A conversation with Bill Gates on how public health has fared in pandemic – Boston, Massachusetts

Boston, Massachusetts 2021-09-13 23:00:45 –

NSOf course, the Covid-19 pandemic has been devastating over the past year.But by other means of public health, the year was not perfect To be miserable As Bill Gates and Melinda French Gates were afraid when they wrote their annual report in 2020.

That doesn’t mean that the first year of the Covid pandemic wasn’t difficult.

Foundation 2021 Goalkeeper ReportPublished late Monday, it shows that another 10 million children around the world did not receive the major pediatric vaccine last year due to public health service disruptions. An additional 31 million people were driven into extreme poverty by the pandemic. Women’s employment is also expected to decline by 13 million worldwide this year compared to 2019.


Covid-19 deepened what was already a deep gap between the rich and the poor, Bill Gates told STAT.

“All aspects of inequality — rich and poor in the United States, central and suburban schools, blacks and whites, rich and middle-income earners, and low-income earners. [countries] — This exacerbated every aspect of the inequality I could think of, ”said Gates.


Gates spoke to STAT as part of an extensive interview that coincided with the release of the goalkeeper report. The excerpt from the interview has been lightly edited for clarity and length.

What are your biggest concerns in this year’s goalkeeper report?

Of greatest concern is the economic situation in low-income countries. Their economic losses are so high that they cannot stimulate the economy like most wealthy and some middle-income countries do. And debt levels are rising. Therefore, borrowing is restricted. That was true before the pandemic, but now it’s even worse.

Therefore, in a sense, the number of extreme poverty is the most depressing number. And world trade, tourism to low-income countries—all of this, but the level of activity will still be low in the coming years. This is especially true if Covid is still in circulation in these low-income countries, making it difficult for people to get in and out just to limit the spread of the disease.

Until the advent of the Delta variant, low-income countries … for a variety of reasons, weren’t as terrible as almost all middle-income and developed countries. Young age, outdoor work, and … many people are in rural areas.Well, it’s not yet miserable in most African places, but when you look Institute for Health Metrics The numbers predict that there will be a significant number of deaths. So they will be hit most hard on the tail.

Some things didn’t work as we expected. NS [non-Covid] Previously, vaccination coverage had dropped by only 7%, but we predicted it could drop by 14%. We predicted that malaria deaths could increase significantly, but in reality they were flat. [treated] Bed net out.World Fund [to Fight AIDS, Tuberculosis and Malaria] I did a very good job on that. But economic figures are like the ultimate measure that poor countries have experienced a very terrible epidemic on the basis of economic factors alone.

Your foundation focuses on positives and always seeks to encourage people to make a difference by emphasizing positives rather than negatives.But last week Annual report With the emergence of the World Fund, it has made some of the metrics in your report much more disastrous. Have you ever wondered if focusing on the positives downplays the urgency of the situation?

There are trade-offs. Unless you explain the progress the world has made in reducing poverty and reducing child mortality, you are not really drawing the exact picture.

There is really good news there. And if you give only bad news-it’s both health and climate, and sometimes it’s the way the message is delivered-people may think, well, it’s hopeless, I’m all of these Should be ignored.

So I think it’s pretty well balanced. But now, with delta waves, we must admit that it’s not over yet. And we couldn’t get the vaccine where we needed it.

Did you think you were closer to the end of the acute phase of the pandemic than at this point?

There are two big things that made things not farther than I expected. One is that many vaccines took a long time to launch large-scale production. This includes Novavax and Johnson & Johnson. I’m not blaming those companies by any means. This is difficult and new. So it’s very complicated. In retrospect, I was too optimistic about increasing the amount of these vaccines.

And the second is the delta variant. Its transparency is worse than I expected, depending on how well it replicates in the airways. And these are two major things that have delayed modifying the vaccine supply side. However, even after it has been resolved, it will be resolved in the next 6 months, but there are delivery logistics that are very difficult in low-income countries.

The report calls inequality in vaccine distribution between high-income and low- and middle-income countries “serious moral anger.” It also explains the need to build capacity in different parts of the world. But that’s the next pandemic solution. How will the problem be resolved?

If the supply is modified in the next 6 months, the amount of all vaccines will increase. [But] Now some people are getting noisy. Then we’ll see who is willing to take AstraZeneca and who is willing to take the Chinese vaccine. If everyone wants to wait only for mRNA, it pushes supply challenges further into the future.

However, it quickly hits logistics and demand limits. That’s why the Foundation sees places with low coverage of regular immunity, such as places like Nigeria and the Democratic Republic of the Congo, joins and builds now, and adopts some of the tactics used in polio. And use them to increase capacity. But as you know, the demand is not that great. This is partly because the epidemic wasn’t so bad. It’s a paradox. If done well, there will be less demand.

You mentioned polio, but I’m wondering. Are you worried about what’s happening in Afghanistan and the potential to eventually eradicate wild polio?

Wild polio exists only in Pakistan and Afghanistan. And in fact, the number of cases in both countries is currently quite low, partly because the restriction of coronavirus has also reduced polio infections. So I don’t know how people can get vaccinated in Afghanistan, which is a very uncertain situation, but it can be a big problem.

And we can see that we have a good relationship with the government and they have very few cases and are very grateful to polio. [campaign] Infrastructure has emerged to support Covid’s pandemic. So, in a sense, they really want to finally get rid of that kind of dirt in Pakistan. That is, they are one of the last two countries. So I can’t give you a lot of visibility about Afghanistan, but I know the situation in Pakistan is pretty hopeful.

And we’re talking to the US government to increase the amount, double the amount actually invested in it, and raise it to the same level as the Foundation (more than $ 400 million a year). To date, the United States has invested about $ 200 million annually.

I think we can succeed in the next three years.But the pandemic was a big setback..

When we talked about the goalkeeper report last year, we asked you about your thoughts on the US response to a pandemic.You explain it as follows shocking.. What do you think about the current US response?

Even if we are at the forefront of all vaccines, it is still embarrassing that the United States is currently far behind most Western European countries due to demand issues...

Is it because of vaccine repellent?

Yeah — I call it demand.

Now that Delta is here, it means that there are many older people, some of them have a weak immune system, or just those who choose not to be vaccinated are at risk. Being exposed. And that’s too bad. When we show the number of deaths, we should show every day that it is unvaccinated and overwhelmingly dead.

So in the US situation, nothing is as good as we want. And of course, people are fed up with really bad things, such as not going to school. So we’re going to school, which I happen to agree with.

But they are tired of mask compliance. It’s a shame because the inconvenience of the mask isn’t that great, but it’s a kind of magical tool. We have talked with many pharmaceutical companies about a new class of inhalation blockers that not only reduce infections, but also prevent infections and illnesses. In fact, even the best inhalation blockers only match what a mask can do. Masks are a very effective intervention, although they may be more accepted now. But, as you know, the tiredness of people and the lack of a clear message about them means that this fall will be tougher than it should be.

Last question: Has the United States taken the test correctly?

We couldn’t do the test correctly. There is an innovative toolbox solution for diagnostics. And I’m a little surprised that the United States wasn’t more aggressive about them.

Same as the cure. The ability to prove that things don’t work and that things work isn’t very well coordinated. And there are still some good ideas that the idea of ​​how to coordinate these tests so that such things can be done quickly is necessary for both this pandemic and the next pandemic. I have.

A conversation with Bill Gates on how public health has fared in pandemic Source link A conversation with Bill Gates on how public health has fared in pandemic

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