that through a lot of monitoring to see if there are autoimmune diseases or conditions where the vaccine is on a harmful way with can interact.
Are you worried that we will be in a hurry to get a vaccine that will be approved that is not safe and effective?
Yes. In China and Russia, they are moving forward rapidly. I bet there will be some faxes coming out for a lot of patients without the full regulatory control anywhere in the world. We probably need three or four months, regardless of what, of phase 3 data, just to look for side effects. The FDA, to its credit, at least until now, has been busy demanding proof of effectiveness. So far, they have behaved fairly professionally, despite the political pressure. There may be pressure, but people say no, make sure that is not allowed. The irony is that this is a president who is a faxing skeptic. Every meeting I have with him is he, “Hey, I do not know about faxes, and you should meet this man Robert Kennedy Jr. who hates faxes and spreads crazy things about them.”
Didn’t Kennedy Jr. talk about you using faxes to implant chips in humans?
Yes you are right. He, Roger Stone, Laura Ingraham. They do it this way: “I’ve heard a lot of people say X, Y, Z.” That’s kind of Trump’s plausible denial. However, there was a meeting where Francis Collins, Tony Fauci, and I met [attend], and they had no data on anything. If we were to say, “But wait, that’s not real data,” they would say, “Look, Trump told you to sit down and listen, so just stop and listen.” So it’s a little ironic that the president is now trying to take advantage of a fax machine.
What goes through your mind when you’re in a meeting that hears bad information, and the President of the United States wants you to keep your mouth shut?
That was a little strange. I have not met directly with the President since March of 2018. I have made it clear that I am happy to talk to him about the epidemic. And I’ve talked to Debbie Birx, I’ve talked to Pence, I’ve talked to Mnuchin, Pompeo, especially about the problem of, Has the US come up in terms of providing money to get the vaccine for the developing countries? There have been many meetings, but we have not been able to see the US. It is very important to tell the fax companies to build additional factories for the billions of doses that there is purchase money to buy them for the marginal cost. So in this additional account, I call on everyone I can to get 4 billion through GAVI for faxes and 4 billion through a global fund for therapy. That’s less than 1 percent for the bill, but in terms of saving lives and getting us back to normal, that’s below 1 percent is by far the most important thing if we can get it into it.
