By Tom Quach
Microsoft co-founder Bill Gates raised concerns about vaccine confidence and discussed ways to address inequities in healthcare during COVID-19 in a StanfordMed LIVE discussion on Wednesday. He said the public could expect “two or three vaccines with emergency use licenses coming” in the first half of 2021.
Currently, six pharmaceutical companies, including Johnson & Johnson, Pfizer and AstraZeneca, have reached Phase III trials, the final step of clinical testing before approval for general public use.
Gates has warned the public about the dangers of pandemics as early as 2010, when he published an article titled, “A Better Response To The Next Pandemic.” He warned readers that the government had been unprepared and laid out ways the next pandemic could be better contained, including by limiting movement of people from place to place. And in 2015, Gates gave a TED talk titled “The next outbreak? We’re not ready.” Viewed over 37 million times, he again outlined the steps required for pandemic mitigation, from scenario preparation to vaccine research to healthcare worker training.
In conversation with Stanford Medicine Dean Dr. Lloyd Minor, Gates, an advocate of vaccines and a philanthropist focusing on world health, said COVID-19 research is developing at an unprecedented rate.
“It’s been great seeing the scientific cooperation; academics are publishing papers at high speeds and interacting with these [vaccine manufacturing] companies,” Gates said. “We have a lot of vaccines underway.”
However, Gates noted that the public should focus on vaccines that successfully pass through “gold standard” approval of departments such as the Food and Drug Administration (FDA) in the United States and respective European vaccine regulators. Gates said that with the technology available to create multiple vaccines simultaneously, the public could potentially see “two or three [vaccines] with emergency use licenses coming in the first half of next year.”
Gates said he hopes 20 to 30% of the population will be willing to take the vaccine early after a public release, adding that he is concerned about how misinformation and conspiracy theories may affect public confidence in a vaccine.
“Even when they are false, there’s a tendency, particularly in digital media, for conspiracy theories to get out there and spread much faster than the truth,” Gates said.
If about a quarter of the population takes the vaccine early and only a rare few experience negative side effects, Gates hopes trust in a vaccine will increase.
More importantly, Gates believes that to offset inaccurate theories, scientists and public officials must be “creative about the truthful message” by focusing on “the heroes that invent the vaccine and the facts about how the safety trials have been done.”
But before a vaccine arrives, many countries are now relying on testing, among other measures, to control the spread of the virus.
Gates said the U.S. could have better addressed the pandemic: “Diagnostics and quarantine: we knew those were important, but we didn’t do a good job executing them,” he said. “By not having the federal government say early on we needed to intervene aggressively, we missed what capacity there is in the CDC to minimize the epidemic.”
Gates added that “even before the pandemic, there were very troubling trends” regarding inequities in health and healthcare delivery between people of color (POC) and non-POC.
“The lack of understanding and the zeal to actually get to the bottom of it by collecting health records and trying out various interventions are agendas that we need to take more seriously,” Gates said.
Healthcare inequalities extend to a global scale, especially with certain countries dealing with insufficient testing capacities. As Gates explained, the U.S. has an abundance of Polymerase Chain Reaction (PCR) machines — devices used in labs to detect COVID-19 — while certain nations do not, leading to a “backed-up system” and longer waiting times for results. To solve this, Gates and his team are looking into low-cost sequencing machines that “are incredibly efficient” and tend to “up to a quarter-million patients per day per machine.”
The Bill and Melinda Gates Foundation has also led the funding of vaccine research and public health processes to combat the COVID-19 pandemic, donating over $350 million to global health foundations as of August 2020.
Rami Awwad ’23 left the event impressed, praising Gates for his forward-thinking and philanthropy.
“I’m inspired by the philanthropist mindset of Bill Gates,” said Awwad. “People should be more selfless and considerate of other people around them in their neighborhoods, communities and society in general — not only during COVID-19, but every day.”
Stanford Medicine spokesperson Julie Greicius wrote in a statement to The Daily that Gates — like other StanfordMed LIVE guests — was invited for his “unique insight and engagement on critical issues.”
In a statement to The Daily, Minor thanked Gates for participating in the discussion, describing him as a “visionary leader who is transforming global health.”
“I found his insights into the broad impact of COVID-19, our path to emerging from this pandemic and our preparedness for future global health responses truly enlightening,” Minor said.