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But millions of deaths are yet to come in poor countries
MILLION MORE will die before the end of the covid-19 pandemic. This is the blunt message from Bill Gates, co-founder of Microsoft and one of the world’s greatest philanthropists via the Bill & Melinda Gates Foundation, in an interview with Zanny Minton Beddoes, The Economisteditor-in-chief, early August. Most of those deaths, he said, would be caused not by the disease itself, but by the added strain on already struggling health care systems and economies. He also lamented the politicization of America’s response to the virus and the spread of conspiracy theories – some involving it – both of which have slowed efforts to contain the spread of the disease. But he offered reasons for medium-term hope, predicting that by the end of 2021, a reasonably effective vaccine would be in mass production and that a large enough portion of the world’s population would be vaccinated to stop the pandemic in its momentum.
Mr Gates had spent much of his time thinking about viruses and vaccines, long before the novel coronavirus was first detected in Wuhan in China’s Hubei province late last year. The Gates Foundation is at the heart of the global alliance that is trying to eradicate polio by vaccinating everyone, reducing the burden of malaria and finding a vaccine against it. 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 hold “Germ Games” modeled on military-led wargames. . The foundation has already pledged more than $ 350 million for the response to the covid-19 pandemic, much of which is focused on reducing its impact in the developing world. But more is needed. “We all need to spend billions to get the vaccine out and save the trillions in economic damage,” he says.
Fragmented data make it difficult to assess the true extent of the damage in many poor countries. As of August 17, the African Centers for Disease Control and Prevention, a public health body, had recorded more than one million cases and more than 25,000 deaths of covid-19 in Africa. In India, nearly 52,000 people are believed to have died from the disease. The actual number in both places is probably much higher. But the coronavirus is not the only deadly force at play in the developing world stricken by a pandemic. The millions of deaths Mr. Gates predicts will be caused not only directly by covid-19, but also by the spillover effects. Almost 90% will be indirect deaths, he says. The lockdowns will reduce access to vaccinations and drugs for other diseases. Deaths from malaria and HIV will increase. Declining agricultural productivity will lead to a spread of hunger and lower education rates. In the fight against poverty, the virus could wipe out a decade of gains.
To mitigate this risk, 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 to reappear in others. If vaccine prices are high enough in rich countries to cover the fixed costs of production – clinical trials, building factories, etc. – then the marginal cost of supplying poor countries would be relatively modest: around 10 to 12 billion dollars in total. He sees that most of that money comes from America, which he also attributes “by far the highest mark” to vaccine research and development, accounting for 80% of the world total. He hopes to see money pledged to buy vaccines for the poor world in the next congressional supplementary spending bill.
It depends on the policy. Congressional negotiations on the next US stimulus package have been stalled for weeks. The country’s strong political polarization has complicated its response to the virus, introducing problems that other countries do not face. The mere act of wearing a mask has become a political statement, rather than a matter of seeking and following expert advice, as is the case almost everywhere else. Depressingly, Mr Gates thinks this cannot be undone, even if the November election means a change of leadership at the top. Once public trust is lost and policy has shifted from cost-benefit analysis to partisanship, it is not easy to turn back the clock. Under President Joe Biden, Gates believes, refusing to wear a mask could become a way for Donald Trump supporters to signal their anger and resistance.
The lack of leadership in America has also hampered the response to the pandemic outside the country’s borders. The world’s only superpower has long taken the lead in global public health efforts, and without it, consensus is all the more difficult to forge. And the mood in many countries is one of withdrawal from multilateralism and cooperation through international institutions. It is difficult to see this trend reversed, as the disease is hitting public revenues everywhere. Generosity, which is as beneficial to the donor as it is to the recipient, is rare when budgets are tight.
It is not enough that there is a vaccine: people have to be ready to take it. And on this too, the Americans are lagging behind. A recent Gallup poll found that one in three people would not agree to receive an FDA-approved vaccine, even if it was free. But here the news is more favorable. The latest research, Gates explained, suggests that other circulating coronaviruses, and the partial immunity offered 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. The current best estimate is that 30-60% of the world’s population will need an effective vaccine to end the pandemic. “Fortunately, it’s not measles. We don’t need more than 90% of people to get vaccinated. “
In 2000, when Mr. Gates resigned his position as CEO of Microsoft, the Gates Foundation launched GAVI, a global alliance for the delivery of vaccines to poor countries. His involvement in polio and measles vaccines has made him an expert in ensuring equitable distribution – especially in poor countries. And this is where Mr Gates’ outlook is most positive. He believes the covid-19 vaccine will be the fastest ever made. If it’s ready for distribution on schedule, it will be by far the fastest vaccine ever to hit the market.
The world is on the right track to achieve this goal. More than 150 vaccines are in development worldwide, six of which are in final large-scale clinical trials. Mr. Gates has already donated hundreds of millions to the cause. He is ready to give a lot more. But private foundation money has limits – governments must take the lead, he believes, both because it’s their health care infrastructure that will need to be used for distribution and for gaining support. and public confidence. So far, they have only pledged around $ 10 billion for global vaccine manufacturing and distribution efforts. It is not enough.
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