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Bill Gates evaluates US COVID response and offers latest vaccine outlook

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Bill Gates, co-chair of the Bill and Melinda Gates Foundation, talks to Yahoo Finance Editor-in-Chief Andy Serwer about the outlook for a COVID-19 vaccine and the shortcomings of the U.S. pandemic response.

Video Transcript

- Bill Gates is the co-chair of the Bill & Melinda Gates Foundation. The Microsoft co-founder is one of the world's most well-known and most respected philanthropists. His organizations' programs work across the globe in several key areas, including health, education, economic development, and gender equality.

ANDY SERWER: I'm Andy Serwer, Editor in Chief of Yahoo Finance and I'm joined by Bill Gates, Co-chair of the Bill & Melinda Gates Foundation. So we're seven months in, Bill, since the pandemic really hit the United States, late October. What's your assessment of how the US has handled the pandemic?

BILL GATES: Well, sadly, as we go into the fall, the number of cases and deaths is going to go back up again. And the reason those numbers are so high is partly because our response was very poor. Our testing, our messages about masks and social distancing make us near the bottom in terms of rich countries and how bad the epidemic has been.

ANDY SERWER: Do you anticipate it getting even worse in the winter weather?

BILL GATES: Yes. The amount of time you spend indoors, the fact that people are not getting clear messages and they're tired of the restrictions and the fact that, as it's colder, your upper respiratory tract doesn't do a good job of suppressing the virus, so that seasonal transmission level is pretty clear in the data. And so all those things are working against us as we go into the fall.

ANDY SERWER: I know you're loathe to call out people personally, including President Trump, for specific behavior, but what can we do to convince people that maybe they shouldn't hold big public gatherings with people without masks?

BILL GATES: Well, I think the most maligned thing is where you start to attack your own experts and suggest that maybe politicians know better than disease experts. In this case, the CDC has not been allowed to really speak out.

When they tried to put information on their website, that got edited by politicians. We now have a pseudo expert advising the president. Tony Fauci is a great person. His messages are quite clear. But as he gets attacked, those messages aren't able to develop the kind of patience and helping each other that would bring the death rate down.

ANDY SERWER: Let me switch over and ask you about vaccines, Bill, and get your take on where things stand there. How soon do you expect a candidate to be approved?

BILL GATES: Well, I think likely early next year, with any luck. We'll have two or three of the six that are in phase III trials right now. The Pfizer has a good chance of being amongst the first of those. They're a very experienced vaccine company and designed their study very well. But also, AstraZeneca, Johnson & Johnson, Novavax, Moderna, Sanofi, we should have choices of vaccines sometime early next year.

ANDY SERWER: Do the hiccups, I guess, maybe, is one way to characterize it, that J&J and AstraZeneca have seen, does that concern you or is that sort of a normal course of events?

BILL GATES: Well, having one or two safety stops where you going in and look and see how was it related to the vaccine, that's not surprising. But these are-- we need to take these things seriously. And we do have two of the vaccines. AstraZeneca's still-- the FDA trial, specifically, is still on a US hold, and the Johnson & Johnson recently went on a US hold.

Now, those are very professional companies and they'll dig into it. But if it turns out that there is a safety issue, that could knock out some of the six. It's amazing to have six, but some may not be efficacious.

And so it's great we have a second wave of vaccines that our foundation has been funding that come after those for six. And so even if the first six, two or three get approved, their effectiveness in terms of stopping you from being sick and stopping you from transmitting may not be perfect.

ANDY SERWER: And I know you've talked about the need for a global distribution plan for the vaccine. I mean, what could this look like in a best case scenario, Bill, and I guess I should ask you what would be the worst case. I mean, how could this play out?

BILL GATES: Well, I think the likely case, which is fairly positive, is that we have enough approvals and volume in the first half of the year that, by summer, we're in a very different place than we are today. That number of deaths down quite a bit, and so that we're able, in the second half, to almost everywhere open schools back up.

We won't be completely back to normal because we won't have got to the 70% plus of the population vaccinated by then to really drive the numbers down. And as long as this disease exists anywhere in the world, the chance of reinfection will always be there.

And so we need to participate for our own self-interest, for humanitarian reasons, for strategic reasons, we need to connect up with even the poor countries and figure out how we can make sure there's enough vaccine for them.

ANDY SERWER: I mean, China recently joined the COVAX Initiative, which is a group of 183 countries led by WHO that worked together on development and distribution of vaccine. US has not joined, so you would anticipate maybe would? I mean, this sort of puts China in the driver's seat, perhaps, in the way that--

BILL GATES: Oh, no. China has a number of vaccines that, at a technical level, look promising. But because they haven't been submitted to a gold standard regulator, they're unlikely to be used extensively outside of China itself. Now, there's a few of those that could go through a process in Europe or the US and then would join the list of options that we have for vaccines.

That's only good for the entire world. The US has shown a lot of support for funding vaccines for poor countries. The US is a generous giver to a thing called Gavi that got started back in the year 2000. And so all the US has to do is make a special allocation to Gavi to procure these vaccines.

And, in fact, some of the bills in Congress, a Republican bill and a Democratic bill, have had sums of money for that international response. And so we're hopeful, when there is a stimulus bill, which, of course, that's not totally clear, but that it will include this money to buy vaccines for the poor countries. That would be in alignment with the US's past history of being very generous and playing a leadership role in global health.

ANDY SERWER: The administration, Bill, has meddled, really, in the development and release of the FDA's vaccine approval guidelines. Can Americans trust that vaccines will be properly scrutinized before approval?

BILL GATES: Yeah. We did have a very unfortunate incident where the FDA decided that you needed to wait two months after you had enrolled over half of the trial and dosed them in order to have a large enough safety database to see if there might be side effects.

And for a brief period, the White House was blocking that, or saying that it was inappropriate, or claiming that one of the companies had objected to it, which is just not true. Eventually, the FDA did succeed in getting that into their guidance to the companies.

And the companies all have their reputations to defend. So I think if the FDA approves a vaccine that is the gold standard compared to the regulators and the professional staff there, it's clearly on notice that they shouldn't let politicians tell them what to do.

ANDY SERWER: I want to go back to that comment you made about the stimulus bill. So, in other words, International funding for vaccine distribution is tied up in the stimulus bill?

BILL GATES: Yeah. In fact, the stimulus bill is the best opportunity to get that because it'll showcase that in order to be a good citizen and stop the disease outside the United States, that the portion of resources required to do that is less than 1% of the stimulus bill, and it'll just be amongst the various measures to help out there.

I think given how distracted the country is with an election and all the problems the pandemic has brought that no stand alone bills are getting done for anything. And so being part of that overall thing, I think that's how the people in the Congress who support these things have decided that's the most likely way for something to get done.

ANDY SERWER: Interesting. Americans have become increasingly wary of vaccines, sadly. And so with this major time to be taking a vaccine next year, we hope, are you concerned about that maybe resistance, even, and is the Gates Foundation working to address that potential problem, Bill?

BILL GATES: Well, in fact, the wave of wild stories about the vaccine, that it's a conspiracy, it's based on evil intent, often referring to either myself or Dr. Fauci, that is a wild new element that I wouldn't have expected.

And so you do have to ask, is that going to mean things like mask wearing or willingness to take the vaccine are affected. I'm still hopeful that there's 30% of the population who understands this is to benefit other people, and so they'll go first.

And that as that experience clearly is people are seeing that there's very, very few side effects and that it's working well, that then we'll be able to get up to the 70% plus that we need, even if the vaccine is very effective, to block the kind of exponential growth in transmission and put it into an exponential decline. And so I think we'll get there, but it's more at risk than I expected because of that political interference and those political messages.

ANDY SERWER: And a lot of those crazy stories are being shared, of course, on Facebook, and YouTube, and Twitter. Have you or people from your organization been in touch with those companies to try to talk to them about mitigating the spread of that misinformation?

BILL GATES: I think those companies are doing more now to do that. This is kind of a wild phenomena, and we've always had some wariness about vaccines, but not this idea of connecting them to a plot like micro chipping people to track them or things that you-- even in a fiction story, it wouldn't be all that believable. So I hope we can get the truth to be more interesting than the sort of oversimplistic explanation of what's going on with this pandemic.

ANDY SERWER: Bill, many Americans are forced to wait in line at food banks or go to nonessential jobs that expose them to COVID just to get by. Is another round of stimulus important to an effective public health response?

BILL GATES: Yeah. I think we will get a stimulus at some point. Even the Fed chief, who, that's supposed to be a pretty nonpolitical job, is really-- he's an economic expert-- is saying that a stimulus is quite important. And, of course, you're seeing the job losses as the industries that had some support, like the airlines, are now losing that support.

And so the layoffs, including what state and local governments are going to have to do because they have less revenue, so they're going to have to cut their payrolls quite a bit. And you start to get, if you're not careful, into a negative cycle of the economy shrinking.

So although it's ultra confused, like most things with some of the current politicians, I'm hopeful and, in this case, the sooner the better that we do get some type of stimulus out.

ANDY SERWER: Obviously, coronavirus is a key issue in the 2020 presidential election. I know you don't like to wade into politics that much, but the two candidates have very different visions with big implications in terms of how to fight to contain the virus. I wonder if you have any thoughts on either plan, and then just generally about how COVID is affecting the election.

BILL GATES: Well, one thing that everybody may not be aware of is how fantastic the CDC has been historically. They're the best in the world. They train themselves in terms of how to communicate, including getting bad news out and getting people to take measures that protect themselves.

And they've been muzzled. You don't hear from them and they're topping epidemiologists. So if you want to hear what a politician who wants things to go well and people to praise that politician, OK, that's one approach. Or if you want to hear from people who understand diseases and disease models, that's another approach.

And there are many, many issues in this campaign, but one is a bit about, do the experts get to be the ones who are helping to set the policy or are the experts attacked when they try and share the truth about the tough situation we still find ourselves in.

ANDY SERWER: Obviously, the focus of the Bill & Melinda Gates Foundation is public health writ large. But have you considered weighing in or advising in terms of election policy simply because it means so many peoples congregating?

BILL GATES: We're doing a lot on the tools and making sure they get done quickly, making sure that, even within the country, they'll be distributed on an equitable basis as opposed to who can pay the most. And we still have a terrible flaw in our testing system, that the government is paying for tests where you don't get the results back within 24 hours.

And it's so-- such a waste of money and it's helping to drive lots of infection because you don't hear your result until well after you've infected other people. And if somebody works on disease, I keep waiting for sanity. They should run the headline every day, US testing system worst in the world, delayed results being paid for.

ANDY SERWER: I remember early on, Bill, I think maybe it was April, you said that you didn't think things were going to get back to completely normal until the fall of 2021, and it's looking pretty prescient right now. So where do you think we'll be a year from now, October, 2021? Are you still sticking with that?

BILL GATES: Yeah, well, the slowness on the global response means that fall of 2021 won't be completely back to normal. Our goal for that should be that a lot of the service jobs can be back in place and certainly school can be back in place.

But we'll have risk of it coming back into the country during that time period. I hope that-- there's a small chance that the great new tools, the monoclonal antibodies and the vaccines, won't show good results. The probability of that is very, very low, but it's not zero.

So we're all awaiting the effectiveness data from the six trials. And it's very appropriate we have many different approaches that at least the phase I and phase II data did look very good. So I think things will be a lot different, closer to normal than to what they are today.

ANDY SERWER: And finally, Bill, your father passed away recently, and our condolences to you for that and your family. And I don't know if you remember, but in 2009, I visited with you and him in Paris and interviewed both of you for a cover story in "Fortune Magazine," so that was a lot of fun.

And I know your dad was critical in terms of the creation and the mission of the Foundation. What was his role in the creation and the mission and what was his influence on you?

BILL GATES: Yeah, he played a critical role in many respects. One is his example is his book he wrote called "Showing Up for Life" that talked a lot about volunteering, civic duty. So even as I was growing up, my parents were involved in every-- Planned Parenthood, United Way, Municipal League, you name it, and felt that was important.

They talked a lot about philanthropy and giving. But even more concretely, when I endowed the foundation with the first $20 billion, I was still full time at Microsoft. And so it was my dad and Patty Stonesifer, a great Microsoft executive that Melinda and I knew and trusted, it was the two of them in partnership that created the Foundation and got it going.

And did a great job so that, as I got more time free and eventually moved over to the Foundation full time in 2008, a lot had been accomplished there. And the whole tone, the modesty, the integrity that my dad had had this very positive influence that endures to this day.

ANDY SERWER: Bill Gates, thank you very much for your time. Thank you for your work and best of luck to you.

BILL GATES: Thank you.