-
Chris Anderson: Welcome, Bill Gates.
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Bill Gates: Thank you.
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CA: Alright. It's great
to have you here, Bill.
-
You know, we had a TED conversation
about three months ago
-
about this pandemic,
-
and back then, I think fewer than --
I think that was the end of March --
-
back then, fewer than
1,000 people in the US had died,
-
and fewer than 20,000 worldwide.
-
I mean, the numbers now are,
like, 128,000 dead in the US
-
and more than half a million worldwide,
-
in three months.
-
In three months.
-
What is your diagnosis of what is possible
for the rest of this year?
-
You look at a lot of models.
-
What do you think best-
and worst-case scenarios might be?
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BG: Well, the range of scenarios,
sadly, is quite large,
-
including that, as we get into the fall,
-
we could have death rates
that rival the worst of what we had
-
in the April time period.
-
If you get a lot of young people infected,
-
eventually, they will infect
old people again,
-
and so you'll get into the nursing homes,
-
the homeless shelters,
-
the places where we've had
a lot of our deaths.
-
The innovation track,
which probably we'll touch on --
-
diagnostics, therapeutics, vaccines --
-
there's good progress there,
-
but nothing that would
fundamentally alter the fact
-
that this fall in the United States
could be quite bad,
-
and that's worse than
I would have expected a month ago,
-
the degree to which we're back
at high mobility,
-
not wearing masks,
-
and now the virus actually
has gotten into a lot of cities
-
that it hadn't been in before
in a significant way,
-
so it's going to be a challenge.
-
There's no case where we get
much below the current death rate,
-
which is about 500 deaths a day,
-
but there's a significant risk
we'd go back up
-
to the even 2,000 a day
that we had before,
-
because we don't have the distancing,
-
the behavior change,
-
to the degree that we had
in April and May.
-
And we know this virus
is somewhat seasonal,
-
so that the force of infection,
-
both through temperature, humidity,
more time indoors,
-
will be worse as we get into the fall.
-
CA: So there are scenarios
where in the US,
-
like, if you extrapolate
those numbers forward,
-
we end up with, what,
-
more than a quarter of a million
deaths, perchance,
-
even this year if we're not careful,
-
and worldwide, I guess the death toll
could, by the end of the year,
-
be well into the millions, with an "s."
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Is there evidence that the hotter
temperatures of the summer
-
actually have been helping us?
-
BG: They're not absolutely sure,
-
but certainly, the IHME model
definitely wanted to use the season,
-
including temperature and humidity,
-
to try and explain
why May wasn't worse than it was.
-
And so as we came out
and the mobility numbers got higher,
-
the models expected more infections
and deaths to come out of that,
-
and the model kept wanting to say,
-
"But I need to use this seasonality
-
to match why May wasn't worse,
-
why June wasn't worse than it was."
-
And we see in the Southern Hemisphere,
-
you know, Brazil,
-
which is the opposite season,
-
now all of South America
is having a huge epidemic.
-
South Africa is having
a very fast-growing epidemic.
-
Fortunately, Australia and New Zealand,
-
the last countries
in the Southern Hemisphere,
-
are at really tiny case counts,
-
and so although they have
to keep knocking it down,
-
they're talking about,
"Oh, we have 10 cases,
-
that's a big deal,
let's go get rid of that."
-
So they're one of these amazing countries
that got the numbers so low
-
that test, quarantine and trace
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is working to get them,
keep them at very near zero.
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CA: Aided perhaps a bit
by being easier to isolate
-
and by less density,
less population density.
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But nonetheless,
smart policies down there.
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BG: Yeah, everything is so exponential
-
that a little bit of good work
goes a long way.
-
It's not a linear game.
-
You know, contact tracing, if you have
the number of cases we have in the US,
-
it's super important to do,
-
but it won't get you back down to zero.
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It'll help you be down,
-
but it's too overwhelming.
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CA: OK, so in May and June in the US,
-
the numbers were slightly better
than some of the models predicted,
-
and it's hypothesized that that might be
partly because of the warmer weather.
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Now we're seeing, really,
would you describe it
-
as really quite alarming upticks
in case rates in the US?
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BG: That's right, it's --
-
In, say, the New York area,
-
the cases continue to go down somewhat,
-
but in other parts of the country,
-
primarily the South right now,
-
you have increases
that are offsetting that,
-
and you have testing-positive
rates in young people
-
that are actually higher than what we saw
even in some of the tougher areas.
-
And so, clearly, younger people
have come out of mobility
-
more than older people
have increased their mobility,
-
so the age structure
is right now very young,
-
but because of
multigenerational households,
-
people work in nursing care homes,
-
unfortunately, that will
work its way back,
-
both the time lag and the transmission,
-
back up into the elderly,
-
will start to push the death rate back up,
-
which, it is down --
-
way down from 2,000
to around 500 right now.
-
CA: And is that partly because
there's a three-week lag
-
between case numbers and fatality numbers?
-
And also, perhaps, partly because
-
there have been
some effective interventions,
-
and we're actually seeing the possibility
-
that the overall fatality rate
is actually falling a bit
-
now that we've gained
some extra knowledge?
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BG: Yeah, certainly
your fatality rate is always lower
-
when you're not overloaded.
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And so Italy, when they were overloaded,
-
Spain, even New York at the start,
-
certainly China,
-
there you weren't even able
to provide the basics,
-
the oxygen and things.
-
A study that our foundation
funded in the UK
-
found the only thing
other than remdesivir
-
that is a proven therapeutic,
-
which is the dexamethasone,
-
that for serious patients
-
is about a 20 percent death reduction,
-
and there's still quite
a pipeline of those things.
-
You know, hydroxychloroquine
never established positive data,
-
so that's pretty much done.
-
There's still a few trials ongoing,
-
but the list of things being tried,
-
including, eventually,
the monoclonal antibodies,
-
we will have some additional
tools for the fall.
-
And so when you talk about death rates,
-
the good news is,
some innovation we already have,
-
and we'll have more, even in the fall.
-
We should start to have
monoclonal antibodies,
-
which is the single therapeutic
that I'm most excited about.
-
CA: I'll actually ask you to tell me
a bit more about that in one sec,
-
but just putting the pieces
together on death rates:
-
so in a well-functioning health system,
-
so take the US when places
aren't overcrowded,
-
what do you think
-
the current fatality numbers are,
approximately, going forward,
-
like as a percentage of total cases?
-
Are we below one percent, perhaps?
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BG: If you found every case, yes,
-
you're well below one percent.
-
People argue, you know, 0.4, 0.5.
-
By the time you bring in
the never symptomatics,
-
it probably is below 0.5,
-
and that's good news.
-
This disease could have been
a five-percent disease.
-
The transmission dynamics of this disease
-
are more difficult
than even the experts predicted.
-
The amount of presymptomatic
and never symptomatic spread
-
and the fact that it's not coughing,
-
where you would kind of notice,
"Hey, I'm coughing" --
-
most respiratory diseases make you cough.
-
This one, in its early stages,
it's not coughing,
-
it's singing, laughing, talking,
-
actually, still, particularly
for the super-spreaders,
-
people with very high viral loads,
-
causes that spread,
-
and that's pretty novel,
-
and so even the experts have to say,
"Wow, this caught us by surprise."
-
The amount of asymptomatic spread
-
and the fact that there's not
a coughing element
-
is not a major piece like the flu or TB.
-
CA: Yeah, that is
devilish cunning by the virus.
-
I mean, how much is
that nonsymptomatic transmission
-
as a percentage of total transmission?
-
I've heard numbers it could be
as much as half of all transmissions
-
are basically presymptomatic.
-
BG: Yeah, if you count presymptomatics,
-
then most of the studies show
that's like at 40 percent,
-
and we also have never symptomatics.
-
The amount of virus you get
in your upper respiratory area
-
is somewhat disconnected.
-
Some people will have a lot here
and very little in their lungs,
-
and what you get in your lungs
causes the really bad symptoms --
-
and other organs, but mostly the lungs --
-
and so that's when you seek treatment.
-
And so the worst case
in terms of spreading
-
is somebody who's got a lot
in the upper respiratory tract
-
but almost none in their lungs,
-
so they're not care-seeking.
-
CA: Right.
-
And so if you add in the never symptomatic
-
to the presymptomatic,
-
do you get above 50 percent
of the transmission
-
is actually from nonsymptomatic people?
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BG: Yeah, transmission
is harder to measure.
-
You know, we see certain
hotspots and things,
-
but that's a huge question
with the vaccine:
-
Will it, besides avoiding
you getting sick,
-
which is what the trial will test,
-
will it also stop you
from being a transmitter?
-
CA: So that vaccine,
-
it's such an important question,
let's come on to that.
-
But before we go there,
-
any other surprises
in the last couple months
-
that we've learned about this virus
-
that really impact how
we should respond to it?
-
BG: We're still not able to characterize
who the super-spreaders are
-
in terms of what that profile is,
-
and we may never.
-
That may just be quite random.
-
If you could identify them,
-
they're responsible
for the majority of transmission,
-
a few people who have
very high viral loads.
-
But sadly, we haven't figured that out.
-
This mode of transmission,
-
if you're in a room and nobody talks,
-
there's way less transmission.
-
That's partly why,
although planes can transmit,
-
it's less than you would expect
just in terms of time proximity measures,
-
because unlike, say,
a choir or a restaurant,
-
you're not exhaling in loud talking
-
quite as much as in other
indoor environments.
-
CA: Hmm.
-
What do you think about the ethics
of someone who would go on a plane
-
and refuse to wear a mask?
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BG: If they own the plane,
that would be fine.
-
If there's other people on the plane,
-
that would be endangering
those other people.
-
CA: Early on in the pandemic,
-
the WHO did not advise
that people wear masks.
-
They were worried about taking them away
from frontline medical providers.
-
In retrospect, was that
a terrible mistake that they made?
-
BG: Yes.
-
All the experts feel bad
that the value of masks --
-
which ties back somewhat
to the asymptomatics;
-
if people were very symptomatic,
-
like an Ebola,
-
then you know it and you isolate,
-
and so you don't have
a need for a masklike thing.
-
The value of masks,
-
the fact that the medical masks
was a different supply chain
-
than the normal masks,
-
the fact you could scale up
the normal masks so well,
-
the fact that it would stop
that presymptomatic,
-
never symptomatic transmission,
-
it's a mistake.
-
But it's not a conspiracy.
-
It's something that, we now know more.
-
And even now, our error bars
on the benefit of masks
-
are higher than we'd like to admit,
-
but it's a significant benefit.
-
CA: Alright, I'm going to come in
with some questions
-
from the community.
-
Let's pull them up there.
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Jim Pitofsky: "Do you think reopening
efforts in the US have been premature,
-
and if so, how far should the US go
to responsibly confront this pandemic?"
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BG: Well, the question
of how you make trade-offs
-
between the benefits, say,
of going to school
-
versus the risk of people getting sick
because they go to school,
-
those are very tough questions
-
that I don't think
any single person can say,
-
"I will tell you how to make
all these trade-offs."
-
The understanding
of where you have transmission,
-
and the fact that young people
do get infected
-
and are part of the multigenerational
transmission chain,
-
we should get that out.
-
If you just look at the health aspect,
-
we have opened up too liberally.
-
Now, opening up in terms of mental health
-
and seeking normal health things
like vaccines or other care,
-
there are benefits.
-
I think some of our opening up
has created more risk than benefit.
-
Opening the bars up
as quickly as they did,
-
you know, is that critical
for mental health?
-
Maybe not.
-
So I don't think we've been
as tasteful about opening up
-
as I'm sure, as we study it,
-
that we'll realize some things
we shouldn't have opened up as fast.
-
But then you have something like school,
-
where even sitting here today,
-
the exact plan, say,
for inner-city schools for the fall,
-
I wouldn't have a black-and-white view
-
on the relative trade-offs involved there.
-
There are huge benefits
to letting those kids go to school,
-
and how do you weigh the risk?
-
If you're in a city without many cases,
-
I would say probably the benefit is there.
-
Now that means that
you could get surprised.
-
The cases could show up,
and then you'd have to change that,
-
which is not easy.
-
But I think around the US,
-
there will be places
where that won't be a good trade-off.
-
So almost any dimension of inequity,
-
this disease has made worse:
-
job type, internet connection,
-
ability of your school
to do online learning.
-
White-collar workers,
-
people are embarrassed to admit it,
-
some of them are more productive
-
and enjoying the flexibility
that the at-home thing has created,
-
and that feels terrible
-
when you know lots of people
are suffering in many ways,
-
including their kids not going to school.
-
CA: Indeed. Let's have the next question.
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[Nathalie Munyampenda] "For us in Rwanda,
-
early policy interventions
have made the difference.
-
At this point, what policy interventions
do you suggest for the US now?"
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CA: Bill, I dream of the day
where you are appointed
-
the coronavirus czar
-
with authority to actually
speak to the public.
-
What would you do?
-
BG: Well, the innovation tools
-
are where I and the foundation
probably has the most expertise.
-
Clearly, some of the policies
on opening up have been too generous,
-
but I think everybody
-
could engage in that.
-
We need leadership
-
in terms of admitting
that we've still got a huge problem here
-
and not turning that
into almost a political thing
-
of, "Oh, isn't it brilliant what we did?"
-
No, it's not brilliant,
-
but there's many people,
including the experts,
-
where there's a lot
they didn't understand,
-
and everybody wishes a week earlier
whatever action they took,
-
they'd taken that a week earlier.
-
The innovation tools,
-
that's where the foundation's work
-
on antibodies, vaccines,
-
we have deep expertise,
-
and it's outside of the private sector,
-
and so we have kind of a neutral ability
to work with all the governments
-
and the companies to pick.
-
Particularly when you're doing
break-even products,
-
which one should get the resources?
-
There's no market signal for that.
-
Experts have to say, "OK,
this antibody deserves the manufacturing.
-
This vaccine deserves the manufacturing,"
-
because we have very limited
manufacturing for both of those things,
-
and it'll be cross-company,
which never happens in the normal case,
-
where one company invents it
-
and then you're using
the manufacturing plants of many companies
-
to get maximum scale of the best choice.
-
So I would be coordinating those things,
-
but we need a leader
who keeps us up to date,
-
is realistic,
-
and shows us the right behavior,
-
as well as driving the innovation track.
-
CA: I mean, you have
to yourself be a master diplomat
-
in how you talk about this stuff.
-
So I appreciate, almost,
the discomfort here.
-
But I mean, you talk regularly
with Anthony Fauci,
-
who is a wise voice on this
by most people's opinion.
-
But to what extent is he just hamstrung?
-
He's not allowed to play the full role
-
that he could play in this circumstance.
-
BG: Dr. Fauci has emerged
where he was allowed to have some airtime,
-
and even though he was stating
things that are realistic,
-
his prestige has stuck.
-
He can speak out in that way.
-
Typically, the CDC would be
the primary voice here.
-
It's not absolutely necessary,
-
but in previous health crises,
-
you let the experts inside the CDC
-
be that voice.
-
They're trained to do these things,
-
and so it is a bit unusual here
how much we've had to rely on Fauci
-
as opposed to the CDC.
-
It should be Fauci,
who's a brilliant researcher,
-
so experienced, particularly in vaccines.
-
In some ways, he has become,
taking the broad advice
-
that's the epidemiology advice
-
and explaining it in the right way,
-
where he'll admit,
-
"OK, we may have a rebound here,
-
and this is why we need
to behave that way."
-
But it's fantastic that his voice
has been allowed to come through.
-
CA: ... sometimes.
-
Let's have the next question.
-
Nina Gregory: "How are you
and your foundation
-
addressing the ethical questions about
which countries get the vaccine first,
-
assuming you find one?"
-
CA: And maybe, Bill, use this as a moment
-
to just talk about where
the quest for the vaccine is
-
and what are just some of the key things
we should all be thinking about
-
as we track the news on this.
-
BG: There's three vaccines that are,
-
if they work, are the earliest:
-
the Moderna, which unfortunately,
won't scale very easily,
-
so if that works, it'll be mostly
a US-targeted thing;
-
then you have the AstraZeneca,
which comes from Oxford;
-
and the Johnson & Johnson.
-
Those are the three early ones.
-
And we have animal data
-
that looks potentially good
but not definitive,
-
particularly will it work in the elderly,
-
and we'll have human data
over the next several months.
-
Those three will be gated by
the safety and efficacy trial.
-
That is, we'll be able
to manufacture those,
-
although not as much as we want.
-
We'll be able to manufacture those
before the end of the year.
-
Whether the Phase 3 will succeed
-
and whether it'll complete
before the end of the year,
-
I wouldn't be that optimistic about.
-
Phase 3 is where you need
to really look at all the safety profile
-
and efficacy,
-
but those will get started.
-
And then there's four or five vaccines
that use different approaches
-
that are maybe three
or four months behind that:
-
Novavax, Sanofi, Merck.
-
And so we're funding factory capacity
for a lot of these --
-
some complex negotiations
are taking place right now on this --
-
to get factories that will be dedicated
to the poorer countries,
-
what's called low- and middle-income.
-
And the very scalable constructs
-
that include AstraZeneca
and Johnson & Johnson,
-
we'll focus on those,
-
the ones that are inexpensive
-
and you can build a single factory
to make 600 million doses.
-
So a number of the vaccine constructs
-
are potential.
-
I don't see anything
before the end of the year.
-
That's really the best case,
-
and it's down to a few constructs now,
-
which, typically, you have
high failure rates.
-
CA: Bill, is it the case
-
that if you and your foundation
weren't in the picture here
-
that market dynamics would likely
lead to a situation
-
where, as soon as a promising
vaccine candidate emerged,
-
the richer countries
would basically snap up, gobble up
-
all available initial supply --
-
it just takes a while
to manufacture these,
-
and there would be nothing
for the poorer countries --
-
but that what, effectively, you're doing
-
by giving manufacturing
guarantees and capability
-
to some of these candidates,
-
you're making it possible that
at least some of the early vaccine units
-
will go to poorer countries?
-
Is that correct?
-
BG: Well, it's not just us, but yes,
-
we're in the central role there,
-
along with a group we created called CEPI,
Coalition for Epidemic Preparedness,
-
and the European leaders agree with this.
-
Now we have the expertise
to look at each of the constructs
-
and say, "OK, where is there
a factory in the world
-
that has capacity that can build that?
-
Which one should we put
the early money into?
-
What should the milestones be
-
where we'll shift the money
over to a different one?"
-
Because the kind of private sector people
-
who really understand that stuff,
-
some of them work for us,
-
and we're a trusted party on these things,
-
we get to coordinate a lot of it,
particularly that manufacturing piece.
-
Usually, you'd expect the US
to think of this as a global problem
-
and be involved.
-
So far, no activity
on that front has taken place.
-
I am talking to people in the Congress
and the Administration
-
about when the next
relief bill comes along
-
that maybe one percent of that
could go for the tools
-
to help the entire world.
-
And so it's possible,
-
but it's unfortunate,
-
and the vacuum here,
-
the world is not that used to,
-
and a lot of people are stepping in,
including our foundation,
-
to try and have a strategy,
-
including for the poorer countries,
-
who will suffer a high percentage
of the deaths and negative effects,
-
including their health systems
being overwhelmed.
-
Most of the deaths will be
in developing countries,
-
despite the huge deaths we've seen
in Europe and the US.
-
CA: I mean, I wish
I could be a fly on the wall
-
and hearing you and Melinda
talk about this,
-
because of all of the ethical ...
"crimes," let's say,
-
executed by leaders
who should know better,
-
I mean, it's one thing
to not model mask-wearing,
-
but to not play a role
in helping the world
-
when faced with a common enemy,
-
respond as one humanity,
-
and instead ...
-
you know, catalyze a really unseemly
scramble between nations
-
to fight for vaccines, for example.
-
That just seems -- surely, history
is going to judge that harshly.
-
That is just sickening.
-
Isn't it? Am I missing something?
-
BG: Well, it's not quite
as black-and-white as that.
-
The US has put more money out
-
to fund the basic research
on these vaccines
-
than any country by far,
-
and that research is not restricted.
-
There's not, like, some royalty
that says, "Hey, if you take our money,
-
you have to pay the US a royalty."
-
They do, to the degree they fund research,
-
it's for everybody.
-
To the degree they fund factories,
it's just for the US.
-
The thing that makes this tough is that
in every other global health problem,
-
the US totally leads smallpox eradication,
-
the US is totally the leader
on polio eradication,
-
with key partners -- CDC, WHO,
Rotary, UNICEF, our foundation.
-
So the world -- and on HIV,
-
under President Bush's leadership,
but it was very bipartisan,
-
this thing called PEPFAR was unbelievable.
-
That has saved tens of millions of lives.
-
And so it's that the world
always expected the US
-
to at least be at the head of the table,
-
financially, strategy, OK, how do you
get these factories for the world,
-
even if it's just to avoid the infection
coming back to the US
-
or to have the global economy working,
-
which is good for US jobs
-
to have demand outside the US.
-
And so the world is kind of --
-
you know, there's all this uncertainty
about which thing will work,
-
and there's this,
"OK, who's in charge here?"
-
And so the worst thing,
the withdrawal from WHO,
-
that is a difficulty
that hopefully will get remedied
-
at some point,
-
because we need that coordination
-
through WHO.
-
CA: Let's take another question.
-
Ali Kashani: "Are there any
particularly successful models
-
of handling the pandemic
that you have seen around the world?"
-
BG: Well, it's fascinating that,
besides early action,
-
there are definitely things where
you take people who have tested positive
-
and you monitor their pulse ox,
-
which is the oxygen saturation
level in their blood,
-
which is a very cheap detector,
-
and then you know to get them
to the hospitals fairly early.
-
Weirdly, patients don't know
things are about to get severe.
-
It's an interesting physiological reason
that I won't get into.
-
And so Germany has
quite a low case fatality rate
-
that they've done through
that type of monitoring.
-
And then, of course,
once you get into facilities,
-
we've learned that the ventilator,
actually, although extremely well-meaning,
-
was actually overused
and used in the wrong mode
-
in those early days.
-
So the health -- the doctors
are way smarter about treatment today.
-
Most of that, I would say, is global.
-
Using this pulse ox as an early indicator,
-
that'll probably catch on broadly,
-
but Germany was a pioneer there.
-
And now, of course, dexamethasone --
fortunately, it's cheap, it's oral,
-
we can ramp up manufacture.
-
That'll go global as well.
-
CA: Bill, I want to ask you
something about
-
what it's been like for you personally
through this whole process.
-
Because, weirdly, even though
your passion and good intent on this topic
-
seems completely bloody obvious to anyone
who has spent a moment with you,
-
there are these crazy conspiracy theories
out there about you.
-
I just checked in
with a company called Zignal
-
that monitors social media spaces.
-
They say that, to date,
I think on Facebook alone,
-
more than four million posts
have taken place
-
that associate you with some kind
of conspiracy theory around the virus.
-
I read that there was a poll
that more than 40 percent of Republicans
-
believe that the vaccine
that you would roll out
-
would somehow plant a microchip
in people to track their location.
-
I mean, I can't even believe
that poll number.
-
And then some people
are taking this seriously enough,
-
and some of them have even been
recirculated on "Fox News" and so forth,
-
some people are taking this
seriously enough
-
to make really quite horrible
threats and so forth.
-
You seem to do a good job
sort of shrugging this off,
-
but really, like, who else
has ever been in this position?
-
How are you managing this?
-
What on earth world are we in
-
that this kind of misinformation
can be out there?
-
What can we do to help correct it?
-
BG: I'm not sure.
-
And it's a new thing
-
that there's conspiracy theories.
-
I mean, Microsoft had
its share of controversy,
-
but at least that related
to the real world, you know?
-
Did Windows crash more than it should?
-
We definitely had antitrust problems.
-
But at least I knew what that was.
-
When this emerged, I have to say,
-
my instinct was to joke about it.
-
People have said
that's really inappropriate,
-
because this is a very serious thing.
-
It is going to make people
less willing to take a vaccine.
-
And, of course, once we have that vaccine,
-
it'll be like masks,
-
where getting lots of people,
-
particularly when it's
a transmission-blocking vaccine,
-
there's this huge community benefit
-
to widespread adoption of that vaccine.
-
So I am caught a little bit,
-
unsure of what to say or do,
-
because the conspiracy piece
is a new thing for me,
-
and what do you say
-
that doesn't give credence to the thing?
-
The fact that a "Fox News"
commentator, Laura Ingraham,
-
was saying this stuff
about me microchipping people,
-
that survey isn't that surprising
because that's what they heard
-
on the TV.
-
It's wild.
-
And people are clearly seeking
simpler explanations
-
than going and studying virology.
-
CA: I mean,
-
TED is nonpolitical,
-
but we believe in the truth.
-
I would say this:
-
Laura Ingraham, you owe Bill Gates
an apology and a retraction.
-
You do.
-
And anyone who's watching this
-
who thinks for a minute that this man
is involved in some kind of conspiracy,
-
you want your head examined.
-
You are crazy.
-
Enough of us know Bill over many years
-
and have seen the passion
and engagement in this to know
-
that you are crazy.
-
So get over it,
-
and let's look at the actual problem
of solving this pandemic.
-
Honestly.
-
If anyone in the chat here
has a suggestion,
-
a positive suggestion for how you can,
-
how do you get rid of conspiracies,
-
because they feed on each other.
-
Now, oh, well I would say that,
because I'm part of the conspiracy,
-
or whatever.
-
Like, how do we get back to a world
-
where information can be trusted?
-
We have to do better on it.
-
Are there any other questions
out there from the community?
-
Aria Bendix from New York City:
-
"What are your personal recommendations
for those who want to reduce
-
their risk of infection
amid an uptick in cases?"
-
BG: Well, it's great if you have a job
-
that you can stay at your house
and do it through digital meetings,
-
and even some of your social activities,
-
you know, I do video calls
with lots of friends.
-
I have friends in Europe that,
who knows when I'll see them,
-
but we schedule regular calls to talk.
-
If you stay fairly isolated,
-
you don't run much risk,
-
and it's when you're getting together
with lots of other people,
-
either through work or socialization,
-
that drives that risk,
-
and particularly in these communities
where you have increased cases,
-
even though it's not going to be mandated,
-
hopefully, the mobility numbers
will show people responding
-
and minimizing those kind of
out-of-the-house contacts.
-
CA: Bill, I wonder if I could just ask you
-
just a little bit about philanthropy.
-
Obviously, your foundation
has played a huge role in this,
-
but philanthropy more generally.
-
You know, you've started
this Giving Pledge movement,
-
recruited all these billionaires
-
who have pledged to give away
half their net worth
-
before or after their death.
-
But it's really hard to do.
-
It's really hard to give away
that much money.
-
You yourself, I think,
-
since The Giving Pledge was started --
-
what? 10 years ago or something,
I'm not sure when --
-
but your own net worth, I think,
has doubled since that period
-
despite being the world's
leading philanthropist.
-
Is it just fundamentally hard
to give away money effectively
-
to make the world better?
-
Or should the world's donors,
-
and especially the world's
really rich donors,
-
start to almost commit to a schedule,
-
like, "Here's a percentage
of my net worth each year
-
that, as I get older,
-
maybe that goes up.
-
If I'm to take this seriously,
-
I have to give away -- somehow,
I've got to find a way
-
of doing that effectively."
-
Is that an unfair and crazy question?
-
BG: Well, it'd be great to up the rate,
-
and our goal, both as the Gates Foundation
or through The Giving Pledge,
-
is to help people find causes
they connect to.
-
People give through passion.
-
Yes, numbers are important,
-
but there's so many causes out there.
-
The way you're going to pick
is you see somebody who's sick,
-
you see somebody who's not
getting social services.
-
You see something
that helps reduce racism.
-
And you're very passionate,
and so you give to that.
-
And, of course,
-
some philanthropic gifts won't work out.
-
We do need to up the ambition level
of philanthropists.
-
Now, collaborative philanthropy
-
that you're helping to facilitate
through Audacious,
-
there's four or five other groups
that are getting philanthropists together,
-
that is fantastic,
-
because then they learn from each other,
-
they get confidence from each other,
-
they feel like, "Hey, I put in x,
and the four other people put money in,
-
so I'm getting more impact,"
-
and hopefully, it can be made fun for them
even when they find out,
-
OK, that particular gift
didn't work out that well,
-
but let's keep going.
-
So philanthropy, yes,
-
I would like to see the rate go up,
-
and people who do get going,
-
it is fun,
-
it's fulfilling,
-
you pick which of the family members
are partnered in doing it.
-
In my case, Melinda and I
love doing this stuff together,
-
learning together.
-
Some families, it will even
involve the kids in the activities.
-
Sometimes the kids are pushing.
-
When you have lots of money,
-
you still think of a million dollars
as a lot of money,
-
but if you have billions,
-
you should be giving hundreds of millions.
-
So it's kind of charming that,
in terms of your personal expenditure,
-
you stay at the level you were at before.
-
That's societally quite appropriate.
-
But on your giving, you need to scale up
-
or else it will be your will,
-
and you won't get to shape it
and enjoy it quite that same way.
-
And so without --
-
we don't want to mandate it,
-
but yes, both you and I
want to inspire philanthropists
-
to see that passion,
to see those opportunities
-
significantly faster than in the past,
-
because whether it's race or disease,
or all the other social ills,
-
the innovation of what philanthropy
can go to and do quickly
-
that, if it works, government
can come in behind it and scale it up,
-
God knows we need solutions,
-
we need that kind of hope and progress
-
that expectations are high
-
that will solve very tough problems.
-
CA: I mean, most philanthropists,
even the best of them,
-
find it hard to give away more than about
a percent of their net worth every year,
-
and yet the world's richest
often have access
-
to great investment opportunities.
-
Many of them are gaining wealth
at seven to 10 percent plus per year.
-
Isn't it the case that
to have a real chance
-
of giving away half your fortune,
-
at some point you have to plan
to give away five, six, seven, eight,
-
10 percent of your net worth annually?
-
And that is, isn't that the logic
of what should be happening?
-
BG: Yeah, there are people
like Chuck Feeney,
-
who set a good example
and gave away all of his money.
-
Even Melinda and I are talking about,
should we up the rate that we give at?
-
As you say, we've been very lucky
on the investment side
-
through a variety of things.
-
Tech fortunes in general have done well,
-
even this year,
-
which is one of those great contrasts
-
in what's going on in the world.
-
And I do think there's an expectation
that we should speed up,
-
and there's a reason to speed up,
-
and government is going
to miss a lot of needs.
-
Yes, there's tons of government
money out there,
-
but helping it be spent well,
-
helping find places it's not stepping up,
-
and if people are willing to give
to the developing world,
-
they don't have governments
-
that can print checks
for 15 percent of GDP,
-
and so the suffering there broadly,
just the economic stuff alone,
-
put aside the pandemic,
-
is tragic.
-
It's about a five-year setback
-
in terms of these countries
moving forward,
-
and in a few cases, it's tough enough
that the very stability of the country
-
is in question.
-
CA: Well, Bill,
-
I'm in awe of what
you and Melinda have done.
-
You walk this narrow path
-
of trying to juggle
so many different things,
-
and the amount of time that you dedicate
to the betterment of the world at large,
-
and definitely the amount of money
-
and the amount
of passion you put into it --
-
I mean, it's pretty awesome,
-
and I'm really grateful to you
for spending this time with us now.
-
Thank you so much,
-
and honestly, the rest of this year,
-
your skills and resources
are going to be needed more than ever,
-
so good luck.
-
BG: Well, thanks.
-
It's fun work and I'm optimistic,
so thanks, Chris.