WEBVTT - Short Stuff: The Return of Bill Gates! 0:00:04.440 --> 0:00:07.360 Hey, and welcome to the short stuff. I'm Josh, there's Chuck, 0:00:07.440 --> 0:00:10.319 there's Bill Gates. No time to explain, this is short stuff. 0:00:10.360 --> 0:00:14.520 Let's get to it. Uh, thanks for coming back and 0:00:14.600 --> 0:00:19.080 joining us, Bill to talk about COVID and vaccines and therapeutics, 0:00:19.760 --> 0:00:22.040 and uh, you know, we've got a short window here, 0:00:22.079 --> 0:00:24.919 so let's dive right in. And I guess my first 0:00:25.000 --> 0:00:28.080 question is, let's just kind a level said and find 0:00:28.080 --> 0:00:30.840 out where we are with vaccines and how it all 0:00:30.880 --> 0:00:33.519 works with multiple vaccines being worked on, and how that 0:00:33.600 --> 0:00:36.960 kind of goes in the end. Well, there's fortunately a 0:00:37.000 --> 0:00:41.320 lot of different vaccine constructs using uh, most of the 0:00:41.520 --> 0:00:45.560 approaches that we know. And as we get these out 0:00:45.640 --> 0:00:50.520 in larger human studies and eventually have a Human Emergency 0:00:50.520 --> 0:00:54.800 Youth Thought authorization, we'll start to understand for the various 0:00:54.880 --> 0:01:00.920 candidates how much they prevent disease transmission, how much they 0:01:01.000 --> 0:01:05.360 prevent often you get sick, whether they work in the elderly, 0:01:05.880 --> 0:01:09.199 and what type of duration they have, And so they'll 0:01:09.319 --> 0:01:13.320 be quite a range on those parameters for these vaccines. 0:01:14.000 --> 0:01:17.040 You know, eventually we want one that's both very good 0:01:17.040 --> 0:01:22.319 at transmission blocking and preventing sickness. And hast duration and 0:01:22.600 --> 0:01:26.039 is cheap so that we get out to a large 0:01:26.080 --> 0:01:30.399 part of the entire global population and bring the pandemic 0:01:30.480 --> 0:01:33.000 to an end. One of the things that you you 0:01:33.400 --> 0:01:35.399 um brought up though, is that we want like all 0:01:35.440 --> 0:01:39.720 of these different factors that make basically like a perfect vaccine. Um. 0:01:39.760 --> 0:01:42.200 But I read one of your posts on your Gates 0:01:42.240 --> 0:01:46.160 Notes blogs and you said that that's probably not going 0:01:46.200 --> 0:01:48.200 to happen right out of the gate. Is there a 0:01:48.200 --> 0:01:51.800 benefit from having multiple vaccines kind of working in conjunction 0:01:51.920 --> 0:01:54.160 or is it the best route to just kind of 0:01:54.400 --> 0:01:57.640 keep going after that that magic perfect vaccine that that 0:01:57.720 --> 0:02:00.800 works as close to perfect as we can get. Well, 0:02:00.840 --> 0:02:04.000 particularly for the developing countries, we won't be able to 0:02:04.040 --> 0:02:08.120 afford to go out a whole lot of times. And 0:02:08.240 --> 0:02:11.960 so uh, you know, the US has funded a lot 0:02:12.000 --> 0:02:15.120 of the R and D. Our Foundation and a group 0:02:15.440 --> 0:02:17.840 were part of called SEPPI is also funded R and D, 0:02:18.080 --> 0:02:22.919 but well less than what the US itself has done, 0:02:23.720 --> 0:02:27.600 and that's got a really good pipeline. You know, the 0:02:27.639 --> 0:02:32.840 astro Seneca probably will come out first, then Johnson and Johnson, 0:02:32.919 --> 0:02:35.880 then Novavax, then Sonofie. Those are the ford that are 0:02:35.919 --> 0:02:40.359 most promising because they're they're clearly low cost Maderna and 0:02:40.520 --> 0:02:44.240 Visor in that same time frame, but probably pretty expensive 0:02:44.280 --> 0:02:47.959 and may only end up being used in rich countries. 0:02:49.919 --> 0:02:53.480 So that's that's the It's a question of affordability, not 0:02:53.639 --> 0:02:58.640 necessarily efficacy. Yeah, well, of the six, the likelihood that 0:02:58.680 --> 0:03:03.600 they all work without side effects is pretty low. Now 0:03:03.680 --> 0:03:08.880 the Phase one studies, that's pretty small numbers, and you're 0:03:08.919 --> 0:03:11.880 not going out to find sick people, but there you 0:03:12.000 --> 0:03:15.799 can see what the antibody response looks like. And if 0:03:15.840 --> 0:03:18.040 you use some very advanced tools, you can look at 0:03:18.040 --> 0:03:21.160 the other side of the immune system, the T cell side, 0:03:21.600 --> 0:03:24.640 and try and gauge what type of responses you're getting there. 0:03:25.080 --> 0:03:27.880 And I have to say that all these vaccines look 0:03:27.960 --> 0:03:31.480 pretty good. You know, the Nova vacts which just came 0:03:31.480 --> 0:03:35.680 out this week, has the best numbers. But uh, you know, 0:03:35.680 --> 0:03:40.400 we're this kind of respiratory disease. Protecting your lungs is 0:03:40.440 --> 0:03:47.240 easier than many other vaccination tasks like malaria or hivar 0:03:47.560 --> 0:03:52.480 or TV. So, I mean, I hate to keep harping 0:03:52.520 --> 0:03:54.720 on the multiple vaccine thing, but are we looking at 0:03:54.720 --> 0:03:59.320 a situation in six eight months to a year where 0:03:59.360 --> 0:04:03.040 families are going to have to research which one works 0:04:03.080 --> 0:04:07.360 best or is it sort of a regional availability or 0:04:07.520 --> 0:04:11.520 monetary availability, how will that work? Well, certainly in the 0:04:11.600 --> 0:04:16.160 United States, the government will have a clear opinion about 0:04:16.200 --> 0:04:20.560 the first one that's rolling out, and you know, if 0:04:20.600 --> 0:04:26.800 that first vaccine adds enough transmission blocking, then you what 0:04:26.920 --> 0:04:30.080 you have is you have whatever previous protection we get 0:04:30.120 --> 0:04:36.719 from other coronavirus family viruses and the immunity we get 0:04:36.960 --> 0:04:41.720 from the natural infection for this coronavirus, plus whoever we vaccinate, 0:04:42.400 --> 0:04:46.200 and so between those three you can get up to 0:04:46.279 --> 0:04:50.440 her immunity where the total number of cases is very small, 0:04:51.000 --> 0:04:56.560 pretty quickly, probably adding to the US population to the 0:04:56.640 --> 0:05:01.359 vaccinated would do that. And so that's you know, seventy 0:05:01.400 --> 0:05:05.480 million people to be vaccinated, and almost all these vaccines 0:05:06.080 --> 0:05:08.760 unfortunately going to require two doses, so that's a hundred 0:05:08.760 --> 0:05:15.120 and forty million doses. The various UH efforts are building 0:05:15.160 --> 0:05:19.159 their factories in parallel, at least with the scale for 0:05:19.200 --> 0:05:22.599 the United States. We're trying to make sure factories get 0:05:22.600 --> 0:05:25.560 built for the entire world, which is you know, the 0:05:25.640 --> 0:05:28.280 US is only five percent of the world's population, so 0:05:28.320 --> 0:05:32.400 that's a twenty times harder problem, and the rest of 0:05:32.400 --> 0:05:35.440 the world is not as rich. Getting enough money is 0:05:35.920 --> 0:05:39.720 very difficult. The US is one of the countries where 0:05:39.720 --> 0:05:42.560 you could decide to go with the first generation vaccine 0:05:43.279 --> 0:05:48.160 and then decide that its efficacy was limited enough that 0:05:48.200 --> 0:05:52.960 you would four months later, uh say no, now you 0:05:53.120 --> 0:05:56.760 also need to go and get this vaccine after all. 0:05:57.160 --> 0:06:00.400 You know, the economic damage we're trying to put an 0:06:00.480 --> 0:06:04.680 end to is trillions and trillions, and you know, making 0:06:04.720 --> 0:06:10.560 these vaccines and deploying them, assuming there's no side effects, Uh, 0:06:10.600 --> 0:06:14.400 that's just billions, So you know, it's it's highly leveraged, 0:06:14.880 --> 0:06:19.640 uh investment. You you, I mean you kind of mentioned that. 0:06:19.760 --> 0:06:22.320 You know, we also need to be focusing on other 0:06:22.400 --> 0:06:26.120 parts of the world too, low and middle income countries. Um, 0:06:26.160 --> 0:06:29.000 who can't necessarily afford to throw billions of dollars at 0:06:29.000 --> 0:06:32.880 this problem. Um, How how do we help other countries 0:06:32.920 --> 0:06:34.960 and other human beings that just don't happen to live 0:06:35.000 --> 0:06:37.520 in the United States or Canada or the UK or Australia. 0:06:37.760 --> 0:06:40.360 How do we help them? Is it just a matter 0:06:40.400 --> 0:06:43.040 of direct aid? Is it a matter of sharing research? 0:06:43.120 --> 0:06:44.880 Is a matter of just pumping out a bunch of 0:06:44.920 --> 0:06:48.200 doses and shipping them over there. Or is it a 0:06:48.279 --> 0:06:50.880 thing where if we in the United States pay a 0:06:50.880 --> 0:06:53.040 bunch of money for a vaccine, that's going to make 0:06:53.080 --> 0:06:55.919 it that much more likely for the farmer companies to 0:06:56.080 --> 0:06:59.320 sell it for lower no cost to other countries. What's 0:06:59.320 --> 0:07:04.479 the economic to that. Yeah, Typically the vaccine companies for 0:07:04.600 --> 0:07:10.360 the poorest countries, developing countries that a group called gobby 0:07:10.400 --> 0:07:13.760 that we support and the US government other government support 0:07:14.120 --> 0:07:19.240 it does the bind uh for these poor countries. The 0:07:19.320 --> 0:07:23.640 vaccine manufacturers agree that they're not getting any profit, nor 0:07:23.680 --> 0:07:26.800 are they getting any recovery for their fixed costs. Their 0:07:27.000 --> 0:07:29.360 R and D and trial type costs are just getting 0:07:30.200 --> 0:07:33.240 uh close to that marginal cost. And that makes sense 0:07:33.840 --> 0:07:37.200 because they're they're not giving up something they would get otherwise. 0:07:37.720 --> 0:07:40.840 And so all these manufacturers will have tiered pricing. The 0:07:40.920 --> 0:07:43.640 price to the rich countries, middle income countries, and the 0:07:43.680 --> 0:07:48.240 poorest countries will be different. Uh. Some of the companies 0:07:48.240 --> 0:07:50.360 have agreed to make no profits, so when they price 0:07:50.480 --> 0:07:53.880 to the rich in the middle income, they'll just recover 0:07:54.240 --> 0:07:58.040 their fixed costs. Uh. And the poor countries. It's just 0:07:58.160 --> 0:08:01.800 that that marginal cost. A number of these constructs look 0:08:01.880 --> 0:08:06.920 like they'll be around two dollars per dose. Uh, perhaps 0:08:06.960 --> 0:08:12.040 even less. Uh. Yeah, many of these constructs are very productive, 0:08:13.240 --> 0:08:17.840 including the aDNA virus which is astro Centeca and J 0:08:17.960 --> 0:08:22.880 and J and the subunit protein which is UH includes 0:08:23.240 --> 0:08:29.760 Novavax and the Sonofi approaches. There are a name platform 0:08:29.840 --> 0:08:32.520 which you can think, I'm kind of leaving that out, 0:08:32.800 --> 0:08:35.560 you know, in the long rum, we're very enthusiastic about 0:08:35.559 --> 0:08:39.199 that because the speed of development and having generic factories 0:08:39.920 --> 0:08:42.240 even when you don't know which pathogen you're going after, 0:08:42.640 --> 0:08:45.520 will work very well for that. So we've been funding 0:08:45.559 --> 0:08:49.040 that for about a decade. Unfortunately, it's in terms of 0:08:49.040 --> 0:08:52.120 scaling up the manufacturing and a port portion of it 0:08:52.280 --> 0:08:56.760 called the lipid, the costs are still higher than these 0:08:56.800 --> 0:09:01.200 other approaches. So for the big world, I doubt those 0:09:01.280 --> 0:09:07.800 vaccines uh, which includes Maderna and Visor Bio and tech, 0:09:07.920 --> 0:09:11.439 I doubt they'll they'll play much of a role. And 0:09:11.800 --> 0:09:14.800 what you're talking about just now, you you're talking about 0:09:14.840 --> 0:09:18.560 different types of vaccines that are being tested. So there's 0:09:18.840 --> 0:09:23.040 an RNA vaccine that Maderna is working on that UM 0:09:23.400 --> 0:09:26.560 has never a vaccine has never been produced using RNA, right, 0:09:27.120 --> 0:09:28.920 that's right. This would be the first one. Can you 0:09:28.960 --> 0:09:30.760 can you just talk a little bit about how an 0:09:30.920 --> 0:09:34.680 RNA vaccine differs from you know, saying a dina virus 0:09:35.120 --> 0:09:40.120 vaccine or even a flu vaccine. Well, RNA is the 0:09:40.200 --> 0:09:43.679 name of these molecules that are like the software code 0:09:43.720 --> 0:09:50.480 that tell yourselves what proteins to manufacture, and you know, 0:09:50.520 --> 0:09:55.280 so the software idea here is that instead of actually 0:09:55.400 --> 0:09:59.880 sending the particles for the immune system to recognize and 0:10:00.000 --> 0:10:03.840 get ready to attack, you actually send some lines of 0:10:03.880 --> 0:10:07.640 instructions the RNA that tell your own cells to make 0:10:07.679 --> 0:10:10.440 that protein, and then once they make it, then the 0:10:10.480 --> 0:10:14.600 immune system sees that and so the amount of URNA 0:10:14.800 --> 0:10:19.120 you need to send could be way smaller because the 0:10:19.200 --> 0:10:23.120 instructions are smaller than the actual proteins themselves. Now, we 0:10:23.200 --> 0:10:25.560 still have to package up the RNA to get it 0:10:25.600 --> 0:10:29.120 inside the cells, and that creates some cost. That's the 0:10:29.160 --> 0:10:34.440 so called lipid But the basic idea UH is really 0:10:34.520 --> 0:10:39.040 brilliant and in the future of vaccines, UH this will 0:10:39.080 --> 0:10:42.040 be a critical way to bank vaccines because the speed 0:10:42.640 --> 0:10:45.760 and the cost will get figured out and you'll just 0:10:45.800 --> 0:10:50.560 have these general factories. Whether it's UH for malaria, or 0:10:51.160 --> 0:10:55.600 cancer vaccines, and so it's great Maderna and Byron Tech careback. 0:10:56.120 --> 0:11:00.920 These are companies that were founded based on using that 0:11:01.040 --> 0:11:06.360 particular approach. Well, let's take a quick break, everybody, and 0:11:06.400 --> 0:11:28.680 we will be right back with Bill Gates. How closely? 0:11:28.800 --> 0:11:31.080 And I think the answer I want to hear is 0:11:31.080 --> 0:11:34.200 that we've never seen a response like this as far 0:11:34.240 --> 0:11:38.480 as sharing of research. But how closely is the international 0:11:38.520 --> 0:11:43.040 research community working together? And have we seen anything like this? No, 0:11:43.160 --> 0:11:46.200 it's quite novel. Um. And what we're gonna have is 0:11:47.920 --> 0:11:50.800 the company who invents a vaccine is going to allow 0:11:51.920 --> 0:11:56.160 other companies to use their factories to do the manufacturer. 0:11:56.760 --> 0:12:01.040 So we scale up very quickly to this billions of doses. 0:12:01.600 --> 0:12:04.000 And that's never been done before. And so we're our 0:12:04.080 --> 0:12:07.320 foundation because we have a lot of that expertise, people 0:12:07.800 --> 0:12:10.800 who have spent their careers at these private sector companies. 0:12:11.800 --> 0:12:15.360 We're able to broker through our relationships with the companies 0:12:15.400 --> 0:12:19.360 and the governments how that works. So, for example, two 0:12:19.360 --> 0:12:24.280 of the companies in India have big capacity, but they're 0:12:24.320 --> 0:12:28.560 unlikely to invent one of these vaccines. But Serum and 0:12:28.640 --> 0:12:33.480 bioe are these two companies, and so we're giving money 0:12:33.520 --> 0:12:37.839 to them and making sure the licensing and cooperation is 0:12:37.920 --> 0:12:42.400 such that they can latch onto whichever of the other 0:12:42.480 --> 0:12:47.000 companies work looks promising and be there to to make 0:12:47.040 --> 0:12:50.400 a lot of the volume. So yes, I'm very pleased 0:12:51.040 --> 0:12:53.800 with the cooperation. We didn't practice for this the way 0:12:53.840 --> 0:12:57.400 we should have, either the governments or the private sector. 0:12:57.520 --> 0:13:02.160 But uh, you know, my days are mostly those conversations 0:13:02.720 --> 0:13:08.080 which everybody has a good attitude. Uh. You know, very 0:13:08.080 --> 0:13:11.280 few people are being greedy about this, most being willing 0:13:11.320 --> 0:13:15.600 to do things in a very novel high speed way. Now, 0:13:15.920 --> 0:13:18.280 just follow up on that. It seems to me as 0:13:18.320 --> 0:13:21.600 an optimist, that that could present a new way forward 0:13:22.080 --> 0:13:25.920 for humanity, for things to work together on things that 0:13:25.920 --> 0:13:30.400 aren't necessarily uh COVID nineteen related. Is that is that 0:13:30.960 --> 0:13:33.040 naive and foolish or or could this be a good 0:13:33.040 --> 0:13:35.840 opportunity for something like that? Well, it's a little bit naive, 0:13:35.920 --> 0:13:44.920 and that the economic comparative of a coronavirus vaccine is 0:13:45.280 --> 0:13:49.880 a stronger market signal than you've ever seen for any disease. 0:13:50.320 --> 0:13:54.960 It's costing economies trillions of dollars. It's you know, the 0:13:55.080 --> 0:13:59.040 US alone has put out already three trillion and relief money, 0:13:59.040 --> 0:14:04.160 and they're talking about additional trillions, and so the net 0:14:04.200 --> 0:14:08.880 gain from being bringing this epidemic to an end in 0:14:09.160 --> 0:14:13.360 economic terms is very clear. Whereas a lot of the 0:14:13.480 --> 0:14:18.120 diseases we need vaccines for are just in poor countries, 0:14:18.440 --> 0:14:21.560 are mostly in poor countries where the rich countries, Like 0:14:21.600 --> 0:14:27.680 tuberculosis or malaria is basically not seen in any rich country, 0:14:27.760 --> 0:14:31.120 so they're the economic comparative isn't great. And that's where 0:14:31.120 --> 0:14:35.240 our foundation, uh you know, for HIV, we and the 0:14:35.360 --> 0:14:37.960 U S governments are the big funders. For milaria, we're 0:14:37.960 --> 0:14:41.920 the big funder. There is no market signal and you know, 0:14:42.280 --> 0:14:44.560 in a way, it's terrible that this disease hit the 0:14:44.640 --> 0:14:48.440 rich world, but whatever, somebody in the rich world gets sick. Wow, 0:14:48.600 --> 0:14:53.960 then uh, you know, resources are put into play in 0:14:54.080 --> 0:15:00.760 a way that is you know, just incredible. So, um, 0:15:02.200 --> 0:15:04.200 I should I feel like I should probably preface this, 0:15:04.280 --> 0:15:07.480 But there are some people you may not be aware 0:15:07.480 --> 0:15:11.200 of this. There are some people who are wary of vaccines, 0:15:12.200 --> 0:15:16.000 and um, there there's a possibility that some people might 0:15:16.040 --> 0:15:20.800 feel wariness toward covid um vaccine in particular because everything 0:15:20.920 --> 0:15:25.800 is is being stepped up as quickly as possible. UM. 0:15:25.800 --> 0:15:27.680 And one of the things that I've run into is 0:15:28.000 --> 0:15:31.040 this idea that um, it might not even work. That 0:15:31.120 --> 0:15:33.160 you know, sometimes you go in for a flu vaccine 0:15:33.560 --> 0:15:36.240 and you still get the flu that year. Um. Can 0:15:36.280 --> 0:15:38.440 you kind of talk about how how that differs and 0:15:38.480 --> 0:15:41.360 how it would be more effective than say, like your 0:15:41.360 --> 0:15:44.320 average flu vaccine, how the two are different. Yeah, there's 0:15:44.360 --> 0:15:48.480 two problems with the flu vaccine. One is that there 0:15:48.480 --> 0:15:53.320 are multiple varieties of flu that circulate, and as you 0:15:53.360 --> 0:15:59.120 get into flu season, we try by going to China, 0:15:59.200 --> 0:16:04.320 where most flues originate, to sample what's there and make 0:16:05.600 --> 0:16:09.080 a two or three components seasonal flu vaccine, but we 0:16:09.240 --> 0:16:14.000 often miss the strain that UH is most prevalent during 0:16:14.000 --> 0:16:17.520 a season, and the way those flu vaccines are made, 0:16:17.960 --> 0:16:22.720 they're not very effective and elderly people. And that's really 0:16:22.800 --> 0:16:27.680 bad because the flu mostly kills old people very similar 0:16:27.920 --> 0:16:34.440 in the age profile two COVID. And so here we 0:16:34.520 --> 0:16:37.240 are in the trials for this vaccine making sure it 0:16:37.280 --> 0:16:40.480 works well and old people, because otherwise the sickness protection 0:16:40.520 --> 0:16:44.920 thing is almost useless. But flu is very difficult. It's 0:16:45.000 --> 0:16:50.040 constantly emerging in new forms and reassorting this disease. There's 0:16:50.120 --> 0:16:55.600 one target. The genetic variation is very, very minor, So 0:16:55.640 --> 0:17:00.400 the vaccine will be able to target every coronavirus that 0:17:00.440 --> 0:17:03.400 we've seen, and once we get rid of it, it 0:17:03.520 --> 0:17:09.600 won't be crossing over into humans on a regular basis. Uh. 0:17:09.800 --> 0:17:12.199 You know, we could go a long long time before 0:17:12.800 --> 0:17:15.240 we would ever see it again, and then we'll have 0:17:15.400 --> 0:17:22.760 surveillance and catch it when it's small numbers. Now, you know, 0:17:22.880 --> 0:17:25.080 it's important to talk about vaccines. I think that's the 0:17:25.160 --> 0:17:28.800 sort of um carrot dangling in front of the world. 0:17:29.400 --> 0:17:32.840 But what about therapeutics. I know that's something that we 0:17:32.920 --> 0:17:36.080 don't hear enough of probably in the news. Where where 0:17:36.080 --> 0:17:39.880 are we with therapeutics and where can we go with therapeutics? Well, 0:17:39.920 --> 0:17:45.119 the doctors are way better at treating COVID patients now 0:17:45.760 --> 0:17:49.960 than at the start. They're not as overloaded. They realize 0:17:50.040 --> 0:17:53.160 that you don't use the ventilator nearly as much because 0:17:53.200 --> 0:17:56.439 it has bad side effects. They use oxygen earlier, they 0:17:56.520 --> 0:18:01.119 use the chrome position. The two drugs that are being 0:18:01.200 --> 0:18:05.040 used ramdasevere, which is an anti viral, and Dexi methos on, 0:18:05.119 --> 0:18:06.920 which was proven out in a trial we funded in 0:18:06.920 --> 0:18:12.360 the UK is a immune modulator. There are two other 0:18:12.400 --> 0:18:18.320 anti virals that are actually as promising as ramdasevere and 0:18:18.560 --> 0:18:23.400 actually could be used orally, which is much easier. There's 0:18:23.480 --> 0:18:28.600 monoclonal antibodies where uh dozens of companies are working on that, 0:18:28.640 --> 0:18:32.040 but Regeneran, Eli, Lilly and Astro Seneca have the three 0:18:32.800 --> 0:18:37.520 that are leading the way there. And you know, by 0:18:37.520 --> 0:18:40.520 the time we get more anti virals, monclone antibodies and 0:18:40.720 --> 0:18:45.000 some improved immune modulators, we could cut the death rate 0:18:45.600 --> 0:18:52.520 by eight to nine. And testing therapeutics is easier because 0:18:52.520 --> 0:18:55.679 you just take a few hundred sick people and if 0:18:55.720 --> 0:18:59.359 you're going to have substantial results, you you know, a 0:18:59.480 --> 0:19:04.080 hundred at the intervention a hundred don't uh, you'll see, 0:19:04.520 --> 0:19:09.560 you know, significant variance between those and so yes, the 0:19:09.760 --> 0:19:13.960 death rate will come down quite a bit, well before 0:19:14.560 --> 0:19:17.439 we get the vaccine out in the large numbers to 0:19:17.760 --> 0:19:22.640 stop dropping the case numbers. Great um, Bill, you kind 0:19:22.640 --> 0:19:26.680 of referenced a point in time that is on everyone's mind, 0:19:26.680 --> 0:19:29.040 but I think it seems kind of amorphous, which is 0:19:29.520 --> 0:19:34.679 the point where we have viable vaccine and good treatments. 0:19:35.080 --> 0:19:38.760 What does the world with coronavirus look like after that, 0:19:38.840 --> 0:19:41.320 does it just like disappeared, does it hit a reservoir, 0:19:41.359 --> 0:19:44.359 does it come back seasonally? What? What is what is 0:19:44.400 --> 0:19:46.280 it going to look like? And then how far off 0:19:46.560 --> 0:19:50.680 are we from that goal of reaching that that world. 0:19:52.280 --> 0:19:57.720 If we get this cheap vaccine um and it's not 0:19:57.800 --> 0:20:02.639 only safe, but everybody uh knows that it's safe, so 0:20:02.640 --> 0:20:06.520 they're willing in large numbers to take the vaccine. And 0:20:06.560 --> 0:20:10.199 if we get the generosity that the rich countries are 0:20:11.200 --> 0:20:16.240 along with our foundation are funding the vaccine so it's 0:20:16.359 --> 0:20:20.840 uh available even in the developing countries, we can truly 0:20:20.880 --> 0:20:25.960 bring this into an end where it won't be coming back. Uh, 0:20:26.119 --> 0:20:29.920 You'll get rid of all the pockets the disease or 0:20:30.040 --> 0:20:32.240 in you'll be willing to go to big public events 0:20:32.840 --> 0:20:35.959 and then will monitor to see if it if something 0:20:36.040 --> 0:20:39.919 similar is crossing over and catch that very quickly. We 0:20:40.000 --> 0:20:43.560 might not hang around with bats quite as much uh 0:20:43.680 --> 0:20:49.680 as we do now. Uh these live markets where uh 0:20:49.720 --> 0:20:55.000 this crossover almost certainly took place. But you know, I'm 0:20:55.359 --> 0:20:59.040 spending a lot of time getting the US to provide 0:20:59.119 --> 0:21:03.280 money to help buy the vaccine for other countries. Historically, 0:21:03.280 --> 0:21:05.840 the US has been super generous. You know, we we 0:21:06.000 --> 0:21:10.359 drove smallpox eradication, we fund the polio effort that's near 0:21:10.720 --> 0:21:14.520 to completion on HIV and malaria. We've been super generous here. 0:21:15.520 --> 0:21:19.800 The leadership has been distracted and not wanting to talk 0:21:19.840 --> 0:21:22.320 about the epidemics, so we haven't gotten the money yet. 0:21:22.359 --> 0:21:27.600 But I'm optimistic that'll get solved by the Congress because 0:21:27.600 --> 0:21:30.720 it's hitting both people. It's hitting both the bleeding hearts 0:21:30.720 --> 0:21:33.359 you care about human lives, and it's hitting both the 0:21:33.440 --> 0:21:36.480 hard cases you care about the bottom line. Huh, it's 0:21:38.280 --> 0:21:42.919 the humanitarian argument, the strategic argument of not creating a 0:21:43.000 --> 0:21:47.680 vacuum for China and others, and the selfish argument of hey, 0:21:47.880 --> 0:21:50.800 we don't want it coming back again and again. You know, 0:21:50.880 --> 0:21:54.280 countries like Australia, South Korea that did a competent job, 0:21:54.880 --> 0:21:58.560 even they have found it hard that everybody was coming 0:21:58.600 --> 0:22:02.199 into the country potentially can start up a chain of 0:22:02.240 --> 0:22:06.560 infection again. So uh, you know, they're doing great, but 0:22:07.320 --> 0:22:10.080 they have to keep fighting and fighting and and doing 0:22:10.160 --> 0:22:14.520 local shutdowns. Whereas if if they the rest of the 0:22:14.520 --> 0:22:18.400 world had done what they've done, you know, they they 0:22:18.400 --> 0:22:24.240 could go and and have their economy in a normal state. Yeah, 0:22:24.280 --> 0:22:27.879 you know, you mentioned the live markets and the crossover 0:22:28.000 --> 0:22:32.560 and sort of the problems with that. What um, what 0:22:32.640 --> 0:22:34.760 does that future look like? And what can we do 0:22:34.840 --> 0:22:38.160 about it? As Americans? Are we working with China? Are 0:22:38.200 --> 0:22:40.800 they willing to close these things down? Like? How is 0:22:40.800 --> 0:22:44.600 all that going to work? Yeah? A lot of species 0:22:44.600 --> 0:22:50.480 of bats are there south of Wuhan uh, and you know, 0:22:50.520 --> 0:22:54.640 the cross protection from related cornervirces may explain why vietnamal 0:22:54.680 --> 0:22:57.240 that they've certainly done a good job. You know, they 0:22:57.400 --> 0:23:02.080 just had their first death, and so coronaviruses do come out, 0:23:02.600 --> 0:23:07.119 and if you're looking with modern tools, you'll see it 0:23:07.160 --> 0:23:11.040 when the numbers are very small. So those uh, you know, 0:23:11.320 --> 0:23:14.560 making sure the exposures to bats are reduced, it reduced, 0:23:14.560 --> 0:23:18.480 and that the surveillance is very strong. And then once 0:23:18.520 --> 0:23:22.600 you see meaningful spread, then kicking up a sort of 0:23:22.680 --> 0:23:26.679 what I call mega testing diagnostic capability that is all 0:23:26.880 --> 0:23:32.520 very doable and and so we won't suffer from a 0:23:32.640 --> 0:23:35.720 coronavirus being widespread like this again, we will really have 0:23:35.800 --> 0:23:41.120 our act together for pretty modest level of resources. Chuck, 0:23:41.160 --> 0:23:43.200 I have one last question. Do you have any anymore? 0:23:44.160 --> 0:23:46.840 I got one more, but you go first. Okay, well, 0:23:46.880 --> 0:23:49.520 well my bill was um, and I'm presuming here. I 0:23:49.560 --> 0:23:51.720 hope I'm not overly presuming that it's okay for me 0:23:51.800 --> 0:23:54.040 to call you Bill. Sure at this point, Okay, I 0:23:54.080 --> 0:23:58.639 probably should have verified that before. But UM, what I 0:23:58.680 --> 0:24:03.760 think people are there's like an inherent suspicion or suspiciousness 0:24:03.800 --> 0:24:07.200 that I think people can can kind of lean towards 0:24:07.240 --> 0:24:11.480 when they encounter a mind bogglingly wealthy person who um, 0:24:11.640 --> 0:24:15.440 wants to help eradicate disease around the world and uses 0:24:15.480 --> 0:24:18.520 their money for that end. Um, So what is it 0:24:18.600 --> 0:24:21.280 that that interested you that kind of took you from 0:24:21.320 --> 0:24:26.280 you know, uh, pioneering computers to pioneering eradicating disease around 0:24:26.280 --> 0:24:28.680 the world. What was that was that Melinda's influence? Was 0:24:28.720 --> 0:24:31.400 that something that you've always been interested in? What? What? 0:24:31.400 --> 0:24:36.160 What's the deal? Well, like your listeners, I I'm curious 0:24:36.200 --> 0:24:42.840 to understand things. And so as I was uh starting 0:24:42.880 --> 0:24:45.879 to wind down, uh and spend a little bit less 0:24:46.160 --> 0:24:51.080 time on my Microsoft work, I was reading. I was thinking, Okay, 0:24:51.080 --> 0:24:55.240 how can I give this wealth back to society? Uh? 0:24:55.280 --> 0:25:00.080 And I was learning about what kills children and I 0:25:00.160 --> 0:25:04.919 was stunned that there were diseases that we had solutions for, 0:25:05.040 --> 0:25:09.080 we had vaccines for, but uh, millions would die of 0:25:09.080 --> 0:25:13.440 those diseases because they weren't affordable to the poor countries, 0:25:13.480 --> 0:25:17.000 even though the cost of manufacturer was very, very low. 0:25:17.760 --> 0:25:21.840 And so I saw that Melinda and I could focus 0:25:21.880 --> 0:25:26.560 on global health and get the death rate down, which 0:25:26.600 --> 0:25:31.240 amazingly encounterintuitively reduces population growth because parents, when they know 0:25:31.359 --> 0:25:35.560 their kids are likely to survive, have less children. And 0:25:35.640 --> 0:25:40.120 so that quest, you know, which involved creating this gobby 0:25:40.760 --> 0:25:45.640 organization to help buy the vaccines. Overall, the under five 0:25:45.680 --> 0:25:48.480 death rate has gone from ten percent now down to 0:25:48.560 --> 0:25:53.919 about five globally, and you know, so that's you know, 0:25:54.040 --> 0:25:57.360 that's mind blowing. It was over ten million children here 0:25:57.400 --> 0:26:01.680 now less than then five million a year, and we 0:26:01.720 --> 0:26:04.320 have a clear path with a few new vaccines to 0:26:04.400 --> 0:26:07.560 get down to two and a half million two and 0:26:07.600 --> 0:26:11.200 a half percent. Uh, and even rich countries are close 0:26:11.240 --> 0:26:13.240 to one percent. So you're getting pretty close to the 0:26:13.320 --> 0:26:17.240 kind of equity that any child point anywhere, their life 0:26:17.320 --> 0:26:21.080 is treated as having value. Now on this journey, you 0:26:21.080 --> 0:26:23.320 you know, I've gotten to learn about the immune system 0:26:23.480 --> 0:26:27.760 and meet great scientists, and so I love the work. Uh, 0:26:27.880 --> 0:26:30.159 you know, it gives purpose to how we take the 0:26:30.200 --> 0:26:32.960 Microsoft money and get it back out to the world 0:26:34.080 --> 0:26:38.959 because we don't need it for our consumption. And you know, 0:26:39.000 --> 0:26:41.679 so this work in partnership with me Linda has been 0:26:41.960 --> 0:26:46.240 a great joy to me. Uh So, I guess in 0:26:46.320 --> 0:26:49.600 finishing up, I mean, you know, you've been pretty busy 0:26:49.920 --> 0:26:54.200 being Bill Gates Superhero during this time. I'm curious though 0:26:54.240 --> 0:26:56.920 about you know, you've been locked down like the rest 0:26:56.960 --> 0:26:59.480 of us. What's what is Bill Gates human being been doing? 0:27:00.359 --> 0:27:01.960 Have you had any fun? What have you guys been doing? 0:27:02.000 --> 0:27:04.240 What have you been up to? Well, you know, in 0:27:04.240 --> 0:27:06.920 a way, Uh, I don't know what the kids think, 0:27:06.920 --> 0:27:09.560 but we've got more time with our kids than we 0:27:09.600 --> 0:27:13.320 would have expected, including one that's at medical school, one 0:27:13.359 --> 0:27:18.920