1 00:00:04,440 --> 00:00:07,360 Speaker 1: Hey, and welcome to the short stuff. I'm Josh, there's Chuck, 2 00:00:07,440 --> 00:00:10,319 Speaker 1: there's Bill Gates. No time to explain, this is short stuff. 3 00:00:10,360 --> 00:00:14,520 Speaker 1: Let's get to it. Uh, thanks for coming back and 4 00:00:14,600 --> 00:00:19,080 Speaker 1: joining us, Bill to talk about COVID and vaccines and therapeutics, 5 00:00:19,760 --> 00:00:22,040 Speaker 1: and uh, you know, we've got a short window here, 6 00:00:22,079 --> 00:00:24,919 Speaker 1: so let's dive right in. And I guess my first 7 00:00:25,000 --> 00:00:28,080 Speaker 1: question is, let's just kind a level said and find 8 00:00:28,080 --> 00:00:30,840 Speaker 1: out where we are with vaccines and how it all 9 00:00:30,880 --> 00:00:33,519 Speaker 1: works with multiple vaccines being worked on, and how that 10 00:00:33,600 --> 00:00:36,960 Speaker 1: kind of goes in the end. Well, there's fortunately a 11 00:00:37,000 --> 00:00:41,320 Speaker 1: lot of different vaccine constructs using uh, most of the 12 00:00:41,520 --> 00:00:45,560 Speaker 1: approaches that we know. And as we get these out 13 00:00:45,640 --> 00:00:50,520 Speaker 1: in larger human studies and eventually have a Human Emergency 14 00:00:50,520 --> 00:00:54,800 Speaker 1: Youth Thought authorization, we'll start to understand for the various 15 00:00:54,880 --> 00:01:00,920 Speaker 1: candidates how much they prevent disease transmission, how much they 16 00:01:01,000 --> 00:01:05,360 Speaker 1: prevent often you get sick, whether they work in the elderly, 17 00:01:05,880 --> 00:01:09,199 Speaker 1: and what type of duration they have, And so they'll 18 00:01:09,319 --> 00:01:13,320 Speaker 1: be quite a range on those parameters for these vaccines. 19 00:01:14,000 --> 00:01:17,040 Speaker 1: You know, eventually we want one that's both very good 20 00:01:17,040 --> 00:01:22,319 Speaker 1: at transmission blocking and preventing sickness. And hast duration and 21 00:01:22,600 --> 00:01:26,039 Speaker 1: is cheap so that we get out to a large 22 00:01:26,080 --> 00:01:30,399 Speaker 1: part of the entire global population and bring the pandemic 23 00:01:30,480 --> 00:01:33,000 Speaker 1: to an end. One of the things that you you 24 00:01:33,400 --> 00:01:35,399 Speaker 1: um brought up though, is that we want like all 25 00:01:35,440 --> 00:01:39,720 Speaker 1: of these different factors that make basically like a perfect vaccine. Um. 26 00:01:39,760 --> 00:01:42,200 Speaker 1: But I read one of your posts on your Gates 27 00:01:42,240 --> 00:01:46,160 Speaker 1: Notes blogs and you said that that's probably not going 28 00:01:46,200 --> 00:01:48,200 Speaker 1: to happen right out of the gate. Is there a 29 00:01:48,200 --> 00:01:51,800 Speaker 1: benefit from having multiple vaccines kind of working in conjunction 30 00:01:51,920 --> 00:01:54,160 Speaker 1: or is it the best route to just kind of 31 00:01:54,400 --> 00:01:57,640 Speaker 1: keep going after that that magic perfect vaccine that that 32 00:01:57,720 --> 00:02:00,800 Speaker 1: works as close to perfect as we can get. Well, 33 00:02:00,840 --> 00:02:04,000 Speaker 1: particularly for the developing countries, we won't be able to 34 00:02:04,040 --> 00:02:08,120 Speaker 1: afford to go out a whole lot of times. And 35 00:02:08,240 --> 00:02:11,960 Speaker 1: so uh, you know, the US has funded a lot 36 00:02:12,000 --> 00:02:15,120 Speaker 1: of the R and D. Our Foundation and a group 37 00:02:15,440 --> 00:02:17,840 Speaker 1: were part of called SEPPI is also funded R and D, 38 00:02:18,080 --> 00:02:22,919 Speaker 1: but well less than what the US itself has done, 39 00:02:23,720 --> 00:02:27,600 Speaker 1: and that's got a really good pipeline. You know, the 40 00:02:27,639 --> 00:02:32,840 Speaker 1: astro Seneca probably will come out first, then Johnson and Johnson, 41 00:02:32,919 --> 00:02:35,880 Speaker 1: then Novavax, then Sonofie. Those are the ford that are 42 00:02:35,919 --> 00:02:40,359 Speaker 1: most promising because they're they're clearly low cost Maderna and 43 00:02:40,520 --> 00:02:44,240 Speaker 1: Visor in that same time frame, but probably pretty expensive 44 00:02:44,280 --> 00:02:47,959 Speaker 1: and may only end up being used in rich countries. 45 00:02:49,919 --> 00:02:53,480 Speaker 1: So that's that's the It's a question of affordability, not 46 00:02:53,639 --> 00:02:58,640 Speaker 1: necessarily efficacy. Yeah, well, of the six, the likelihood that 47 00:02:58,680 --> 00:03:03,600 Speaker 1: they all work without side effects is pretty low. Now 48 00:03:03,680 --> 00:03:08,880 Speaker 1: the Phase one studies, that's pretty small numbers, and you're 49 00:03:08,919 --> 00:03:11,880 Speaker 1: not going out to find sick people, but there you 50 00:03:12,000 --> 00:03:15,799 Speaker 1: can see what the antibody response looks like. And if 51 00:03:15,840 --> 00:03:18,040 Speaker 1: you use some very advanced tools, you can look at 52 00:03:18,040 --> 00:03:21,160 Speaker 1: the other side of the immune system, the T cell side, 53 00:03:21,600 --> 00:03:24,640 Speaker 1: and try and gauge what type of responses you're getting there. 54 00:03:25,080 --> 00:03:27,880 Speaker 1: And I have to say that all these vaccines look 55 00:03:27,960 --> 00:03:31,480 Speaker 1: pretty good. You know, the Nova vacts which just came 56 00:03:31,480 --> 00:03:35,680 Speaker 1: out this week, has the best numbers. But uh, you know, 57 00:03:35,680 --> 00:03:40,400 Speaker 1: we're this kind of respiratory disease. Protecting your lungs is 58 00:03:40,440 --> 00:03:47,240 Speaker 1: easier than many other vaccination tasks like malaria or hivar 59 00:03:47,560 --> 00:03:52,480 Speaker 1: or TV. So, I mean, I hate to keep harping 60 00:03:52,520 --> 00:03:54,720 Speaker 1: on the multiple vaccine thing, but are we looking at 61 00:03:54,720 --> 00:03:59,320 Speaker 1: a situation in six eight months to a year where 62 00:03:59,360 --> 00:04:03,040 Speaker 1: families are going to have to research which one works 63 00:04:03,080 --> 00:04:07,360 Speaker 1: best or is it sort of a regional availability or 64 00:04:07,520 --> 00:04:11,520 Speaker 1: monetary availability, how will that work? Well, certainly in the 65 00:04:11,600 --> 00:04:16,160 Speaker 1: United States, the government will have a clear opinion about 66 00:04:16,200 --> 00:04:20,560 Speaker 1: the first one that's rolling out, and you know, if 67 00:04:20,600 --> 00:04:26,800 Speaker 1: that first vaccine adds enough transmission blocking, then you what 68 00:04:26,920 --> 00:04:30,080 Speaker 1: you have is you have whatever previous protection we get 69 00:04:30,120 --> 00:04:36,719 Speaker 1: from other coronavirus family viruses and the immunity we get 70 00:04:36,960 --> 00:04:41,720 Speaker 1: from the natural infection for this coronavirus, plus whoever we vaccinate, 71 00:04:42,400 --> 00:04:46,200 Speaker 1: and so between those three you can get up to 72 00:04:46,279 --> 00:04:50,440 Speaker 1: her immunity where the total number of cases is very small, 73 00:04:51,000 --> 00:04:56,560 Speaker 1: pretty quickly, probably adding to the US population to the 74 00:04:56,640 --> 00:05:01,359 Speaker 1: vaccinated would do that. And so that's you know, seventy 75 00:05:01,400 --> 00:05:05,480 Speaker 1: million people to be vaccinated, and almost all these vaccines 76 00:05:06,080 --> 00:05:08,760 Speaker 1: unfortunately going to require two doses, so that's a hundred 77 00:05:08,760 --> 00:05:15,120 Speaker 1: and forty million doses. The various UH efforts are building 78 00:05:15,160 --> 00:05:19,159 Speaker 1: their factories in parallel, at least with the scale for 79 00:05:19,200 --> 00:05:22,599 Speaker 1: the United States. We're trying to make sure factories get 80 00:05:22,600 --> 00:05:25,560 Speaker 1: built for the entire world, which is you know, the 81 00:05:25,640 --> 00:05:28,280 Speaker 1: US is only five percent of the world's population, so 82 00:05:28,320 --> 00:05:32,400 Speaker 1: that's a twenty times harder problem, and the rest of 83 00:05:32,400 --> 00:05:35,440 Speaker 1: the world is not as rich. Getting enough money is 84 00:05:35,920 --> 00:05:39,720 Speaker 1: very difficult. The US is one of the countries where 85 00:05:39,720 --> 00:05:42,560 Speaker 1: you could decide to go with the first generation vaccine 86 00:05:43,279 --> 00:05:48,160 Speaker 1: and then decide that its efficacy was limited enough that 87 00:05:48,200 --> 00:05:52,960 Speaker 1: you would four months later, uh say no, now you 88 00:05:53,120 --> 00:05:56,760 Speaker 1: also need to go and get this vaccine after all. 89 00:05:57,160 --> 00:06:00,400 Speaker 1: You know, the economic damage we're trying to put an 90 00:06:00,480 --> 00:06:04,680 Speaker 1: end to is trillions and trillions, and you know, making 91 00:06:04,720 --> 00:06:10,560 Speaker 1: these vaccines and deploying them, assuming there's no side effects, Uh, 92 00:06:10,600 --> 00:06:14,400 Speaker 1: that's just billions, So you know, it's it's highly leveraged, 93 00:06:14,880 --> 00:06:19,640 Speaker 1: uh investment. You you, I mean you kind of mentioned that. 94 00:06:19,760 --> 00:06:22,320 Speaker 1: You know, we also need to be focusing on other 95 00:06:22,400 --> 00:06:26,120 Speaker 1: parts of the world too, low and middle income countries. Um, 96 00:06:26,160 --> 00:06:29,000 Speaker 1: who can't necessarily afford to throw billions of dollars at 97 00:06:29,000 --> 00:06:32,880 Speaker 1: this problem. Um, How how do we help other countries 98 00:06:32,920 --> 00:06:34,960 Speaker 1: and other human beings that just don't happen to live 99 00:06:35,000 --> 00:06:37,520 Speaker 1: in the United States or Canada or the UK or Australia. 100 00:06:37,760 --> 00:06:40,360 Speaker 1: How do we help them? Is it just a matter 101 00:06:40,400 --> 00:06:43,040 Speaker 1: of direct aid? Is it a matter of sharing research? 102 00:06:43,120 --> 00:06:44,880 Speaker 1: Is a matter of just pumping out a bunch of 103 00:06:44,920 --> 00:06:48,200 Speaker 1: doses and shipping them over there. Or is it a 104 00:06:48,279 --> 00:06:50,880 Speaker 1: thing where if we in the United States pay a 105 00:06:50,880 --> 00:06:53,040 Speaker 1: bunch of money for a vaccine, that's going to make 106 00:06:53,080 --> 00:06:55,919 Speaker 1: it that much more likely for the farmer companies to 107 00:06:56,080 --> 00:06:59,320 Speaker 1: sell it for lower no cost to other countries. What's 108 00:06:59,320 --> 00:07:04,479 Speaker 1: the economic to that. Yeah, Typically the vaccine companies for 109 00:07:04,600 --> 00:07:10,360 Speaker 1: the poorest countries, developing countries that a group called gobby 110 00:07:10,400 --> 00:07:13,760 Speaker 1: that we support and the US government other government support 111 00:07:14,120 --> 00:07:19,240 Speaker 1: it does the bind uh for these poor countries. The 112 00:07:19,320 --> 00:07:23,640 Speaker 1: vaccine manufacturers agree that they're not getting any profit, nor 113 00:07:23,680 --> 00:07:26,800 Speaker 1: are they getting any recovery for their fixed costs. Their 114 00:07:27,000 --> 00:07:29,360 Speaker 1: R and D and trial type costs are just getting 115 00:07:30,200 --> 00:07:33,240 Speaker 1: uh close to that marginal cost. And that makes sense 116 00:07:33,840 --> 00:07:37,200 Speaker 1: because they're they're not giving up something they would get otherwise. 117 00:07:37,720 --> 00:07:40,840 Speaker 1: And so all these manufacturers will have tiered pricing. The 118 00:07:40,920 --> 00:07:43,640 Speaker 1: price to the rich countries, middle income countries, and the 119 00:07:43,680 --> 00:07:48,240 Speaker 1: poorest countries will be different. Uh. Some of the companies 120 00:07:48,240 --> 00:07:50,360 Speaker 1: have agreed to make no profits, so when they price 121 00:07:50,480 --> 00:07:53,880 Speaker 1: to the rich in the middle income, they'll just recover 122 00:07:54,240 --> 00:07:58,040 Speaker 1: their fixed costs. Uh. And the poor countries. It's just 123 00:07:58,160 --> 00:08:01,800 Speaker 1: that that marginal cost. A number of these constructs look 124 00:08:01,880 --> 00:08:06,920 Speaker 1: like they'll be around two dollars per dose. Uh, perhaps 125 00:08:06,960 --> 00:08:12,040 Speaker 1: even less. Uh. Yeah, many of these constructs are very productive, 126 00:08:13,240 --> 00:08:17,840 Speaker 1: including the aDNA virus which is astro Centeca and J 127 00:08:17,960 --> 00:08:22,880 Speaker 1: and J and the subunit protein which is UH includes 128 00:08:23,240 --> 00:08:29,760 Speaker 1: Novavax and the Sonofi approaches. There are a name platform 129 00:08:29,840 --> 00:08:32,520 Speaker 1: which you can think, I'm kind of leaving that out, 130 00:08:32,800 --> 00:08:35,560 Speaker 1: you know, in the long rum, we're very enthusiastic about 131 00:08:35,559 --> 00:08:39,199 Speaker 1: that because the speed of development and having generic factories 132 00:08:39,920 --> 00:08:42,240 Speaker 1: even when you don't know which pathogen you're going after, 133 00:08:42,640 --> 00:08:45,520 Speaker 1: will work very well for that. So we've been funding 134 00:08:45,559 --> 00:08:49,040 Speaker 1: that for about a decade. Unfortunately, it's in terms of 135 00:08:49,040 --> 00:08:52,120 Speaker 1: scaling up the manufacturing and a port portion of it 136 00:08:52,280 --> 00:08:56,760 Speaker 1: called the lipid, the costs are still higher than these 137 00:08:56,800 --> 00:09:01,200 Speaker 1: other approaches. So for the big world, I doubt those 138 00:09:01,280 --> 00:09:07,800 Speaker 1: vaccines uh, which includes Maderna and Visor Bio and tech, 139 00:09:07,920 --> 00:09:11,439 Speaker 1: I doubt they'll they'll play much of a role. And 140 00:09:11,800 --> 00:09:14,800 Speaker 1: what you're talking about just now, you you're talking about 141 00:09:14,840 --> 00:09:18,560 Speaker 1: different types of vaccines that are being tested. So there's 142 00:09:18,840 --> 00:09:23,040 Speaker 1: an RNA vaccine that Maderna is working on that UM 143 00:09:23,400 --> 00:09:26,560 Speaker 1: has never a vaccine has never been produced using RNA, right, 144 00:09:27,120 --> 00:09:28,920 Speaker 1: that's right. This would be the first one. Can you 145 00:09:28,960 --> 00:09:30,760 Speaker 1: can you just talk a little bit about how an 146 00:09:30,920 --> 00:09:34,680 Speaker 1: RNA vaccine differs from you know, saying a dina virus 147 00:09:35,120 --> 00:09:40,120 Speaker 1: vaccine or even a flu vaccine. Well, RNA is the 148 00:09:40,200 --> 00:09:43,679 Speaker 1: name of these molecules that are like the software code 149 00:09:43,720 --> 00:09:50,480 Speaker 1: that tell yourselves what proteins to manufacture, and you know, 150 00:09:50,520 --> 00:09:55,280 Speaker 1: so the software idea here is that instead of actually 151 00:09:55,400 --> 00:09:59,880 Speaker 1: sending the particles for the immune system to recognize and 152 00:10:00,000 --> 00:10:03,840 Speaker 1: get ready to attack, you actually send some lines of 153 00:10:03,880 --> 00:10:07,640 Speaker 1: instructions the RNA that tell your own cells to make 154 00:10:07,679 --> 00:10:10,440 Speaker 1: that protein, and then once they make it, then the 155 00:10:10,480 --> 00:10:14,600 Speaker 1: immune system sees that and so the amount of URNA 156 00:10:14,800 --> 00:10:19,120 Speaker 1: you need to send could be way smaller because the 157 00:10:19,200 --> 00:10:23,120 Speaker 1: instructions are smaller than the actual proteins themselves. Now, we 158 00:10:23,200 --> 00:10:25,560 Speaker 1: still have to package up the RNA to get it 159 00:10:25,600 --> 00:10:29,120 Speaker 1: inside the cells, and that creates some cost. That's the 160 00:10:29,160 --> 00:10:34,440 Speaker 1: so called lipid But the basic idea UH is really 161 00:10:34,520 --> 00:10:39,040 Speaker 1: brilliant and in the future of vaccines, UH this will 162 00:10:39,080 --> 00:10:42,040 Speaker 1: be a critical way to bank vaccines because the speed 163 00:10:42,640 --> 00:10:45,760 Speaker 1: and the cost will get figured out and you'll just 164 00:10:45,800 --> 00:10:50,560 Speaker 1: have these general factories. Whether it's UH for malaria, or 165 00:10:51,160 --> 00:10:55,600 Speaker 1: cancer vaccines, and so it's great Maderna and Byron Tech careback. 166 00:10:56,120 --> 00:11:00,920 Speaker 1: These are companies that were founded based on using that 167 00:11:01,040 --> 00:11:06,360 Speaker 1: particular approach. Well, let's take a quick break, everybody, and 168 00:11:06,400 --> 00:11:28,680 Speaker 1: we will be right back with Bill Gates. How closely? 169 00:11:28,800 --> 00:11:31,080 Speaker 1: And I think the answer I want to hear is 170 00:11:31,080 --> 00:11:34,200 Speaker 1: that we've never seen a response like this as far 171 00:11:34,240 --> 00:11:38,480 Speaker 1: as sharing of research. But how closely is the international 172 00:11:38,520 --> 00:11:43,040 Speaker 1: research community working together? And have we seen anything like this? No, 173 00:11:43,160 --> 00:11:46,200 Speaker 1: it's quite novel. Um. And what we're gonna have is 174 00:11:47,920 --> 00:11:50,800 Speaker 1: the company who invents a vaccine is going to allow 175 00:11:51,920 --> 00:11:56,160 Speaker 1: other companies to use their factories to do the manufacturer. 176 00:11:56,760 --> 00:12:01,040 Speaker 1: So we scale up very quickly to this billions of doses. 177 00:12:01,600 --> 00:12:04,000 Speaker 1: And that's never been done before. And so we're our 178 00:12:04,080 --> 00:12:07,320 Speaker 1: foundation because we have a lot of that expertise, people 179 00:12:07,800 --> 00:12:10,800 Speaker 1: who have spent their careers at these private sector companies. 180 00:12:11,800 --> 00:12:15,360 Speaker 1: We're able to broker through our relationships with the companies 181 00:12:15,400 --> 00:12:19,360 Speaker 1: and the governments how that works. So, for example, two 182 00:12:19,360 --> 00:12:24,280 Speaker 1: of the companies in India have big capacity, but they're 183 00:12:24,320 --> 00:12:28,560 Speaker 1: unlikely to invent one of these vaccines. But Serum and 184 00:12:28,640 --> 00:12:33,480 Speaker 1: bioe are these two companies, and so we're giving money 185 00:12:33,520 --> 00:12:37,839 Speaker 1: to them and making sure the licensing and cooperation is 186 00:12:37,920 --> 00:12:42,400 Speaker 1: such that they can latch onto whichever of the other 187 00:12:42,480 --> 00:12:47,000 Speaker 1: companies work looks promising and be there to to make 188 00:12:47,040 --> 00:12:50,400 Speaker 1: a lot of the volume. So yes, I'm very pleased 189 00:12:51,040 --> 00:12:53,800 Speaker 1: with the cooperation. We didn't practice for this the way 190 00:12:53,840 --> 00:12:57,400 Speaker 1: we should have, either the governments or the private sector. 191 00:12:57,520 --> 00:13:02,160 Speaker 1: But uh, you know, my days are mostly those conversations 192 00:13:02,720 --> 00:13:08,080 Speaker 1: which everybody has a good attitude. Uh. You know, very 193 00:13:08,080 --> 00:13:11,280 Speaker 1: few people are being greedy about this, most being willing 194 00:13:11,320 --> 00:13:15,600 Speaker 1: to do things in a very novel high speed way. Now, 195 00:13:15,920 --> 00:13:18,280 Speaker 1: just follow up on that. It seems to me as 196 00:13:18,320 --> 00:13:21,600 Speaker 1: an optimist, that that could present a new way forward 197 00:13:22,080 --> 00:13:25,920 Speaker 1: for humanity, for things to work together on things that 198 00:13:25,920 --> 00:13:30,400 Speaker 1: aren't necessarily uh COVID nineteen related. Is that is that 199 00:13:30,960 --> 00:13:33,040 Speaker 1: naive and foolish or or could this be a good 200 00:13:33,040 --> 00:13:35,840 Speaker 1: opportunity for something like that? Well, it's a little bit naive, 201 00:13:35,920 --> 00:13:44,920 Speaker 1: and that the economic comparative of a coronavirus vaccine is 202 00:13:45,280 --> 00:13:49,880 Speaker 1: a stronger market signal than you've ever seen for any disease. 203 00:13:50,320 --> 00:13:54,960 Speaker 1: It's costing economies trillions of dollars. It's you know, the 204 00:13:55,080 --> 00:13:59,040 Speaker 1: US alone has put out already three trillion and relief money, 205 00:13:59,040 --> 00:14:04,160 Speaker 1: and they're talking about additional trillions, and so the net 206 00:14:04,200 --> 00:14:08,880 Speaker 1: gain from being bringing this epidemic to an end in 207 00:14:09,160 --> 00:14:13,360 Speaker 1: economic terms is very clear. Whereas a lot of the 208 00:14:13,480 --> 00:14:18,120 Speaker 1: diseases we need vaccines for are just in poor countries, 209 00:14:18,440 --> 00:14:21,560 Speaker 1: are mostly in poor countries where the rich countries, Like 210 00:14:21,600 --> 00:14:27,680 Speaker 1: tuberculosis or malaria is basically not seen in any rich country, 211 00:14:27,760 --> 00:14:31,120 Speaker 1: so they're the economic comparative isn't great. And that's where 212 00:14:31,120 --> 00:14:35,240 Speaker 1: our foundation, uh you know, for HIV, we and the 213 00:14:35,360 --> 00:14:37,960 Speaker 1: U S governments are the big funders. For milaria, we're 214 00:14:37,960 --> 00:14:41,920 Speaker 1: the big funder. There is no market signal and you know, 215 00:14:42,280 --> 00:14:44,560 Speaker 1: in a way, it's terrible that this disease hit the 216 00:14:44,640 --> 00:14:48,440 Speaker 1: rich world, but whatever, somebody in the rich world gets sick. Wow, 217 00:14:48,600 --> 00:14:53,960 Speaker 1: then uh, you know, resources are put into play in 218 00:14:54,080 --> 00:15:00,760 Speaker 1: a way that is you know, just incredible. So, um, 219 00:15:02,200 --> 00:15:04,200 Speaker 1: I should I feel like I should probably preface this, 220 00:15:04,280 --> 00:15:07,480 Speaker 1: But there are some people you may not be aware 221 00:15:07,480 --> 00:15:11,200 Speaker 1: of this. There are some people who are wary of vaccines, 222 00:15:12,200 --> 00:15:16,000 Speaker 1: and um, there there's a possibility that some people might 223 00:15:16,040 --> 00:15:20,800 Speaker 1: feel wariness toward covid um vaccine in particular because everything 224 00:15:20,920 --> 00:15:25,800 Speaker 1: is is being stepped up as quickly as possible. UM. 225 00:15:25,800 --> 00:15:27,680 Speaker 1: And one of the things that I've run into is 226 00:15:28,000 --> 00:15:31,040 Speaker 1: this idea that um, it might not even work. That 227 00:15:31,120 --> 00:15:33,160 Speaker 1: you know, sometimes you go in for a flu vaccine 228 00:15:33,560 --> 00:15:36,240 Speaker 1: and you still get the flu that year. Um. Can 229 00:15:36,280 --> 00:15:38,440 Speaker 1: you kind of talk about how how that differs and 230 00:15:38,480 --> 00:15:41,360 Speaker 1: how it would be more effective than say, like your 231 00:15:41,360 --> 00:15:44,320 Speaker 1: average flu vaccine, how the two are different. Yeah, there's 232 00:15:44,360 --> 00:15:48,480 Speaker 1: two problems with the flu vaccine. One is that there 233 00:15:48,480 --> 00:15:53,320 Speaker 1: are multiple varieties of flu that circulate, and as you 234 00:15:53,360 --> 00:15:59,120 Speaker 1: get into flu season, we try by going to China, 235 00:15:59,200 --> 00:16:04,320 Speaker 1: where most flues originate, to sample what's there and make 236 00:16:05,600 --> 00:16:09,080 Speaker 1: a two or three components seasonal flu vaccine, but we 237 00:16:09,240 --> 00:16:14,000 Speaker 1: often miss the strain that UH is most prevalent during 238 00:16:14,000 --> 00:16:17,520 Speaker 1: a season, and the way those flu vaccines are made, 239 00:16:17,960 --> 00:16:22,720 Speaker 1: they're not very effective and elderly people. And that's really 240 00:16:22,800 --> 00:16:27,680 Speaker 1: bad because the flu mostly kills old people very similar 241 00:16:27,920 --> 00:16:34,440 Speaker 1: in the age profile two COVID. And so here we 242 00:16:34,520 --> 00:16:37,240 Speaker 1: are in the trials for this vaccine making sure it 243 00:16:37,280 --> 00:16:40,480 Speaker 1: works well and old people, because otherwise the sickness protection 244 00:16:40,520 --> 00:16:44,920 Speaker 1: thing is almost useless. But flu is very difficult. It's 245 00:16:45,000 --> 00:16:50,040 Speaker 1: constantly emerging in new forms and reassorting this disease. There's 246 00:16:50,120 --> 00:16:55,600 Speaker 1: one target. The genetic variation is very, very minor, So 247 00:16:55,640 --> 00:17:00,400 Speaker 1: the vaccine will be able to target every coronavirus that 248 00:17:00,440 --> 00:17:03,400 Speaker 1: we've seen, and once we get rid of it, it 249 00:17:03,520 --> 00:17:09,600 Speaker 1: won't be crossing over into humans on a regular basis. Uh. 250 00:17:09,800 --> 00:17:12,199 Speaker 1: You know, we could go a long long time before 251 00:17:12,800 --> 00:17:15,240 Speaker 1: we would ever see it again, and then we'll have 252 00:17:15,400 --> 00:17:22,760 Speaker 1: surveillance and catch it when it's small numbers. Now, you know, 253 00:17:22,880 --> 00:17:25,080 Speaker 1: it's important to talk about vaccines. I think that's the 254 00:17:25,160 --> 00:17:28,800 Speaker 1: sort of um carrot dangling in front of the world. 255 00:17:29,400 --> 00:17:32,840 Speaker 1: But what about therapeutics. I know that's something that we 256 00:17:32,920 --> 00:17:36,080 Speaker 1: don't hear enough of probably in the news. Where where 257 00:17:36,080 --> 00:17:39,880 Speaker 1: are we with therapeutics and where can we go with therapeutics? Well, 258 00:17:39,920 --> 00:17:45,119 Speaker 1: the doctors are way better at treating COVID patients now 259 00:17:45,760 --> 00:17:49,960 Speaker 1: than at the start. They're not as overloaded. They realize 260 00:17:50,040 --> 00:17:53,160 Speaker 1: that you don't use the ventilator nearly as much because 261 00:17:53,200 --> 00:17:56,439 Speaker 1: it has bad side effects. They use oxygen earlier, they 262 00:17:56,520 --> 00:18:01,119 Speaker 1: use the chrome position. The two drugs that are being 263 00:18:01,200 --> 00:18:05,040 Speaker 1: used ramdasevere, which is an anti viral, and Dexi methos on, 264 00:18:05,119 --> 00:18:06,920 Speaker 1: which was proven out in a trial we funded in 265 00:18:06,920 --> 00:18:12,360 Speaker 1: the UK is a immune modulator. There are two other 266 00:18:12,400 --> 00:18:18,320 Speaker 1: anti virals that are actually as promising as ramdasevere and 267 00:18:18,560 --> 00:18:23,400 Speaker 1: actually could be used orally, which is much easier. There's 268 00:18:23,480 --> 00:18:28,600 Speaker 1: monoclonal antibodies where uh dozens of companies are working on that, 269 00:18:28,640 --> 00:18:32,040 Speaker 1: but Regeneran, Eli, Lilly and Astro Seneca have the three 270 00:18:32,800 --> 00:18:37,520 Speaker 1: that are leading the way there. And you know, by 271 00:18:37,520 --> 00:18:40,520 Speaker 1: the time we get more anti virals, monclone antibodies and 272 00:18:40,720 --> 00:18:45,000 Speaker 1: some improved immune modulators, we could cut the death rate 273 00:18:45,600 --> 00:18:52,520 Speaker 1: by eight to nine. And testing therapeutics is easier because 274 00:18:52,520 --> 00:18:55,679 Speaker 1: you just take a few hundred sick people and if 275 00:18:55,720 --> 00:18:59,359 Speaker 1: you're going to have substantial results, you you know, a 276 00:18:59,480 --> 00:19:04,080 Speaker 1: hundred at the intervention a hundred don't uh, you'll see, 277 00:19:04,520 --> 00:19:09,560 Speaker 1: you know, significant variance between those and so yes, the 278 00:19:09,760 --> 00:19:13,960 Speaker 1: death rate will come down quite a bit, well before 279 00:19:14,560 --> 00:19:17,439 Speaker 1: we get the vaccine out in the large numbers to 280 00:19:17,760 --> 00:19:22,640 Speaker 1: stop dropping the case numbers. Great um, Bill, you kind 281 00:19:22,640 --> 00:19:26,680 Speaker 1: of referenced a point in time that is on everyone's mind, 282 00:19:26,680 --> 00:19:29,040 Speaker 1: but I think it seems kind of amorphous, which is 283 00:19:29,520 --> 00:19:34,679 Speaker 1: the point where we have viable vaccine and good treatments. 284 00:19:35,080 --> 00:19:38,760 Speaker 1: What does the world with coronavirus look like after that, 285 00:19:38,840 --> 00:19:41,320 Speaker 1: does it just like disappeared, does it hit a reservoir, 286 00:19:41,359 --> 00:19:44,359 Speaker 1: does it come back seasonally? What? What is what is 287 00:19:44,400 --> 00:19:46,280 Speaker 1: it going to look like? And then how far off 288 00:19:46,560 --> 00:19:50,680 Speaker 1: are we from that goal of reaching that that world. 289 00:19:52,280 --> 00:19:57,720 Speaker 1: If we get this cheap vaccine um and it's not 290 00:19:57,800 --> 00:20:02,639 Speaker 1: only safe, but everybody uh knows that it's safe, so 291 00:20:02,640 --> 00:20:06,520 Speaker 1: they're willing in large numbers to take the vaccine. And 292 00:20:06,560 --> 00:20:10,199 Speaker 1: if we get the generosity that the rich countries are 293 00:20:11,200 --> 00:20:16,240 Speaker 1: along with our foundation are funding the vaccine so it's 294 00:20:16,359 --> 00:20:20,840 Speaker 1: uh available even in the developing countries, we can truly 295 00:20:20,880 --> 00:20:25,960 Speaker 1: bring this into an end where it won't be coming back. Uh, 296 00:20:26,119 --> 00:20:29,920 Speaker 1: You'll get rid of all the pockets the disease or 297 00:20:30,040 --> 00:20:32,240 Speaker 1: in you'll be willing to go to big public events 298 00:20:32,840 --> 00:20:35,959 Speaker 1: and then will monitor to see if it if something 299 00:20:36,040 --> 00:20:39,919 Speaker 1: similar is crossing over and catch that very quickly. We 300 00:20:40,000 --> 00:20:43,560 Speaker 1: might not hang around with bats quite as much uh 301 00:20:43,680 --> 00:20:49,680 Speaker 1: as we do now. Uh these live markets where uh 302 00:20:49,720 --> 00:20:55,000 Speaker 1: this crossover almost certainly took place. But you know, I'm 303 00:20:55,359 --> 00:20:59,040 Speaker 1: spending a lot of time getting the US to provide 304 00:20:59,119 --> 00:21:03,280 Speaker 1: money to help buy the vaccine for other countries. Historically, 305 00:21:03,280 --> 00:21:05,840 Speaker 1: the US has been super generous. You know, we we 306 00:21:06,000 --> 00:21:10,359 Speaker 1: drove smallpox eradication, we fund the polio effort that's near 307 00:21:10,720 --> 00:21:14,520 Speaker 1: to completion on HIV and malaria. We've been super generous here. 308 00:21:15,520 --> 00:21:19,800 Speaker 1: The leadership has been distracted and not wanting to talk 309 00:21:19,840 --> 00:21:22,320 Speaker 1: about the epidemics, so we haven't gotten the money yet. 310 00:21:22,359 --> 00:21:27,600 Speaker 1: But I'm optimistic that'll get solved by the Congress because 311 00:21:27,600 --> 00:21:30,720 Speaker 1: it's hitting both people. It's hitting both the bleeding hearts 312 00:21:30,720 --> 00:21:33,359 Speaker 1: you care about human lives, and it's hitting both the 313 00:21:33,440 --> 00:21:36,480 Speaker 1: hard cases you care about the bottom line. Huh, it's 314 00:21:38,280 --> 00:21:42,919 Speaker 1: the humanitarian argument, the strategic argument of not creating a 315 00:21:43,000 --> 00:21:47,680 Speaker 1: vacuum for China and others, and the selfish argument of hey, 316 00:21:47,880 --> 00:21:50,800 Speaker 1: we don't want it coming back again and again. You know, 317 00:21:50,880 --> 00:21:54,280 Speaker 1: countries like Australia, South Korea that did a competent job, 318 00:21:54,880 --> 00:21:58,560 Speaker 1: even they have found it hard that everybody was coming 319 00:21:58,600 --> 00:22:02,199 Speaker 1: into the country potentially can start up a chain of 320 00:22:02,240 --> 00:22:06,560 Speaker 1: infection again. So uh, you know, they're doing great, but 321 00:22:07,320 --> 00:22:10,080 Speaker 1: they have to keep fighting and fighting and and doing 322 00:22:10,160 --> 00:22:14,520 Speaker 1: local shutdowns. Whereas if if they the rest of the 323 00:22:14,520 --> 00:22:18,400 Speaker 1: world had done what they've done, you know, they they 324 00:22:18,400 --> 00:22:24,240 Speaker 1: could go and and have their economy in a normal state. Yeah, 325 00:22:24,280 --> 00:22:27,879 Speaker 1: you know, you mentioned the live markets and the crossover 326 00:22:28,000 --> 00:22:32,560 Speaker 1: and sort of the problems with that. What um, what 327 00:22:32,640 --> 00:22:34,760 Speaker 1: does that future look like? And what can we do 328 00:22:34,840 --> 00:22:38,160 Speaker 1: about it? As Americans? Are we working with China? Are 329 00:22:38,200 --> 00:22:40,800 Speaker 1: they willing to close these things down? Like? How is 330 00:22:40,800 --> 00:22:44,600 Speaker 1: all that going to work? Yeah? A lot of species 331 00:22:44,600 --> 00:22:50,480 Speaker 1: of bats are there south of Wuhan uh, and you know, 332 00:22:50,520 --> 00:22:54,640 Speaker 1: the cross protection from related cornervirces may explain why vietnamal 333 00:22:54,680 --> 00:22:57,240 Speaker 1: that they've certainly done a good job. You know, they 334 00:22:57,400 --> 00:23:02,080 Speaker 1: just had their first death, and so coronaviruses do come out, 335 00:23:02,600 --> 00:23:07,119 Speaker 1: and if you're looking with modern tools, you'll see it 336 00:23:07,160 --> 00:23:11,040 Speaker 1: when the numbers are very small. So those uh, you know, 337 00:23:11,320 --> 00:23:14,560 Speaker 1: making sure the exposures to bats are reduced, it reduced, 338 00:23:14,560 --> 00:23:18,480 Speaker 1: and that the surveillance is very strong. And then once 339 00:23:18,520 --> 00:23:22,600 Speaker 1: you see meaningful spread, then kicking up a sort of 340 00:23:22,680 --> 00:23:26,679 Speaker 1: what I call mega testing diagnostic capability that is all 341 00:23:26,880 --> 00:23:32,520 Speaker 1: very doable and and so we won't suffer from a 342 00:23:32,640 --> 00:23:35,720 Speaker 1: coronavirus being widespread like this again, we will really have 343 00:23:35,800 --> 00:23:41,120 Speaker 1: our act together for pretty modest level of resources. Chuck, 344 00:23:41,160 --> 00:23:43,200 Speaker 1: I have one last question. Do you have any anymore? 345 00:23:44,160 --> 00:23:46,840 Speaker 1: I got one more, but you go first. Okay, well, 346 00:23:46,880 --> 00:23:49,520 Speaker 1: well my bill was um, and I'm presuming here. I 347 00:23:49,560 --> 00:23:51,720 Speaker 1: hope I'm not overly presuming that it's okay for me 348 00:23:51,800 --> 00:23:54,040 Speaker 1: to call you Bill. Sure at this point, Okay, I 349 00:23:54,080 --> 00:23:58,639 Speaker 1: probably should have verified that before. But UM, what I 350 00:23:58,680 --> 00:24:03,760 Speaker 1: think people are there's like an inherent suspicion or suspiciousness 351 00:24:03,800 --> 00:24:07,200 Speaker 1: that I think people can can kind of lean towards 352 00:24:07,240 --> 00:24:11,480 Speaker 1: when they encounter a mind bogglingly wealthy person who um, 353 00:24:11,640 --> 00:24:15,440 Speaker 1: wants to help eradicate disease around the world and uses 354 00:24:15,480 --> 00:24:18,520 Speaker 1: their money for that end. Um, So what is it 355 00:24:18,600 --> 00:24:21,280 Speaker 1: that that interested you that kind of took you from 356 00:24:21,320 --> 00:24:26,280 Speaker 1: you know, uh, pioneering computers to pioneering eradicating disease around 357 00:24:26,280 --> 00:24:28,680 Speaker 1: the world. What was that was that Melinda's influence? Was 358 00:24:28,720 --> 00:24:31,400 Speaker 1: that something that you've always been interested in? What? What? 359 00:24:31,400 --> 00:24:36,160 Speaker 1: What's the deal? Well, like your listeners, I I'm curious 360 00:24:36,200 --> 00:24:42,840 Speaker 1: to understand things. And so as I was uh starting 361 00:24:42,880 --> 00:24:45,879 Speaker 1: to wind down, uh and spend a little bit less 362 00:24:46,160 --> 00:24:51,080 Speaker 1: time on my Microsoft work, I was reading. I was thinking, Okay, 363 00:24:51,080 --> 00:24:55,240 Speaker 1: how can I give this wealth back to society? Uh? 364 00:24:55,280 --> 00:25:00,080 Speaker 1: And I was learning about what kills children and I 365 00:25:00,160 --> 00:25:04,919 Speaker 1: was stunned that there were diseases that we had solutions for, 366 00:25:05,040 --> 00:25:09,080 Speaker 1: we had vaccines for, but uh, millions would die of 367 00:25:09,080 --> 00:25:13,440 Speaker 1: those diseases because they weren't affordable to the poor countries, 368 00:25:13,480 --> 00:25:17,000 Speaker 1: even though the cost of manufacturer was very, very low. 369 00:25:17,760 --> 00:25:21,840 Speaker 1: And so I saw that Melinda and I could focus 370 00:25:21,880 --> 00:25:26,560 Speaker 1: on global health and get the death rate down, which 371 00:25:26,600 --> 00:25:31,240 Speaker 1: amazingly encounterintuitively reduces population growth because parents, when they know 372 00:25:31,359 --> 00:25:35,560 Speaker 1: their kids are likely to survive, have less children. And 373 00:25:35,640 --> 00:25:40,120 Speaker 1: so that quest, you know, which involved creating this gobby 374 00:25:40,760 --> 00:25:45,640 Speaker 1: organization to help buy the vaccines. Overall, the under five 375 00:25:45,680 --> 00:25:48,480 Speaker 1: death rate has gone from ten percent now down to 376 00:25:48,560 --> 00:25:53,919 Speaker 1: about five globally, and you know, so that's you know, 377 00:25:54,040 --> 00:25:57,360 Speaker 1: that's mind blowing. It was over ten million children here 378 00:25:57,400 --> 00:26:01,680 Speaker 1: now less than then five million a year, and we 379 00:26:01,720 --> 00:26:04,320 Speaker 1: have a clear path with a few new vaccines to 380 00:26:04,400 --> 00:26:07,560 Speaker 1: get down to two and a half million two and 381 00:26:07,600 --> 00:26:11,200 Speaker 1: a half percent. Uh, and even rich countries are close 382 00:26:11,240 --> 00:26:13,240 Speaker 1: to one percent. So you're getting pretty close to the 383 00:26:13,320 --> 00:26:17,240 Speaker 1: kind of equity that any child point anywhere, their life 384 00:26:17,320 --> 00:26:21,080 Speaker 1: is treated as having value. Now on this journey, you 385 00:26:21,080 --> 00:26:23,320 Speaker 1: you know, I've gotten to learn about the immune system 386 00:26:23,480 --> 00:26:27,760 Speaker 1: and meet great scientists, and so I love the work. Uh, 387 00:26:27,880 --> 00:26:30,159 Speaker 1: you know, it gives purpose to how we take the 388 00:26:30,200 --> 00:26:32,960 Speaker 1: Microsoft money and get it back out to the world 389 00:26:34,080 --> 00:26:38,959 Speaker 1: because we don't need it for our consumption. And you know, 390 00:26:39,000 --> 00:26:41,679 Speaker 1: so this work in partnership with me Linda has been 391 00:26:41,960 --> 00:26:46,240 Speaker 1: a great joy to me. Uh So, I guess in 392 00:26:46,320 --> 00:26:49,600 Speaker 1: finishing up, I mean, you know, you've been pretty busy 393 00:26:49,920 --> 00:26:54,200 Speaker 1: being Bill Gates Superhero during this time. I'm curious though 394 00:26:54,240 --> 00:26:56,920 Speaker 1: about you know, you've been locked down like the rest 395 00:26:56,960 --> 00:26:59,480 Speaker 1: of us. What's what is Bill Gates human being been doing? 396 00:27:00,359 --> 00:27:01,960 Speaker 1: Have you had any fun? What have you guys been doing? 397 00:27:02,000 --> 00:27:04,240 Speaker 1: What have you been up to? Well, you know, in 398 00:27:04,240 --> 00:27:06,920 Speaker 1: a way, Uh, I don't know what the kids think, 399 00:27:06,920 --> 00:27:09,560 Speaker 1: but we've got more time with our kids than we 400 00:27:09,600 --> 00:27:13,320 Speaker 1: would have expected, including one that's at medical school, one 401 00:27:13,359 --> 00:27:18,920 Speaker 1: that's uh at University of Chicago and college and so 402 00:27:19,080 --> 00:27:22,480 Speaker 1: you know, lots of family game nights. Uh. You know, 403 00:27:22,520 --> 00:27:26,840 Speaker 1: I'm using the team software from Microsoft and Zoom and 404 00:27:27,359 --> 00:27:29,399 Speaker 1: some of the others, and so I'm giving a lot 405 00:27:29,480 --> 00:27:32,119 Speaker 1: of feedback to the Microsoft team that now this this 406 00:27:32,160 --> 00:27:35,400 Speaker 1: has becomes so mainstream, let's make it easy to take 407 00:27:35,440 --> 00:27:39,640 Speaker 1: notes and review the slides and search through A previous 408 00:27:39,720 --> 00:27:43,920 Speaker 1: meeting to see what was done. You know, so the 409 00:27:44,040 --> 00:27:50,240 Speaker 1: rated innovation the software will be up to quite a bit. Uh. 410 00:27:50,359 --> 00:27:52,000 Speaker 1: You know, it's been simple for me to meet with 411 00:27:52,080 --> 00:27:55,479 Speaker 1: leaders because they don't expect to show that you're serious 412 00:27:55,480 --> 00:27:57,919 Speaker 1: that you have to fly all the way there. And 413 00:27:57,960 --> 00:28:01,320 Speaker 1: even for these African leaders there they're the most stuck. 414 00:28:01,359 --> 00:28:03,520 Speaker 1: They have to fly to the US and fly to Europe, 415 00:28:03,560 --> 00:28:06,040 Speaker 1: so they're they're able to stay in their countries and 416 00:28:06,080 --> 00:28:10,080 Speaker 1: get more of their work done. Uh. So you know 417 00:28:10,160 --> 00:28:14,320 Speaker 1: how once it's all over, we realized, Wow, some of 418 00:28:14,359 --> 00:28:18,400 Speaker 1: those trips our time in the office wasn't necessary. That 419 00:28:18,800 --> 00:28:25,080 Speaker 1: is pretty fascinating that it's really accelerated rethinking office work 420 00:28:25,119 --> 00:28:30,120 Speaker 1: and business travel. Uh. And you know we really can 421 00:28:31,240 --> 00:28:34,720 Speaker 1: uh save a lot of the overhead from those things. 422 00:28:34,720 --> 00:28:39,440 Speaker 1: But you know, I've gotten to read more than normal, uh, 423 00:28:39,480 --> 00:28:43,160 Speaker 1: you know, less jet legg than normal. Uh. Any particular 424 00:28:43,200 --> 00:28:46,720 Speaker 1: books that you've been that you've you've enjoyed most Uh 425 00:28:46,760 --> 00:28:49,239 Speaker 1: you know, I was just reading Zeke Emmanuel has one 426 00:28:49,280 --> 00:28:52,280 Speaker 1: about which is the best health system in the world 427 00:28:52,960 --> 00:28:55,440 Speaker 1: that does a good job of talking about the strengths 428 00:28:55,480 --> 00:28:59,360 Speaker 1: and weaknesses. You know, where the US has a lot 429 00:28:59,400 --> 00:29:04,360 Speaker 1: of weakness is but has you know big chance to 430 00:29:04,360 --> 00:29:08,920 Speaker 1: to get better? Um, well, we're working on a stuff 431 00:29:08,960 --> 00:29:10,800 Speaker 1: you should know board game, Bill, so we'll make sure 432 00:29:10,840 --> 00:29:14,640 Speaker 1: the Gates family gets one. Fantastic I'd love that, maybe 433 00:29:14,680 --> 00:29:18,600 Speaker 1: even signed. All right, Chuck, you got anything else? I 434 00:29:18,680 --> 00:29:20,640 Speaker 1: got nothing else. Thanks a lot, sir, it's great talking 435 00:29:20,680 --> 00:29:23,200 Speaker 1: to you again. Yeah, thank you, Bill. But wait, Bill, 436 00:29:23,200 --> 00:29:27,400 Speaker 1: do you have anything else? No? Uh uh, you know. 437 00:29:27,520 --> 00:29:32,760 Speaker 1: Thanks for feeding people's curiosity. You guys do a great job. Hey, well, 438 00:29:32,760 --> 00:29:35,200 Speaker 1: thank you for saving the world from doing a great 439 00:29:35,240 --> 00:29:38,040 Speaker 1: job too. Well. Since we just made Bill Gates lap, 440 00:29:38,080 --> 00:29:40,600 Speaker 1: that's it for short stuff. Everybody's short stuff is out. 441 00:29:43,800 --> 00:29:46,040 Speaker 1: Stuff you Should Know is a production of iHeart Radio's 442 00:29:46,040 --> 00:29:48,760 Speaker 1: How Stuff Works. For more podcasts for my heart Radio, 443 00:29:48,880 --> 00:29:51,720 Speaker 1: visit the iHeart Radio app, Apple Podcasts, or wherever you 444 00:29:51,760 --> 00:29:52,920 Speaker 1: listen to your favorite shows.