Is Bill Gates to Blame for Lagging Vaccinations?

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S1: I called up Tim Schwab because I was hoping he could tell me the origin of this phrase. I’ve been hearing more and more of recently vaccine apartheid. I’ve heard it from the head of the World Health Organization.

S2: I think I would go one step further and say not just that the world is at risk of vaccine apartheid. The world is

S3: in vaccine apartheid.

S1: I’ve heard it on the floor of the United Nations. Vaccine apartheid has resulted in significant disparities. But Tim had heard it way before all that, first in conversation with friends and colleagues and then in this article in a South African newspaper called the Mail and Guardian.

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S3: I think that term had already been around, but was striking to me was when it’s coming from a South African outlet to describe the inequity where pharmaceutical companies predictably have prioritized selling COVID vaccines to the wealthiest buyers.

S1: Rich nations This article was written by a journalist who’d been warning that Africa could become the continent of COVID. He was angry, and this resonated with him because the article didn’t just blame structural inequality or manufacturing delays for vaccine apartheid. It blamed Bill Gates. Tim has spent the last few years investigating Gates and his foundation.

S3: It is giving charitable grants, but it’s just operating in such a complicated way that, you know, on paper, sometimes it feels more like an investment bank than it does a charity, as many of us imagine it.

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S1: Do you have, like all of their IRS filings on your desk? Yeah, yeah. If you ask Tim, having one of the world’s biggest global health charities work like an investment bank, that’s the real origin of vaccine apartheid, and the cost is high. As of this month, only 27 percent of people in low income countries have received a single coronavirus vaccine. Compare that to 70 percent of people in some high income countries. Do you consider Bill Gates a philanthropist?

S3: It’s hard, it’s hard to say, I mean, sometimes it feels like the Gates Foundation is more about, you know, consolidating power and control and the Bill Gates hands under the auspices of the Gates Foundation, that it really does seem like an effort to share power with the global poor. It’s this model of funding the rich to help the poor. And we should probably start to realize that there is a difference between giving away money and sharing power.

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S1: Today on the show, how the global response to COVID was shaped by the charity of Bill Gates when we talk about vaccine apartheid is an American billionaire to blame. I’m Mary Harris. You’re listening to what next? Stick around. Tim Schwab says it’s not an accident. Bill Gates and his foundation had so much to do with the fight against COVID 19. He says it was many years and much investment in the making and in some ways when COVID became a pandemic, the foundation might have been the world’s best bet.

S3: Bill Gates, you know, he had decades of experience working with vaccines that was has always been an important essential feature of the Gates Foundation’s work. They had contacts and networks with pharmaceutical companies with which they’ve worked closely for decades. They’ve worked on R&D that work on distribution well.

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S1: In some ways, it sounds like they were prepared to help.

S3: Yeah, they came in and they were the first mover. They came in, they had the network, they had the people on staff. They had a plan when a lot of government leaders didn’t have a plan and everyone just looks to them for leadership because they seem to know what they’re doing.

S1: In previous outbreaks, like when Ebola hit in 2014, governments were calling the Gates Foundation and begging for help. So this time around, they were prepared. They’d already set up something called the Coalition for Epidemic Preparedness Innovations and then to address COVID. Specifically, they popped open COVAX, a global vaccine distribution project. All in all, the Gates Foundation spent $1.8 billion on global public health in 2020 alone. But Tim says that meant there were few checks and balances on what Gates funded groups were up to.

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S3: I mean, if you look across global health, they’re funding everybody. I mean, nobody is more than one degree removed from the Gates Foundation, so it’s really difficult to avoid the Gates Foundation’s money and say that’s also the case for journalists. If you’re a journalist writing about global health, you might in one way or the other end up getting a fellowship or a grant to do reporting that’s funded by the Gates Foundation. So it’s really hard to overstate how much influence that gives the foundation in shaping the direction of the field, the questions that are asked scrutiny about the Gates Foundation’s role in global health.

S1: So COVID struck. My understanding is that the Gates Foundation, they were kind of like, This is what we do like we do innovation. And so, you know, we should really be leading this almost. To the chagrin of someone like the World Health Organization that was saying, hold it. Is this what we do? Is that your impression as well?

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S3: Well, I mean, at the World Health Organization, it’s the obvious place where this pandemic response should be happening for the global poor because they have a mandate. It’s has some semblance of a democratic institution where you have member states and you have votes. This should be the place where this is happening. But you know, the World Health Organization has really been hollowed out over the decades because it hasn’t been well-funded. And what that’s meant is that Bill Gates and the Gates Foundation has come in to become one of the most important funders is the second largest funder. I think of the World Health Organization, which gives it a really outsized role in influencing how the show works. So at the point that the pandemic came, I think the Gates Foundation certainly felt like it had more of a network and more of a background and better capacity to be leading this pandemic. So the response did end up being rooted, you know, nominally through the World Health Organization. But all the phone calls, all the working groups, all the meetings, it was really the Gates Foundation that was directing and putting down the markers to guide which direction things went

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S1: seems like a shadow government.

S3: I don’t know if I call it a shadow government, but it’s maybe shadow government is not the right word, but there is certainly something that’s fundamentally undemocratic about it. You know, the Gates Foundation doesn’t have a constituency that elects it or the unelected. There is virtually no checks and balances over a private foundation. There’s no transparency. So I would say it’s undemocratic and maybe even anti-democratic. And in some important ways, I think the foundations, you know, the growing institutionalized influence of the foundation in fields like global health and other public policies, it’s really eroding democratic institutions and the power of democracy to solve these problems instead, where we’re looking to a private billionaire in Seattle for solutions.

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S1: I understand that from the very beginning, the sort of Gates Foundation ethos of open markets influenced how some of these projects worked, like the vaccine that they got behind was the AstraZeneca vaccine. But my understanding was that that was supposed to be an open license like anyone could make it. But that didn’t happen. Why?

S3: Yeah. And I think this is part and parcel of these halcyon early days of the pandemic response when there was this really rich discourse around like a people’s vaccine and not doing a business as usual approach. And one of the early vaccine innovators, it wasn’t a pharmaceutical company. It was university, the University of Oxford in the UK. And, you know, early in the pandemic, there were all these stories about how they had a head start against the coronavirus compared to other vaccine companies because they had a research lab that had been doing work so closely related to the coronavirus. And as these stories were coming out, you had, you know, the researchers in this lab saying that, you know, this can’t be a profit driven pandemic response. This really needs to be about public goods and public health. And certainly, the message that they were telegraphing was that you could develop this vaccine and have it available as an open license, which would mean that any capable manufacturer anywhere around the world could get a hold of the vaccine technology and start start producing. It sounds smart. Yeah, it does sound sport. It sounds super resilient. You know this idea that you could have manufacturing facilities, you could build them, you could retrofit them in sub-Saharan Africa and Southeast Asia. So you’d have these manufacturing facilities getting on stream all over the world because they knew they could access the vaccine technology and start producing it. And if the University of Oxford had gone that direction, you know, some of the sources I’ve talked to in my reporting said, you know, that could have really changed the direction of the pandemic. You know, this could have been if they were a first mover to have that effect and to really inspire, you know, other players to go in that direction also. But that’s not what happened.

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S1: So what you’re saying is that in the beginning, everyone was just out there trying stuff. And so if a big mover had said, Hey, we’re putting our stake in the ground, like, let’s share all of our information that might have influenced beyond their specific vaccine.

S3: I think we would have been a really different pandemic response if they had made that decision. But but this story that came out was that Bill Gates and the Gates Foundation came to the University of Oxford said they’d been funding the University of Oxford, their work in vaccines for years. You know, Gates also funds other groups that were providing them funding for their COVID vaccine development. So Bill Gates and the Gates Foundation had a relationship. You could even say they had leverage there, and they they talked to the university and they they encouraged them. They pushed them, really. And they said, you know, you should really be partnering up with a major multinational pharmaceutical company, somebody who has the wherewithal, the resources, the experience to get this over the finish line and out into people’s arms. And not long after that, Oxford, they partnered with AstraZeneca. And that really sort of the die was cast. Now it was an exclusive license with AstraZeneca. And so they they ended up going down this sort of business as usual route to, you know, patents exclusive license. The way the pharmaceutical industry has always operated,

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S1: locking up intellectual property has been a key criticism of the Gates Foundation approach to every public health crisis. Tim says when it comes to COVID vaccines. Bill Gates has actually responded to those criticisms, but his rebuttals seem dubious.

S3: One of the arguments that Bill Gates continues to make is that there simply are not available manufacturing facilities around the world that could scale up production. So, you know, he wants to say there’s no reason that we should be having this conversation about waiving intellectual property and patents because it’s not like they’re all of these idle manufacturing facilities out there that could be producing these vaccines. And I think to a lot of people, that smacks of a certain like patriarchy or colonialism. You know, this idea that poor nations aren’t sophisticated enough or smart enough to produce this complicated vaccine, which just doesn’t make sense because at the same time that Bill Gates is saying this, you know, the New York Times is coming out with a big investigation, highlighting 10 vaccine manufacturers around the world, which could be producing these RNA vaccines that have the capacity they had the professional expertise. Have all the ingredients in place that some or all of them could be producing these vaccines, and this is not a new story, you know, throughout the spring of this year, you’ve had these vaccine companies who are waving their hands saying if these vaccine companies would waive the patents and share the technology, my facility could be producing this many doses this year. You know, Bill Gates isn’t really engage with that. He just reverts back to this talking point just to say that there’s no such facilities out there.

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S1: But then there was this other desire to sort of speed up vaccine distribution. Was the Gates Foundation able to help do that?

S3: Well, I mean, vaccine distribution is limited by the supply. And so the supply was all being snapped up by rich nations, which were making all these advance purchases against, you know, Pfizer and Moderna and everyone else. And so the Gates Foundation had a long standing relationship with the Serum Institute of India as the largest vaccine manufacturer in the world. Interestingly, it’s located in India. So the foundation leaned on this Serum Institute and made several deals that they were going to start producing vaccines, and those vaccines would go into the arms, the global poor. But then a second wave of COVID hit India. They had a major problem. The Indian government issued an export ban, which basically meant everything the Serum Institute was producing was going into the arms of Indians. So, you know, and that’s now that we’re starting to do an autopsy of everything that went wrong with COVAX and the pandemic response. You know, people are saying, where is the risk assessment to put all of our eggs in one basket? You know, so much of this gates led project went to this one manufacturer in India. And you know, when when things went wrong, they went really wrong for everybody.

S1: Hmm. And the goal was two billion doses out in the world by the end of 2021. It sounds like they’re not going to meet that by any stretch.

S3: No, they keep scaling back what they say that they can deliver by the end of the year. But, you know, we’ll see, you know, how much they’ll have to the end of this year. But I don’t think they’re to be anywhere near two billion doses, and I don’t think they’re saying they’re going to be anywhere near two billion. I don’t know what they’re at now. I think their latest prediction might be like one point five billion. And that also, I think, is pretty ambitious and we’ll see if they can achieve that.

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S1: More with Tim Schwab after a break. I mean, some people might listen to your criticisms and say, does this guy like really have it in for Bill Gates? What would you say to someone who heard you and thought that?

S3: Well, I mean, it’s not just me saying this. I mean, what’s been interesting to me is, you know, you’re all these news stories are coming out right now sort of providing sort of an autopsy of what went wrong with COVAX. But what’s what’s not at the front of the center of this is Bill Gates of the Gates Foundation.

S1: Yeah, I noticed that too. There’s there’s a lot of conversation about inequity, but not a lot of conversation about how we got there.

S3: Yeah. And I think that’s part of the autopsy. You have to do that to figure out, well, how do we pivot and move forward in this pandemic and how do we prepare for the next pandemic? And you know, in my mind, as a general principle, if you want to step up and be a leader when things go wrong, you should take responsibility. And the Gates Foundation clearly is incapable of doing that because, you know, they seem to think that the pandemic response is going OK. But that’s also where journalists need to step up and look at, you know, we know if you go back to 2020, there were several news articles talking about how the Gates Foundation was really the chief architect of this program. So now here we are on the other end, and this is the paradox of reporting on the Gates Foundation is just so little reporting that goes backwards. It looks back. That does accountability journalism and to say, well, what was the Gates Foundation’s role in all of this? And does it make sense for a billionaire in Seattle to have as much power as Bill Gates seems to have? And it’s not. It goes even beyond this pandemic response, but you could look across U.S. education, African agriculture, global health more broadly, whether you’re looking at malaria control or polio eradication. I mean, you have this private institution is private foundation with Bill Gates money in Seattle, and it’s just an incredible amount of power. And I mean, in my mind, the pandemic response is just this really important moment that we need to be looking back at the foundation’s role in all this and think like, well, you know, maybe next time we should have a more democratic response. We shouldn’t depend on billionaire philanthropy that has no checks and balances or transparency to play such an influential role.

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S1: I wonder if you’ve spoken to people in developing countries who both need to work with someone like the Gates Foundation, but then also maybe feel like there’s something the foundation just doesn’t get about them and how maybe their perspective on the work the foundation does has changed.

S3: I mean, the Gates Foundation is a very top-down sort of technocratic enterprise where, you know, Bill Gates sees himself as this really smart guy with these innovative ideas and technology, and he surrounds himself with this kind of elite cadre of highly educated experts. And you know, it’s his view that from this person, Seattle, that they can devise solutions to fix all the problems of the global poor. And you know, that’s a very different approach than going out into a poor nation or a poor community and talking to people and asking them what they need and what they want.

S1: You’ve called it colonial.

S3: Yeah, I mean, it’s it’s not just me, but a lot of people see that as colonial or neo colonial. I recently did a study looking at the Gates Foundation’s funding of the $70 billion in charitable grants they’ve pledged over the last two decades. And you know, the face of the foundation is very much these poor black and brown faces in the in the global south, as it’s called. But if you start to look at their grant making, almost all of their money goes to, you know, the wealthiest, whitest nations. They’re funding NGOs and companies in the United States, in the United Kingdom and Switzerland. Very little of their grant making actually goes to institutions in sub-Saharan Africa, for example. And I think it’s hard not to raise a question about colonialism when you see it. This played out in such a striking way. You know, Bill Gates is one of the richest people in the world, and he’s getting richer year over year. He’s not getting poorer. We have this idea that he’s giving away all of his money, but that’s not the case. Bill Gates is getting richer every year now poorer and, you know, from such a privileged position and from such an unequal position. Bill Gates has nevertheless managed to brand the Gates Foundation as this as geared uniquely towards equity to making sure that all lives have equal value. So there’s a real paradox in how the foundation functions along along those lines of wealth and power.

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S1: Tim, thank you so much for joining me. Thanks for having me, Mary. Tim Schwab is a freelance investigative journalist. He’s currently writing a book about the Gates Foundation. And that is our show. What next is produced by Carmel Delshad Davis Land, Daniel Hewitt, Mary Wilson and Elena Schwartz. We are led by Alison Benedict and Alicia Montgomery. And I’m Mary Harris. Before I get going, you know how I’ve been telling you all the reasons you should subscribe to Slate Plus this month? It turns out I’ve got one more reason. If you signed up, you can get free. What next? Swag, talking stickers, buttons? Here’s how it works. Go to our show notes. Click the link to fill out a Google form, and I will pop some swag into the mail for you, but only if you’ve joined Slate Plus and only if you’re one of the first 30 people to sign up. So get on it. I will be back in this feed tomorrow.