WEBVTT 00:00:02.690 --> 00:00:06.145 align:middle line:84% Melinda Gates, thanks so much for being with us. 00:00:06.145 --> 00:00:07.670 align:middle line:90% Thanks for having me. 00:00:07.670 --> 00:00:13.130 align:middle line:84% Let's start with the pandemic, and with vaccine nationalism. 00:00:13.130 --> 00:00:15.770 align:middle line:84% Something that I know is of great concern to you, 00:00:15.770 --> 00:00:19.100 align:middle line:90% you've spoken up about. 00:00:19.100 --> 00:00:22.460 align:middle line:84% Your foundation has done some research. 00:00:22.460 --> 00:00:26.670 align:middle line:84% You modelled vaccine scenarios to see the impact, whether... 00:00:26.670 --> 00:00:28.820 align:middle line:84% if there was nationalism and if there 00:00:28.820 --> 00:00:31.640 align:middle line:90% was vaccine fair distribution. 00:00:31.640 --> 00:00:35.990 align:middle line:84% And you found a very clearly that the deaths 00:00:35.990 --> 00:00:42.050 align:middle line:84% were doubled in the case of rich countries hoarding vaccines. 00:00:42.050 --> 00:00:45.240 align:middle line:84% That is what is happening today, isn't it? 00:00:45.240 --> 00:00:45.740 align:middle line:90% It is. 00:00:45.740 --> 00:00:48.740 align:middle line:84% You're seeing wealthy nations vaccinate their populations 00:00:48.740 --> 00:00:52.250 align:middle line:90% and it's incredibly unfortunate. 00:00:52.250 --> 00:00:56.250 align:middle line:84% Do you accept that, to a certain extent, 00:00:56.250 --> 00:00:59.810 align:middle line:84% it is quite difficult for governments 00:00:59.810 --> 00:01:06.050 align:middle line:84% who know that they need to be re-elected or elected, 00:01:06.050 --> 00:01:10.820 align:middle line:84% that there is a lot of political pressure on them 00:01:10.820 --> 00:01:14.995 align:middle line:84% to vaccinate their own population first? 00:01:14.995 --> 00:01:15.495 align:middle line:90% Yeah. 00:01:15.495 --> 00:01:19.460 align:middle line:84% ...and how do you strike that balance between convincing them 00:01:19.460 --> 00:01:24.420 align:middle line:84% that actually what's happening in India today, for example, 00:01:24.420 --> 00:01:28.040 align:middle line:90% will affect them down the road? 00:01:28.040 --> 00:01:30.360 align:middle line:84% Well I think if you're a leader of a country, 00:01:30.360 --> 00:01:33.250 align:middle line:84% absolutely you want to vaccinate your population. 00:01:33.250 --> 00:01:35.580 align:middle line:84% And so, while I say it's disappointing to see 00:01:35.580 --> 00:01:38.370 align:middle line:84% that the wealthy countries are vaccinating, 00:01:38.370 --> 00:01:39.930 align:middle line:90% it's great for their nation. 00:01:39.930 --> 00:01:42.420 align:middle line:84% But I think you should vaccinate up to a point, 00:01:42.420 --> 00:01:45.100 align:middle line:84% and you hit a certain age population where you say, 00:01:45.100 --> 00:01:48.330 align:middle line:84% OK, we're going to pause and make sure 00:01:48.330 --> 00:01:52.230 align:middle line:84% that we then put both money and extra supply 00:01:52.230 --> 00:01:53.760 align:middle line:90% on the global market. 00:01:53.760 --> 00:01:56.490 align:middle line:84% There's a mechanism called COVAX. 00:01:56.490 --> 00:02:01.890 align:middle line:84% It needs $2bn more funding, and it needs vaccine supply. 00:02:01.890 --> 00:02:05.070 align:middle line:84% But we know - thank goodness it got set up during the pandemic 00:02:05.070 --> 00:02:07.230 align:middle line:84% - we know it can distribute vaccine. 00:02:07.230 --> 00:02:10.020 align:middle line:84% It's distributed vaccine to 40 countries already, 00:02:10.020 --> 00:02:12.200 align:middle line:84% but it needs more money and more supply. 00:02:12.200 --> 00:02:16.470 align:middle line:84% So I think you don't need to vaccinate all the way down, 00:02:16.470 --> 00:02:21.390 align:middle line:84% say, to your teen population before you - you can certainly 00:02:21.390 --> 00:02:26.280 align:middle line:84% make a donation now of money - but before you send out 00:02:26.280 --> 00:02:29.670 align:middle line:90% vaccine doses to COVAX. 00:02:29.670 --> 00:02:31.950 align:middle line:84% So where would you draw the line? 00:02:31.950 --> 00:02:34.450 align:middle line:84% Is it for under 30s, for example? 00:02:34.450 --> 00:02:37.650 align:middle line:84% So once you've vaccinated everyone who's over 30 00:02:37.650 --> 00:02:40.920 align:middle line:84% then you would suggest that donations 00:02:40.920 --> 00:02:45.670 align:middle line:84% are made to developing and poorer countries? 00:02:45.670 --> 00:02:46.170 align:middle line:90% Yes. 00:02:46.170 --> 00:02:48.270 align:middle line:90% I think you pick an age.. 00:02:48.270 --> 00:02:51.270 align:middle line:90% 20, 30... right in that range. 00:02:51.270 --> 00:02:54.810 align:middle line:84% You give money now, so we fully fund COVAX. 00:02:54.810 --> 00:02:57.360 align:middle line:84% But you also start to give vaccines, 00:02:57.360 --> 00:02:59.640 align:middle line:90% and you give extra doses. 00:02:59.640 --> 00:03:03.870 align:middle line:84% We will get out of this problem as the manufacturing comes 00:03:03.870 --> 00:03:06.000 align:middle line:84% along and there's far more of it. 00:03:06.000 --> 00:03:09.150 align:middle line:84% But look, to have low-income countries who can't even 00:03:09.150 --> 00:03:11.440 align:middle line:84% vaccinate their healthcare workers. 00:03:11.440 --> 00:03:14.280 align:middle line:84% I mean that's the system people are going into 00:03:14.280 --> 00:03:16.410 align:middle line:90% to take care of one another. 00:03:16.410 --> 00:03:20.190 align:middle line:84% You have to get the entire health system populated 00:03:20.190 --> 00:03:23.240 align:middle line:84% and the elderly vaccinated as well. 00:03:26.070 --> 00:03:31.020 align:middle line:84% This, to a certain extent, is what a lot of leaders 00:03:31.020 --> 00:03:35.160 align:middle line:84% have talked about, but are not actually doing. 00:03:35.160 --> 00:03:38.940 align:middle line:84% So there have been proposals, for example, that 5 per cent 00:03:38.940 --> 00:03:43.970 align:middle line:84% or 6 per cent of your own vaccine supply 00:03:43.970 --> 00:03:47.880 align:middle line:90% should be donated. 00:03:47.880 --> 00:03:51.210 align:middle line:84% What can you do, and what do you think 00:03:51.210 --> 00:03:56.040 align:middle line:84% can be done in order to convince governments to do this now? 00:03:56.040 --> 00:03:58.020 align:middle line:84% Well you can both use the moral argument 00:03:58.020 --> 00:04:00.142 align:middle line:84% - we don't want to see more people die. 00:04:00.142 --> 00:04:02.100 align:middle line:84% We're seeing it on the news, every morning when 00:04:02.100 --> 00:04:03.808 align:middle line:84% you turn on the news, we're seeing what's 00:04:03.808 --> 00:04:05.740 align:middle line:90% happening around the world. 00:04:05.740 --> 00:04:07.950 align:middle line:84% Governments are starting to realise, oh my gosh, 00:04:07.950 --> 00:04:10.613 align:middle line:84% if we don't get the global population vaccinated 00:04:10.613 --> 00:04:12.030 align:middle line:84% we're going to have more variants, 00:04:12.030 --> 00:04:14.113 align:middle line:84% and they're going to spring up in different places 00:04:14.113 --> 00:04:17.110 align:middle line:84% in the world, and bounce back into our own countries. 00:04:17.110 --> 00:04:19.769 align:middle line:84% So that is an argument that absolutely leaders 00:04:19.769 --> 00:04:20.820 align:middle line:90% are listening to. 00:04:20.820 --> 00:04:25.170 align:middle line:84% And they want to get, not just their own economy reopen, 00:04:25.170 --> 00:04:28.110 align:middle line:84% they want to get the world's economy reopen. 00:04:28.110 --> 00:04:30.060 align:middle line:84% If you want to get tourism going again, 00:04:30.060 --> 00:04:32.130 align:middle line:84% you want to get manufacturing going again, 00:04:32.130 --> 00:04:36.790 align:middle line:84% it benefits all of us to have the global economy reopened. 00:04:36.790 --> 00:04:38.790 align:middle line:84% So those are arguments that are being made, 00:04:38.790 --> 00:04:41.310 align:middle line:84% and governments are beginning to listen. 00:04:41.310 --> 00:04:43.245 align:middle line:90% Who do you think is listening? 00:04:43.245 --> 00:04:45.060 align:middle line:84% I do think the US government is looking 00:04:45.060 --> 00:04:49.860 align:middle line:84% at their supply of vaccine and deciding, OK, how much of it 00:04:49.860 --> 00:04:51.960 align:middle line:90% should we do through COVAX? 00:04:51.960 --> 00:04:54.690 align:middle line:84% How much should we do bilaterally? 00:04:54.690 --> 00:04:58.050 align:middle line:84% So I think you're going to start to see some movement there. 00:04:58.050 --> 00:05:00.900 align:middle line:90% Let's talk about patents and IP. 00:05:00.900 --> 00:05:02.520 align:middle line:84% I know that the foundation defends 00:05:02.520 --> 00:05:05.250 align:middle line:90% patents to drive innovation. 00:05:05.250 --> 00:05:08.730 align:middle line:84% Some activists argue that they really should be overturned, 00:05:08.730 --> 00:05:15.720 align:middle line:84% and this is a very special case, the global pandemic. 00:05:15.720 --> 00:05:19.055 align:middle line:90% What's your thinking on this? 00:05:19.055 --> 00:05:20.430 align:middle line:84% Well I think you have to look at, 00:05:20.430 --> 00:05:24.450 align:middle line:84% where is the current problem in the system right now 00:05:24.450 --> 00:05:26.370 align:middle line:84% during this pandemic, and how do we 00:05:26.370 --> 00:05:29.050 align:middle line:90% fix that piece of the system? 00:05:29.050 --> 00:05:32.980 align:middle line:84% So if you look at what we call the upstream, the R&D piece. 00:05:32.980 --> 00:05:38.220 align:middle line:84% A vaccine, several vaccines have been created in the shortest 00:05:38.220 --> 00:05:41.970 align:middle line:84% period possible in the history of the world for a disease 00:05:41.970 --> 00:05:44.010 align:middle line:90% that humanity has never seen. 00:05:44.010 --> 00:05:48.030 align:middle line:84% So that part of the system is actually working today. 00:05:48.030 --> 00:05:51.700 align:middle line:84% The piece that is not working today is the manufacturing. 00:05:51.700 --> 00:05:54.360 align:middle line:84% We have huge manufacturing bottlenecks, 00:05:54.360 --> 00:05:56.800 align:middle line:84% we don't have enough raw materials, 00:05:56.800 --> 00:05:59.190 align:middle line:84% we don't have manufacturing in the right places. 00:05:59.190 --> 00:06:01.020 align:middle line:84% And so it's allowing the nations that 00:06:01.020 --> 00:06:05.130 align:middle line:84% have the manufacturing in place to hoard their vaccines. 00:06:05.130 --> 00:06:07.380 align:middle line:84% And so we've got to fix that piece, 00:06:07.380 --> 00:06:13.470 align:middle line:84% and then we also have to do the appropriate tech transfers 00:06:13.470 --> 00:06:15.210 align:middle line:84% from the pharmaceutical companies 00:06:15.210 --> 00:06:18.690 align:middle line:84% and have the incentives so that they tech transfer. 00:06:18.690 --> 00:06:20.675 align:middle line:90% And so that's the role of-... 00:06:20.675 --> 00:06:25.890 align:middle line:84% So you favour tech transfers, but not patents? 00:06:25.890 --> 00:06:27.930 align:middle line:84% Not changing the patent system as it 00:06:27.930 --> 00:06:31.410 align:middle line:84% exists right now in the middle of a pandemic. 00:06:31.410 --> 00:06:35.070 align:middle line:84% That system has benefited, is benefiting 00:06:35.070 --> 00:06:37.640 align:middle line:90% the world at the moment. 00:06:37.640 --> 00:06:40.770 align:middle line:84% But it doesn't have to set a precedent necessarily, does it? 00:06:40.770 --> 00:06:45.277 align:middle line:84% Given that this is such a special case. 00:06:45.277 --> 00:06:48.910 align:middle line:84% But you're seeing the tech transfers happen. 00:06:48.910 --> 00:06:50.890 align:middle line:84% So when you're in the middle of a pandemic, 00:06:50.890 --> 00:06:53.820 align:middle line:84% I wouldn't take down the system that's working. 00:06:53.820 --> 00:06:55.830 align:middle line:84% I would look at, where is the problem? 00:06:55.830 --> 00:06:57.870 align:middle line:90% It's a manufacturing problem. 00:06:57.870 --> 00:07:00.360 align:middle line:84% Should we look at the IP piece over time? 00:07:00.360 --> 00:07:02.850 align:middle line:84% Absolutely, and maybe what you do 00:07:02.850 --> 00:07:05.430 align:middle line:84% is set up ahead of time in a pandemic. 00:07:05.430 --> 00:07:08.088 align:middle line:84% Hey, if they're going to be certain companies that 00:07:08.088 --> 00:07:09.630 align:middle line:84% are able to make vaccines, how do you 00:07:09.630 --> 00:07:13.140 align:middle line:84% keep them incentivised to do those tech transfers? 00:07:13.140 --> 00:07:17.100 align:middle line:84% And how do we put the money in up-front to have manufacturing? 00:07:17.100 --> 00:07:19.020 align:middle line:84% We should have far more manufacturing 00:07:19.020 --> 00:07:21.220 align:middle line:90% on the continent of Africa. 00:07:21.220 --> 00:07:24.330 align:middle line:84% But if you look at the current system, the AstraZeneca 00:07:24.330 --> 00:07:26.490 align:middle line:84% vaccine, we've been deeply involved 00:07:26.490 --> 00:07:29.010 align:middle line:84% in the tech transfer that happened to Serum Institute 00:07:29.010 --> 00:07:32.940 align:middle line:84% in India, they are pumping out millions of doses every month. 00:07:32.940 --> 00:07:36.465 align:middle line:84% They're about to get up to 100m doses a month. 00:07:36.465 --> 00:07:39.300 align:middle line:84% But now they are in a situation, which is quite ironic, 00:07:39.300 --> 00:07:41.850 align:middle line:90% because there was... 00:07:41.850 --> 00:07:43.470 align:middle line:90% AstraZeneca is being made there. 00:07:43.470 --> 00:07:46.950 align:middle line:84% But now they're in a situation where they will not be 00:07:46.950 --> 00:07:49.145 align:middle line:90% able to send it anywhere else. 00:07:49.145 --> 00:07:49.950 align:middle line:90% That's right. 00:07:49.950 --> 00:07:51.877 align:middle line:90% Because they've got a new surge. 00:07:51.877 --> 00:07:54.160 align:middle line:90% Exactly, and so that's my point. 00:07:54.160 --> 00:07:56.520 align:middle line:84% That's why we need to have manufacturing 00:07:56.520 --> 00:08:00.300 align:middle line:84% in far more places around the world, 00:08:00.300 --> 00:08:02.310 align:middle line:84% so that we can get it out and you 00:08:02.310 --> 00:08:06.255 align:middle line:84% don't have this hoarding problem that we're seeing right now. 00:08:06.255 --> 00:08:09.450 align:middle line:84% You mentioned AstraZeneca and the vaccines 00:08:09.450 --> 00:08:13.680 align:middle line:84% made by both AstraZeneca and Johnson & Johnson are 00:08:13.680 --> 00:08:17.880 align:middle line:84% the ones that are expected to immunise a lot of people 00:08:17.880 --> 00:08:20.010 align:middle line:90% in poorer countries. 00:08:20.010 --> 00:08:24.270 align:middle line:84% And yet they seem to carry this very rare blood clotting 00:08:24.270 --> 00:08:26.850 align:middle line:90% disease, the side effects. 00:08:26.850 --> 00:08:29.310 align:middle line:84% What impact do you think this is going to have? 00:08:29.310 --> 00:08:33.240 align:middle line:84% And do you think that it is already increasing vaccine 00:08:33.240 --> 00:08:35.085 align:middle line:90% hesitancy? 00:08:35.085 --> 00:08:37.620 align:middle line:84% Well we know if you interview populations today, 00:08:37.620 --> 00:08:41.309 align:middle line:84% for instance in France, there was already vaccine hesitancy. 00:08:41.309 --> 00:08:43.200 align:middle line:84% And if you talk to people, it is going up 00:08:43.200 --> 00:08:46.320 align:middle line:84% because of what they're hearing about this thrombosis. 00:08:46.320 --> 00:08:50.250 align:middle line:84% However, once you start rolling vaccine out, 00:08:50.250 --> 00:08:54.630 align:middle line:84% what we've seen even in the US, is that the vaccine hesitancy 00:08:54.630 --> 00:08:56.040 align:middle line:90% begins to go down. 00:08:56.040 --> 00:08:59.290 align:middle line:84% We all want to know that what we're putting in our bodies, 00:08:59.290 --> 00:09:03.870 align:middle line:84% these biologics, are safe for us, and for our family members, 00:09:03.870 --> 00:09:05.370 align:middle line:90% and our grandparents. 00:09:05.370 --> 00:09:08.190 align:middle line:84% And so it will go down over time. 00:09:08.190 --> 00:09:10.950 align:middle line:84% Four out of five people on the continent of Africa 00:09:10.950 --> 00:09:16.035 align:middle line:84% still say they want the AstraZeneca or the J&J vaccine. 00:09:16.035 --> 00:09:19.050 align:middle line:84% It's interesting that in the UK it hasn't really 00:09:19.050 --> 00:09:20.670 align:middle line:90% increased vaccine hesitancy. 00:09:20.670 --> 00:09:24.150 align:middle line:84% People are taking it every single day, 00:09:24.150 --> 00:09:26.520 align:middle line:90% and everyone's desperate for it. 00:09:26.520 --> 00:09:27.070 align:middle line:90% That's right. 00:09:27.070 --> 00:09:30.090 align:middle line:84% And I think you have to look at what are the number of cases? 00:09:30.090 --> 00:09:32.730 align:middle line:84% Sure it's tragic for those who do 00:09:32.730 --> 00:09:35.700 align:middle line:84% have these cases of thrombosis, but you also 00:09:35.700 --> 00:09:37.860 align:middle line:84% have to look at what are your chances of getting 00:09:37.860 --> 00:09:41.580 align:middle line:84% COVID and ending up on a ventilator or dying. 00:09:41.580 --> 00:09:45.060 align:middle line:84% And so if you weigh that cost-benefit analysis, 00:09:45.060 --> 00:09:48.040 align:middle line:84% certainly I would take the J&J vaccine, 00:09:48.040 --> 00:09:50.670 align:middle line:84% even though I'm a female in the age category 00:09:50.670 --> 00:09:52.880 align:middle line:90% that has that risk. 00:09:52.880 --> 00:09:54.570 align:middle line:90% Yeah, I'm with you on that. 00:09:54.570 --> 00:09:58.140 align:middle line:84% But how do you rate the overall performance of the pharma 00:09:58.140 --> 00:10:03.370 align:middle line:90% industry in this pandemic? 00:10:03.370 --> 00:10:07.980 align:middle line:84% I wonder whether companies could have acted, not necessarily 00:10:07.980 --> 00:10:11.070 align:middle line:84% faster but with greater transparency. 00:10:11.070 --> 00:10:13.140 align:middle line:84% There have been a lot of calls, for example, 00:10:13.140 --> 00:10:17.970 align:middle line:84% for contracts to be published and to be made public. 00:10:17.970 --> 00:10:22.590 align:middle line:84% There was a dispute between the UK 00:10:22.590 --> 00:10:25.260 align:middle line:84% and the EU when it comes to AstraZeneca, 00:10:25.260 --> 00:10:27.810 align:middle line:84% and in fact the UK's now suing AstraZeneca. 00:10:27.810 --> 00:10:32.190 align:middle line:84% Do you think that there could have been more transparency? 00:10:32.190 --> 00:10:34.380 align:middle line:84% And there should have been more transparency? 00:10:34.380 --> 00:10:36.760 align:middle line:84% There certainly could have been more transparency. 00:10:36.760 --> 00:10:40.080 align:middle line:84% I don't think you can rate the entire industry overall. 00:10:40.080 --> 00:10:42.600 align:middle line:84% I think you have some good actors in this pandemic, 00:10:42.600 --> 00:10:44.310 align:middle line:90% and some not good actors. 00:10:44.310 --> 00:10:47.700 align:middle line:84% And I think we'll see as this rolls forward, you 00:10:47.700 --> 00:10:50.010 align:middle line:84% know who is making enormous profits off 00:10:50.010 --> 00:10:52.980 align:middle line:84% of vaccine, versus who did do the right thing 00:10:52.980 --> 00:10:54.930 align:middle line:90% and do tech transfers. 00:10:54.930 --> 00:10:58.050 align:middle line:84% So you know I think there is a reckoning to be had here, 00:10:58.050 --> 00:11:02.230 align:middle line:84% but I don't think that during the middle of a pandemic 00:11:02.230 --> 00:11:04.800 align:middle line:84% I should be criticising the pharmaceutical industry 00:11:04.800 --> 00:11:07.535 align:middle line:90% writ large. 00:11:07.535 --> 00:11:09.380 align:middle line:84% You've written a lot about the impact 00:11:09.380 --> 00:11:13.130 align:middle line:90% of Covid-19 on women and girls. 00:11:13.130 --> 00:11:16.040 align:middle line:84% And you've been making the case that to recover fully 00:11:16.040 --> 00:11:20.000 align:middle line:84% from the pandemic, leaders have to respond to the ways 00:11:20.000 --> 00:11:23.540 align:middle line:84% that it's affecting men and women differently. 00:11:23.540 --> 00:11:25.370 align:middle line:90% What should be done? 00:11:25.370 --> 00:11:30.950 align:middle line:84% And do you see any good examples of what is being done, 00:11:30.950 --> 00:11:35.015 align:middle line:84% any models that other governments could look at? 00:11:35.015 --> 00:11:35.840 align:middle line:90% Yes, so... 00:11:35.840 --> 00:11:37.340 align:middle line:84% I'm really glad you brought this up. 00:11:37.340 --> 00:11:40.310 align:middle line:84% I mean Oxfam published a report just yesterday that says, 00:11:40.310 --> 00:11:45.800 align:middle line:84% women have lost $800bn of income. 00:11:45.800 --> 00:11:47.300 align:middle line:90% And so why is that? 00:11:47.300 --> 00:11:48.670 align:middle line:90% There are multi-reasons. 00:11:48.670 --> 00:11:52.280 align:middle line:84% Women often hold the informal jobs or the low-income jobs 00:11:52.280 --> 00:11:55.040 align:middle line:84% in many countries, but the predominant reason 00:11:55.040 --> 00:11:56.630 align:middle line:90% is caregiving. 00:11:56.630 --> 00:11:59.600 align:middle line:84% And so finally we're seeing what's 00:11:59.600 --> 00:12:01.610 align:middle line:90% always been there all along. 00:12:01.610 --> 00:12:06.140 align:middle line:84% Women on average do 30 hours of caregiving a week. 00:12:06.140 --> 00:12:08.730 align:middle line:84% That is like another full-time job. 00:12:08.730 --> 00:12:13.970 align:middle line:84% And so I'm seeing countries that had already good, paid 00:12:13.970 --> 00:12:16.370 align:middle line:84% family medical leave policies, they're 00:12:16.370 --> 00:12:18.390 align:middle line:90% recovering more quickly. 00:12:18.390 --> 00:12:19.430 align:middle line:90% So what should be done? 00:12:19.430 --> 00:12:23.060 align:middle line:84% I think we should look at this caregiving as infrastructure. 00:12:23.060 --> 00:12:25.490 align:middle line:84% We should say, we can't just rely on women to do it. 00:12:25.490 --> 00:12:27.710 align:middle line:84% If women are going to work they have 00:12:27.710 --> 00:12:30.050 align:middle line:84% to have some solutions for caregiving. 00:12:30.050 --> 00:12:33.260 align:middle line:84% It's both caregiving for the elderly, and for children. 00:12:33.260 --> 00:12:36.620 align:middle line:84% So robust paid family medical leave policies, 00:12:36.620 --> 00:12:40.790 align:middle line:84% looking at women's jobs and investing in women's jobs, 00:12:40.790 --> 00:12:42.350 align:middle line:90% and looking at data. 00:12:42.350 --> 00:12:45.440 align:middle line:84% We've got to collect data so we understand women's lives 00:12:45.440 --> 00:12:48.620 align:middle line:84% and where to make investments on their behalves. 00:12:48.620 --> 00:12:52.340 align:middle line:84% You've called on President Biden to appoint a tzar 00:12:52.340 --> 00:12:55.790 align:middle line:84% for caregiving because you think that the whole system is 00:12:55.790 --> 00:12:56.520 align:middle line:90% broken. 00:12:56.520 --> 00:13:00.140 align:middle line:84% Have you had discussions with the administration about this, 00:13:00.140 --> 00:13:02.838 align:middle line:90% and what's their reaction? 00:13:02.838 --> 00:13:04.880 align:middle line:84% I've had many discussions with the administration 00:13:04.880 --> 00:13:05.630 align:middle line:90% on these topics. 00:13:05.630 --> 00:13:08.420 align:middle line:84% Both before, when it was president-elect Biden, 00:13:08.420 --> 00:13:11.010 align:middle line:84% and since then, and even just last week. 00:13:11.010 --> 00:13:15.000 align:middle line:84% But the point is to look at caregiving as infrastructure. 00:13:15.000 --> 00:13:19.220 align:middle line:84% And if you look at the plan put forward by the president, 00:13:19.220 --> 00:13:23.780 align:middle line:84% just yesterday, he sees caregiving as infrastructure. 00:13:23.780 --> 00:13:27.410 align:middle line:84% As key infrastructure to bring the US economy back. 00:13:27.410 --> 00:13:32.870 align:middle line:84% So they are doing a lot, and they're really thinking hard, 00:13:32.870 --> 00:13:34.490 align:middle line:84% and Congress is now thinking hard 00:13:34.490 --> 00:13:37.520 align:middle line:84% about how do we implement that, and how do we pay for it, 00:13:37.520 --> 00:13:40.365 align:middle line:90% but it is important. 00:13:40.365 --> 00:13:43.050 align:middle line:84% Where do you think that the balance 00:13:43.050 --> 00:13:45.630 align:middle line:84% lies between the role of government 00:13:45.630 --> 00:13:49.050 align:middle line:90% funding versus philanthropy? 00:13:49.050 --> 00:13:52.960 align:middle line:84% The Biden administration clearly sees a more active social role 00:13:52.960 --> 00:13:58.080 align:middle line:84% for government, and it would fund it with higher taxes. 00:13:58.080 --> 00:14:01.110 align:middle line:84% How do you feel about the tax rises that are being proposed? 00:14:01.110 --> 00:14:03.690 align:middle line:84% And do you think that the pandemic because it exposed 00:14:03.690 --> 00:14:07.170 align:middle line:84% inequality so starkly has changed 00:14:07.170 --> 00:14:12.300 align:middle line:84% Americans' views of government and of taxes? 00:14:12.300 --> 00:14:15.300 align:middle line:84% Well I think you can't answer that question yet. 00:14:15.300 --> 00:14:18.060 align:middle line:84% I think you'll have to see in the next election what people 00:14:18.060 --> 00:14:19.860 align:middle line:90% think about government role. 00:14:19.860 --> 00:14:23.280 align:middle line:84% And so as the Biden administration rolls out more 00:14:23.280 --> 00:14:25.740 align:middle line:84% government programmes, I think you'll see in three or four 00:14:25.740 --> 00:14:27.970 align:middle line:84% years how people have reacted to that. 00:14:27.970 --> 00:14:31.140 align:middle line:84% But what I know is that yiu need a robust system 00:14:31.140 --> 00:14:35.460 align:middle line:84% in our democracy that involves government, 00:14:35.460 --> 00:14:39.460 align:middle line:84% private sector, civil society, and philanthropy. 00:14:39.460 --> 00:14:42.000 align:middle line:84% When you get those all working right 00:14:42.000 --> 00:14:44.140 align:middle line:90% you come up with solutions. 00:14:44.140 --> 00:14:48.300 align:middle line:84% But the US today has a lot of gaps in its safety network, 00:14:48.300 --> 00:14:52.590 align:middle line:84% and so that's why you're seeing this vast inequality, 00:14:52.590 --> 00:14:54.960 align:middle line:84% and Covid has finally exposed it. 00:14:54.960 --> 00:14:58.630 align:middle line:84% So I think you're going to see more government policies coming 00:14:58.630 --> 00:14:59.130 align:middle line:90% forward. 00:14:59.130 --> 00:15:01.620 align:middle line:84% I think they're finally going to address caregiving. 00:15:01.620 --> 00:15:05.010 align:middle line:84% You know we are the only country in the world, 00:15:05.010 --> 00:15:06.510 align:middle line:84% of the OECD countries that doesn't 00:15:06.510 --> 00:15:08.125 align:middle line:90% have paid family medical leave. 00:15:08.125 --> 00:15:10.750 align:middle line:84% And yes they're going to have to find a way of paying for that, 00:15:10.750 --> 00:15:14.520 align:middle line:84% and so that probably will be taxing the wealthy more. 00:15:14.520 --> 00:15:18.540 align:middle line:84% And how do you feel about much higher taxes on the wealthy? 00:15:18.540 --> 00:15:21.630 align:middle line:84% Bill and I have said for over the last two years, 00:15:21.630 --> 00:15:23.340 align:middle line:84% the wealthy should be taxed more. 00:15:23.340 --> 00:15:27.120 align:middle line:84% Exactly how you do it and what the right policies are? 00:15:27.120 --> 00:15:30.270 align:middle line:84% I'm not a tax expert, but there are definitely ways to do it. 00:15:30.270 --> 00:15:32.370 align:middle line:84% And you shouldn't have this society where 00:15:32.370 --> 00:15:37.575 align:middle line:90% you have such vast inequity. 00:15:37.575 --> 00:15:39.450 align:middle line:90% Let me ask you this. 00:15:39.450 --> 00:15:43.390 align:middle line:84% I think when I was reading your annual letter, you 00:15:43.390 --> 00:15:46.620 align:middle line:84% and Bill's annual letter, you compared the impact 00:15:46.620 --> 00:15:50.790 align:middle line:84% of the pandemic to the impact of the second world 00:15:50.790 --> 00:15:54.150 align:middle line:90% war on your parents' generation. 00:15:54.150 --> 00:15:58.770 align:middle line:84% And you said that the world has an important opportunity 00:15:58.770 --> 00:16:00.690 align:middle line:84% to turn the lessons of the pandemic 00:16:00.690 --> 00:16:04.440 align:middle line:84% into a healthier, more equal future for all. 00:16:04.440 --> 00:16:07.710 align:middle line:90% Do you see signs of that? 00:16:07.710 --> 00:16:15.900 align:middle line:84% Or once we go back to normality the old habits will come back 00:16:15.900 --> 00:16:20.910 align:middle line:84% and everything will revert to pretty much the old normal? 00:16:20.910 --> 00:16:24.420 align:middle line:84% Well I don't think we know, yet, what normal is going 00:16:24.420 --> 00:16:26.230 align:middle line:90% to look like going forward. 00:16:26.230 --> 00:16:28.620 align:middle line:84% But what I know is these gaps that existed, 00:16:28.620 --> 00:16:30.150 align:middle line:90% Covid has exposed them. 00:16:30.150 --> 00:16:34.710 align:middle line:84% And so now it's the role of civil society and philanthropy 00:16:34.710 --> 00:16:37.990 align:middle line:84% to keep that conversation alive and push it forward. 00:16:37.990 --> 00:16:42.420 align:middle line:84% So you're already seeing the G7 nations come together in June 00:16:42.420 --> 00:16:46.770 align:middle line:84% to talk about a pandemic preparedness plan that 00:16:46.770 --> 00:16:50.220 align:middle line:84% thinks more about how do we build out a manufacturing 00:16:50.220 --> 00:16:50.820 align:middle line:90% network. 00:16:50.820 --> 00:16:53.210 align:middle line:84% How do we build out a surveillance network 00:16:53.210 --> 00:16:56.140 align:middle line:84% so we see these diseases more when they crop up? 00:16:56.140 --> 00:17:00.030 align:middle line:84% So we have to use this moment, if we're going to build back. 00:17:00.030 --> 00:17:02.850 align:middle line:84% And you saw after world war two is things like Nato 00:17:02.850 --> 00:17:05.470 align:middle line:84% came forward, the UN came forward. 00:17:05.470 --> 00:17:07.500 align:middle line:84% So we need to build those systems, 00:17:07.500 --> 00:17:10.769 align:middle line:84% so we are more prepared as a world. 00:17:10.769 --> 00:17:12.810 align:middle line:84% So you think that what we will... 00:17:12.810 --> 00:17:14.670 align:middle line:84% one of the measures that we will see 00:17:14.670 --> 00:17:18.810 align:middle line:84% is a different type, or possibly a reformed World Health 00:17:18.810 --> 00:17:20.835 align:middle line:90% Organization? 00:17:20.835 --> 00:17:23.400 align:middle line:84% Well I do think there'll be a postmortem on the World Health 00:17:23.400 --> 00:17:24.510 align:middle line:90% Organization. 00:17:24.510 --> 00:17:27.329 align:middle line:84% But I think you'll see the global community coming 00:17:27.329 --> 00:17:29.970 align:middle line:84% together to say, what else do we need? 00:17:29.970 --> 00:17:32.380 align:middle line:84% Knowing that other pandemics are going to come, 00:17:32.380 --> 00:17:34.710 align:middle line:84% and if we saw them much more quickly 00:17:34.710 --> 00:17:36.240 align:middle line:84% with the right surveillance system 00:17:36.240 --> 00:17:38.370 align:middle line:84% all over the world, we could have, 00:17:38.370 --> 00:17:41.220 align:middle line:84% if we had a small workforce of people, 00:17:41.220 --> 00:17:44.520 align:middle line:84% maybe about 3,000 people that could go out and respond, 00:17:44.520 --> 00:17:47.080 align:middle line:90% we contain it where it is. 00:17:47.080 --> 00:17:49.650 align:middle line:84% And so we do have to figure out as a world, 00:17:49.650 --> 00:17:50.700 align:middle line:90% how do you fund that? 00:17:50.700 --> 00:17:52.150 align:middle line:90% Where do you house that? 00:17:52.150 --> 00:17:54.120 align:middle line:84% How do you set up the surveillance? 00:17:54.120 --> 00:17:56.530 align:middle line:84% And how do you set up the manufacturing? 00:17:56.530 --> 00:17:58.560 align:middle line:90% So that if we need more... 00:17:58.560 --> 00:18:01.710 align:middle line:84% diagnostics is a problem, or you need more medicines, 00:18:01.710 --> 00:18:03.960 align:middle line:84% or we need more vaccines it can be produced 00:18:03.960 --> 00:18:06.040 align:middle line:84% in many, many places around the world, 00:18:06.040 --> 00:18:09.240 align:middle line:90% not just in the wealthy nations. 00:18:09.240 --> 00:18:11.040 align:middle line:84% Do you assume that we're going to be 00:18:11.040 --> 00:18:16.570 align:middle line:84% living with this pandemic for a couple of more years at least? 00:18:16.570 --> 00:18:17.070 align:middle line:90% Yes. 00:18:17.070 --> 00:18:19.455 align:middle line:90% Do you already see an end? 00:18:19.455 --> 00:18:21.990 align:middle line:84% Well I just know from other diseases, 00:18:21.990 --> 00:18:27.060 align:middle line:84% it takes a long time until a disease is actually eradicated 00:18:27.060 --> 00:18:28.980 align:middle line:90% or burns itself out. 00:18:28.980 --> 00:18:33.150 align:middle line:84% And so without having vaccines out writ large... 00:18:33.150 --> 00:18:35.490 align:middle line:84% I think you'll see lots and lots of vaccinations 00:18:35.490 --> 00:18:37.320 align:middle line:90% by the end of 2022. 00:18:37.320 --> 00:18:39.480 align:middle line:84% But in this meantime, what happens 00:18:39.480 --> 00:18:41.730 align:middle line:90% with variants in various spots? 00:18:41.730 --> 00:18:45.720 align:middle line:84% And then can the vaccines be tuned really quickly to deal 00:18:45.720 --> 00:18:46.980 align:middle line:90% with all of those variants? 00:18:46.980 --> 00:18:49.675 align:middle line:84% So that story is yet to be written. 00:18:49.675 --> 00:18:50.175 align:middle line:90% Luckily... 00:18:50.175 --> 00:18:52.395 align:middle line:84% That's the big challenge for the pharma industry. 00:18:52.395 --> 00:18:54.990 align:middle line:84% Right, and luckily the mRNA vaccines 00:18:54.990 --> 00:18:58.450 align:middle line:84% will be able to be tuned, it looks like very, very quickly. 00:18:58.450 --> 00:19:02.010 align:middle line:84% But many of the others will take more like 9 or 10 months. 00:19:02.010 --> 00:19:06.450 align:middle line:84% So it's still to be seen what will happen from this pandemic. 00:19:06.450 --> 00:19:10.710 align:middle line:84% And how has the pandemic affected you personally? 00:19:10.710 --> 00:19:13.740 align:middle line:84% Obviously you've received a lot of praise for your work, 00:19:13.740 --> 00:19:20.150 align:middle line:84% but a lot of criticism also from people on the anti-vax fringe. 00:19:20.150 --> 00:19:22.725 align:middle line:90% How have you been coping? 00:19:22.725 --> 00:19:26.440 align:middle line:84% Well the disinformation is really hard to see. 00:19:26.440 --> 00:19:29.760 align:middle line:84% And for me personally it has much more to do with... 00:19:29.760 --> 00:19:33.300 align:middle line:84% I think of the women I've met in places 00:19:33.300 --> 00:19:37.470 align:middle line:84% all over the continent of Africa, or in places in India 00:19:37.470 --> 00:19:39.480 align:middle line:90% and I think how are they coping? 00:19:39.480 --> 00:19:43.170 align:middle line:84% And it's unfortunate to see the disinformation spread because I 00:19:43.170 --> 00:19:45.420 align:middle line:84% know it means that they may be less likely to get 00:19:45.420 --> 00:19:46.840 align:middle line:90% their families vaccinated. 00:19:46.840 --> 00:19:49.350 align:middle line:90% So that's been hard to see. 00:19:49.350 --> 00:19:52.590 align:middle line:84% On the other hand, you know I see my own anxiety 00:19:52.590 --> 00:19:53.430 align:middle line:90% during a pandemic. 00:19:53.430 --> 00:19:54.150 align:middle line:90% Can we go out? 00:19:54.150 --> 00:19:55.442 align:middle line:90% Can we go to the grocery store? 00:19:55.442 --> 00:19:57.330 align:middle line:84% What can my 18-year-old daughter do safely? 00:19:57.330 --> 00:20:00.120 align:middle line:84% So I understand people's anxiety, 00:20:00.120 --> 00:20:01.800 align:middle line:84% and I just try to keep looking forward 00:20:01.800 --> 00:20:04.410 align:middle line:84% and say what's the work the foundation can 00:20:04.410 --> 00:20:07.600 align:middle line:84% do to make vaccines, diagnostics, 00:20:07.600 --> 00:20:09.720 align:middle line:84% and therapeutics get out there faster. 00:20:09.720 --> 00:20:14.490 align:middle line:84% And it has meant a lot more video calls this year 00:20:14.490 --> 00:20:16.380 align:middle line:90% than ever before. 00:20:16.380 --> 00:20:18.210 align:middle line:84% But you know I feel incredibly... 00:20:18.210 --> 00:20:21.030 align:middle line:84% we're fortunate as a family for the privilege we have, 00:20:21.030 --> 00:20:25.420 align:middle line:84% and for having a nice garden I can walk in every day. 00:20:25.420 --> 00:20:29.400 align:middle line:84% Melinda Gates, thank you for giving us your time.