Melinda Gates and husband Bill, co-founder of Microsoft, have donated billions to charities for the past two decades through the Bill & Melinda Gates Foundation, mainly supporting education and health.
The pair committed another $250 million Wednesday to support research, development, and delivery of COVID-19 vaccines, diagnostics and therapies, particularly to low-income countries.
Gates has spent the pandemic advocating for a more global approach to tackling it, and promoting the needs of caregivers, who have been particularly stressed by school closures and the loss of community support.
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She spoke with USA TODAY this week about her recent donation, the forthcoming COVID-19 vaccines and why she thinks social media needs to be better controlled:
The power of philanthropy
Question: What do you hope to accomplish with your new donation?
Melinda Gates: What our new funding is really focused on is, how do we make sure that a vaccine gets out equitably around the world, not just to high-income countries? Our foundation has always been about all lives having equal value. We want to help people live healthy and productive lives. So we're now turning to this next piece, which is equitable distribution of that vaccine.
Q: There's obviously a moral argument in support of providing vaccines equitably across the globe, but is it also in Americans' self-interest to help vaccinate people in other parts of the world?
Gates: If we don't get vaccine out equitably, if it only goes to high-income countries, we're literally going to see twice as much death. That's the forecast. Economically, we should care about it because if we want to get the most rapid recovery we can in the United States, it's a benefit to make sure that this disease is not bouncing back and forth across borders and into our own country. Forecasts (say) that if we can get vaccine out to not just high-income, but low- and middle-income countries, we can add $200 billion to the U.S. economy. In the next five years, you'll get things like travel fully up and running, you'll get manufacturing fully up and running, and our supply chains will work again.
Q: What about preventing the next pandemic? Is there anything that you and the foundation can do?
Gates: We were involved several years ago in setting up something called the Centers for Epidemic Preparedness. We got some funding for it, but not nearly enough. What we are going to be focused on next is how do we get really prepared for the next one because there will be another one. We are going to keep facing infectious disease. That's a given. But if we prepare for it – we have the funding for it, we're monitoring it, we actually practice for pandemic as a globe – what will happen is then as we get these outbreaks, we'll be able to tamp them down very quickly before they spread as quickly as COVID-19 did. So we will absolutely be involved in that.
Regaining lost momentum
Q: You've said that the world has regressed, has lost a lot of progress this year in terms of global health because of COVID-19. How do you pick that momentum back up again?
Gates: We're already picking it back up. In terms of polio, for instance, I'm talking with the health ministers in the affected countries like Pakistan, Afghanistan. People are returning for vaccinations, thank goodness because moms in the developing world will tell you how important they are. But it's going to take time to build back. It's not all going to happen overnight because there's been a lot lost.
Q: Can some be built back better?
Gates: Definitely. I think one of the things that has come out of this pandemic is some of the work that we'd all been hoping for in the digital space in the last, let's say, six or seven years, it has accelerated massively this year.
So let's take a mom who lives out in a remote rural area of Senegal. She has a cellphone. She can save $1 a day, $2 a day. Then when the school fees come due, the family has the money for it, or if there's a shock like somebody in the house gets malaria and they need medicine, (new) digital rails have allowed money, government payments to move out to people. Those digital tools are going to take off even faster now and give us all kinds of opportunities for health messaging, for letting people know when vaccines are available, for information about how to keep their baby safe after it's born and it has a fever, how to get help with telemedicine if they can't get to a clinic during the night. So, there will absolutely be opportunities because of that and opportunities in the education space as well.
Q: These same digital tools can also be used to spread misinformation, which has been particularly harmful during the pandemic. How do you think we should be combatting that?
Gates: I think we do need some regulation over social media. We have good regulations around broadcasting, which were put in place many, many years ago – whether it's TV broadcasting or the Motion Picture Association. I think it's time that we do that on social media platforms.
I certainly wouldn't make a decision about a medicine or a vaccine based on information I find on the Internet. I would do it based on what my doctor tells me is right for me or my children.
Caregivers struggling amid pandemic
Q: You've written and talked a lot about the challenges faced by caregivers. How do you see the problem?
Gates: If we want to build back and have a robust recovery, we've got to make sure there's good child care. Otherwise, we're going to lose women in the workforce. We lost 865,000 women in the workforce in September alone, and 1 in 4 women are saying they're going to downshift their career. (Women make up) 88% of our health care workforce and the majority of our teachers and the majority of our grocery store clerks.
Q: What do you think can be done?
Gates: I think that you can put $50 billion immediately into the child care system, and that will keep it on a level playing field instead of breaking. I think you could put more money in Medicaid to get these 800,000 elderly Americans off the rolls, where they can't find good care. And then I think you create very good paid family medical leave policy at the federal level. We have it in more than eight states now in the United States. We have different models, many of which are quite good. But we're literally the only industrialized nation that doesn't have paid family medical leave. And it's putting such a burden on women that they're not only dropping out of the workforce, they're saying they're going to have to downshift because they just can't do it.
Education derailed by the pandemic
Q: I know you've long been devoted to supporting high-quality education, and frustrated that your spending and years of effort haven't yielded more results. Now, in the pandemic, is there any way to avoid backsliding?
Gates: I think it's incredibly unfortunate to see so many low-income students right now, many of whom are of color, who don't have access to broadband, who don't have a laptop, who aren't able to get a good teacher online, even if they do have broadband and a laptop. So we already know those students' learning has been set back by at least seven or eight months, which makes me incredibly sad for them.
We're looking at with our education program, how do we shift some of the things that we are seeing work during COVID for middle- and high-income kids? How do we shift some of those pieces to low-income kids?
Digital is giving us a lot of ways to look at some of these opportunities and these gaps and figure out how can we do things differently. I never think education will be all online, nor do I think it should be. Getting these hybrid models, I think, has taught us a lot. And I think some of that can apply in many, many places where you don't have great teachers or great access to really good lesson plans.
Q: Is that one of the silver linings, one of the things that of good things that have come out of this disastrous pandemic?
Gates: I think it can be. And it can be a way to help students stay on a path to college because we know that to work in this economy and to have a good-paying job, you really do need to be college-educated. And so I do think it will be one of the silver linings we'll learn coming out of it. Or I hope at least.
How to avoid despair in dark times
Q: It takes a certain amount of optimism to devote so much money and effort to fighting the pandemic. What keeps you upbeat?
Gates: Well, certainly I have my days that I'm very sad about this, especially when you hear of a friend, a loved one, who is in the hospital or having trouble breathing. But I stay optimistic because I look at the unbelievable science and ingenuity that has come to bear and scientists working together in ways they never had before. That keeps me optimistic. And also, the small acts of kindness that add up. The person who's taking their elderly neighbor meals and delivering it to their front doorstep or picking up prescriptions for them or people making small kits that others can take home, with a mask and hand sanitizer to keep themselves safe. Those small acts of kindness add up, and it's what's helping us all.
This interview has been edited for length and clarity.
Contact Karen Weintraub at firstname.lastname@example.org.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
This article originally appeared on USA TODAY: Melinda Gates on COVID vaccine world distribution: Q&A on $250M gift