WIRED: You have been warning us about a global pandemic for years. Now that it has happened just as you predicted, are you disappointed with the performance of the United States?
Bill Gates: Yeah. There’s three time periods, all of which have disappointments. There is 2015 until this particular pandemic hit. If we had built up the diagnostic, therapeutic, and vaccine platforms, and if we’d done the simulations to understand what the key steps were, we’d be dramatically better off. Then there’s the time period of the first few 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 that didn’t work at first, and they weren’t letting people test. The travel ban came too late, and it was too narrow to do anything. Then, after the first few months, eventually we figured out about masks, and that leadership is important. . . .
But things are getting better:
At this point, are you optimistic?Gates notes that hospitals have cut the death rate in half with existing drugs and better care, and
Yes. You have to admit there’s been trillions of dollars of economic damage done and a lot of debts, but the innovation pipeline on scaling up diagnostics, on new therapeutics, on vaccines is actually quite impressive. And that makes me feel like, for the rich world, we should largely be able to end this thing by the end of 2021, and for the world at large by the end of 2022. That is only because of the scale of the innovation that’s taking place. Now whenever we get this done, we will have lost many years in malaria and polio and HIV and the indebtedness of countries of all sizes and instability. It’ll take you years beyond that before you’d even get back to where you were at the start of 2020. It’s not World War I or World War II, but it is in that order of magnitude as a negative shock to the system.
This disease, from both the animal data and the phase 1 data, seems to be very vaccine preventableBut Gates remains angry about certain bottlenecks:
But people aren’t getting their tests back quickly enough.
Well, that’s just stupidity. The majority of all US tests are completely garbage, wasted. If you don’t care how late the date is and you reimburse at the same level, of course they’re going to take every customer. Because they are making ridiculous money, and it’s mostly rich people that are getting access to that. You have to have the reimbursement system pay a little bit extra for 24 hours, pay the normal fee for 48 hours, and pay nothing [if it isn’t done by then]. And they will fix it overnight.
Why don’t we just do that?
Because the federal government sets that reimbursement system. When we tell them to change it they say, “As far as we can tell, we’re just doing a great job, it’s amazing!” Here we are, this is August. We are the only country in the world where we waste the most money on tests. Fix the reimbursement. Set up the CDC website. But I have been on that kick, and people are tired of listening to me.