FINANCIAL TIMES: So I want to start by going back in time to five years ago. As many people know, you warned that the greatest risk of global catastrophe wasn't a war, but a highly infectious virus. Why didn't anybody listen? And if some people did, what was done to prepare for the pandemic that exists now?
BILL GATES: Well, not enough was done. A system wasn't built. We didn't really do the number of simulations to try and figure out, OK, how are we going to connect up the diagnostics? How are we going to get the vaccine going? There were some investments. For example, our foundation, Wellcome Trust and a number of governments created Cepi (the Coalition for Epidemic Preparedness Innovation), which is about making vaccine platforms that are ready when we get surprised to manufacture a new vaccine faster than has been done in the past.
So some work was done but, in retrospect, the saddest thing is to be able to say yes, that was right. But the whole point of the speech was to drive the research and the planning and the simulation which would have allowed us to stop this at a very early stage.
FT: And in terms of the global response now, many countries, including the UK and the US, have been criticised for not doing enough testing and not doing it fast enough. What is your assessment of the global response so far and, specifically, of President Trump's response to this crisis in the US?
BG: Well, I'm sure there'll be plenty of time, once we're on top of this, to look at before the epidemic hit, what more could have been done, when the epidemic hit. I don't think any country has a perfect record. Taiwan comes close.
They really were talking about it, and it's unfortunate they weren't part of the WHO (World Health Organization) to really get those warnings paid attention to. Most countries didn't see it as [becoming] as big a problem as it's ended up being. And of course, when you have exponential growth, that means if you miss, you know, three doubling times, it's eight times as big and much, much harder to get under control.
So a few countries, particularly those that have the experience of dealing with Mers or Sars, they were the fastest to respond. South Korea is an example of that. China, which had a lot of cases, now is in a very different state where they are able to get most people going back to school and back to work. And so there's lessons about, what did they do to drop the numbers? And what are they doing to avoid a rebound? Because until we get a vaccine that we've given to a high percentage of the global population, we will be at risk of rebound.
FT: And what would you say is the single most important thing that needs to happen now? The World Health Organization has said test, test, test. Is testing the key here? Or what about, for example, the role of technology? We've seen some Asian countries use technology to spread information so quickly, which has helped them fight the virus. What do you think is the single most important thing that has to happen right now?
BG: Well, testing is what guides you to see, do you need to do more social isolation, or have you gotten to a point where you can start to open up a bit? It can't just be numbers of tests though. You have to have the results coming back in less than 24 hours, and you have to prioritise who gets tested. The demand for tests exceeds supply in every country. And some countries really stepped in, like South Korea, and made sure the right people were being tested. They have a unified system that could look at the individual cases and weigh the criteria.
The US does not have that. We have so many different companies, labs. And most of tests go in without any criterion. And so now we have these backlogs that really devalue what can be done with those tests. So the fact that the numbers have gone up doesn't mean that we're doing this well at all.
That is still ahead of us to get organised on prioritising properly. So your contacts, if you test positive here, before they become infectious, that they need to isolate. The PCR test is sensitive enough to catch it even before you'll have symptoms. And that's the ideal case — where you don't go on to infect anyone else, which is the key to bringing those numbers down.
So today, the appropriate testing and isolation are the primary tactics. In the mid-term, getting some drugs that will reduce the hospitalisation and death rate, that will be very important. And the ultimate solution is a highly effective, safe vaccine. But getting billions of doses is hard. And our foundation works in all of those areas.
We're providing funding even now in parallel to scale up the manufacturing of the most promising vaccines — way more than we will end up picking. Because even though that's a few billion dollars of manufacturing capacity, the fact that it will be ready because we do it in parallel, that anything that cuts a month off of the time until we vaccinate is worth literally hundreds of billions, if not trillions.
FT: And let's talk more about that big picture then for the developing world. We're at this point, it seems like quite a scary point, where, as you say, the virus is just starting to spread in developing countries. We know it's already spread throughout Africa, but hasn't quite taken off yet. How big of an impact do you think it will have in terms of deaths and the number of infections? And how worried are you about the ability of developing countries to fight this?
BG: We could get lucky, and there could be something about [the] weather that means that some countries have lower force of infection — we don't know that. Our assumption has to be, because we are seeing in some southern hemisphere places like Australia, quite a bit of infection, that it's not dramatically seasonal and that it's just gotten started slower in Africa. I hope something shows up that changes that.
It's very easy to say this disease has about a 1 per cent case fatality rate. And when you overload your hospitals you can get up to 2-3 per cent rate. Now, then again, Africa has a younger population, so that brings your numbers down. But the comorbidities in terms of smoke inhalation, both indoor and outdoor, TB, HIV, malnutrition, those are much higher there. And so you'd have quite a bit of uncertainty. But it's not impossible that you'd see [a] 2 per cent overall death rate, which is a horrific situation, potentially, even worse, as you have panic and other healthcare is very disrupted.
Read the original text at The Financial Times.