Bill Gates says COVID-19 pandemic not over, advocates health systems strengthening

CO-CHAIR of the Bill and Melinda Gates Foundation, Bill Gates has said that the COVID-19 pandemic has brought to the fore, the need for governments to do more, including strengthening health systems warming that the pandemic is not over.

He observed that with distributed manufacturing and better regulation, some vaccines like the malaria, tuberculosis (TB) and Human Immuno-deficiency Virus (HIV) vaccines could be produced in Africa.

According to him, there is need to knock mosquito populations down before the foundation could possibly do eliminations in the tougher areas, including the Democratic Republic of Congo (DRC) and Nigeria.

Speaking during a virtual Pan-Africa Roundtable Press Conference on his book, “How to Prevent the Next Pandemic”, Bill Gates noted that the world may have to take a yearly respiratory vaccine that would include both flu and the latest for the coronavirus adding that there’s a big expense of putting that type of yearly vaccination in, including the elderly who are most at risk. He noted that new variants of Covid-19 will come along and how severe they will be is hard to predict.

Gates lamented that the entire world has probably 60 per cent to 80 per cent COVID-19 infection, which is mind blowing adding that as variants come along, that means the likelihood of severe sickness and death, that it’s not going to be as acute as it was in these big waves.

He said, “We’re still learning about variants and many of these things I talk about, like getting diagnostic machines up broadly, getting the therapeutics out broadly, those things apply to this pandemic, and we should design a system that’ll work not just for this one, but for the future threats as well.

Gates also observed that to stop pandemics, it is important for the global community to give priority attention to diagnostics are way more important. It’s only once the pandemic gets out of control that then you go to vaccines.

He stated that disease-modeling work carried out the Gates Foundation showed that it is going to be hard to get rid of malaria, and that’s partly the reason the foundation advocates for tools like Gene Drive that can reduce Anopheles mosquito populations.

He said, “Our simulation shows we really need to knock, at least for about three years, knock the mosquito populations down before we could possibly do eliminations in the tougher areas, including the Democratic Republic of Congo (DRC) and Nigeria. The disease modeling work that the Gates Foundation funds, started because of our work in malaria and polio. We wanted to know where we were going to get polio outbreaks, and we wanted to understand what set of interventions would lead to actual successful malaria eradication. A lot of failed efforts at malaria eradication had taken place in the past. And so, we thought only by having really strong models for this would we understand what was necessary”.

“Now, we’ve generalized those models to things like HIV and TB. We’ve made those open source, and we have a lot of collaborators in Africa who take the base model work we do and they put their data in, their assumptions in. And so, particularly in HIV and TB, we’ve had some great collaboration. With malaria, some of that’s with Swiss Tropical.”

He noted that the foundation is the biggest investor in African regulatory capacity, both to approve drugs and eventually to be able to review drug manufacturing as well. Regulatory has been tough. We’ve been trying to get – the dream would be to have continent-wide regulatory alignment, but that’s been too difficult. What we’ve been funding is more regional alignment. We’ve been at that for now over 15 years and made some progress on both regulatory quality and alignment. There’s a lot more to do with that, which would be a necessary step to have the ideal situation, including the ability to look at manufacturing quality.

On the possibility of Africa achieving self-sustenance and health security when it still has to rely on donor-funded, aid-funded vaccines for its citizens, Bill Gates said, “It is key to note that right now, the world has way more COVID vaccine supply than there is demand for COVID vaccines. In fact, even if the world could achieve 100% coverage, we have too much manufacturing capacity. Because so many of the vaccines succeeded, a number were funded, expecting maybe two-thirds of them would fail, most of them ended up being very good vaccines for severe disease and death. They did not end up being perfect vaccines to block infection. We’re working on a second generation of vaccines that have better duration, better infection protection and better breadth against new variants.

“And so, because building up regulatory capacity in vaccine factories is like a decade-long thing, it was never very likely that, starting from scratch during the pandemic, that a new site would make any contribution to the global vaccine availability. In fact, Serum actually shut down their COVID vaccine manufacturing because there are simply no orders and there’s a lot of vaccines expiring all over the world. The limit to vaccine vaccination is not supply. It is demand and logistics of getting this huge number of vaccines, which at least in some respects are very, very good. At the Gates Foundation, we do things to fund African science. We do things like agricultural productivity things or nutrition things that will play a role in improving productivity, and therefore, over time, economic strength. I’m not sure every country should make everything itself. I think there will still be intercontinental trade for some things, but the path forward is better regulatory science, better understanding of where the new market opportunities are.”