0:00:01.079,0:00:03.291 Chris Anderson. Welcome, Bill Gates. 0:00:03.291,0:00:04.688 Bill Gates: Thank you. 0:00:04.688,0:00:06.419 CA: All right. It's great[br]to have you here, Bill. 0:00:06.419,0:00:08.917 You know, we had a TED conversation 0:00:08.917,0:00:10.764 about three months ago[br]about this pandemic, 0:00:10.764,0:00:12.805 and back then I think fewer than -- 0:00:12.805,0:00:13.821 I think that was the end of March -- 0:00:13.821,0:00:16.733 back then, fewer than[br]a thousand people in the US had died, 0:00:16.733,0:00:19.515 and fewer than 20,000 worldwide. 0:00:19.841,0:00:24.824 I mean, the numbers now are,[br]like, 128,000 dead in the US 0:00:24.824,0:00:27.151 and more than half a million worldwide. 0:00:27.151,0:00:28.864 in three months. 0:00:28.864,0:00:30.045 In three months. 0:00:30.045,0:00:35.087 What is your diagnosis of what is possible[br]for the rest of this year? 0:00:35.263,0:00:37.198 You look at a lot of models. 0:00:37.198,0:00:40.957 What do you think best[br]and worst case scenarios might be? 0:00:43.336,0:00:45.782 BG: Well, the range of scenarios, sadly, 0:00:45.782,0:00:48.260 is quite large, including that, 0:00:48.260,0:00:51.337 as we get into the fall, 0:00:51.337,0:00:53.486 we could have death rates 0:00:53.486,0:00:57.759 that rival the worst of what we had[br]in the April time period. 0:00:58.716,0:01:01.062 If you get a lot of young people infected, 0:01:01.062,0:01:04.217 eventually they will infect[br]old people again, 0:01:04.217,0:01:06.678 and so you'll get into the nursing homes, 9:59:59.000,9:59:59.000 the homeless shelters, 9:59:59.000,9:59:59.000 the places where we've had[br]a lot of our deaths. 9:59:59.000,9:59:59.000 The innovation track,[br]which probably we will touch on -- 9:59:59.000,9:59:59.000 diagnostics, therapeutics, vaccines -- 9:59:59.000,9:59:59.000 there's good progress there, 9:59:59.000,9:59:59.000 but nothing that would[br]fundamentally alter the fact 9:59:59.000,9:59:59.000 that this fall in the United States[br]could be quite bad, 9:59:59.000,9:59:59.000 and that's worse than[br]I would have expected a month ago, 9:59:59.000,9:59:59.000 the degree to which we're back[br]at high mobility, 9:59:59.000,9:59:59.000 not wearing masks, 9:59:59.000,9:59:59.000 and now the virus actually[br]has gotten into a lot of cities 9:59:59.000,9:59:59.000 that it hadn't been in before 9:59:59.000,9:59:59.000 in a significant way, 9:59:59.000,9:59:59.000 so it's going to be a challenge. 9:59:59.000,9:59:59.000 There's no case where we get[br]much below the current death rate, 9:59:59.000,9:59:59.000 which is about 500 deaths a day, 9:59:59.000,9:59:59.000 but there's a significant risk[br]we'd go back up 9:59:59.000,9:59:59.000 to the even 2,000 a day[br]that we had before, 9:59:59.000,9:59:59.000 because we don't have the distancing, 9:59:59.000,9:59:59.000 the behavior change, 9:59:59.000,9:59:59.000 to the degree that we had[br]in April and May, 9:59:59.000,9:59:59.000 and we know this virus[br]is somewhat seasonal, 9:59:59.000,9:59:59.000 so that the force of infection, 9:59:59.000,9:59:59.000 both through temperature, humidity,[br]more time indoors, 9:59:59.000,9:59:59.000 will be worse as we get into the fall. 9:59:59.000,9:59:59.000 CA: So there are scenarios[br]where in the US, 9:59:59.000,9:59:59.000 like, if you extrapolate[br]those numbers forward, 9:59:59.000,9:59:59.000 we end up with, what, 9:59:59.000,9:59:59.000 more than a quarter of a million deaths, 9:59:59.000,9:59:59.000 perchance, even this year[br]if we're not careful, 9:59:59.000,9:59:59.000 and worldwide I guess the death toll[br]could by the end of the year 9:59:59.000,9:59:59.000 be well into the millions, with an s. 9:59:59.000,9:59:59.000 Is there evidence that the hotter[br]temperatures of the summer 9:59:59.000,9:59:59.000 actually have been helping us? 9:59:59.000,9:59:59.000 BG: They're not absolutely sure, 9:59:59.000,9:59:59.000 but certainly the ?? model[br]definitely wanted to use the season, 9:59:59.000,9:59:59.000 including temperature and humidity, 9:59:59.000,9:59:59.000 to try and explain why May[br]wasn't worse than it was. 9:59:59.000,9:59:59.000 And so as we came out[br]and the mobility numbers got higher, 9:59:59.000,9:59:59.000 the models expected more infections[br]and deaths to come out of that, 9:59:59.000,9:59:59.000 and the model kept wanting to say, 9:59:59.000,9:59:59.000 "But I need to use this seasonality 9:59:59.000,9:59:59.000 to match why May wasn't worse, 9:59:59.000,9:59:59.000 why June wasn't worse than it was." 9:59:59.000,9:59:59.000 And we see in the Southern Hemisphere, 9:59:59.000,9:59:59.000 you know, Brazil, 9:59:59.000,9:59:59.000 which is the opposite season, 9:59:59.000,9:59:59.000 all of South America[br]is having a huge epidemic. 9:59:59.000,9:59:59.000 South Africa is having[br]a very fast-growing epidemic. 9:59:59.000,9:59:59.000 Fortunately, Australia and New Zealand, 9:59:59.000,9:59:59.000 the last countries[br]in the Southern Hemisphere, 9:59:59.000,9:59:59.000 are at really tiny case counts, 9:59:59.000,9:59:59.000 and so although they have[br]to keep knocking it down, 9:59:59.000,9:59:59.000 they're talking about, oh,[br]we have 10 cases, 9:59:59.000,9:59:59.000 that's a big deal,[br]let's go get rid of that. 9:59:59.000,9:59:59.000 So they're one of these amazing countries 9:59:59.000,9:59:59.000 that got the numbers so low 9:59:59.000,9:59:59.000 that test, quarantine and trace 9:59:59.000,9:59:59.000 is working to get them, 9:59:59.000,9:59:59.000 keep them at very near zero. 9:59:59.000,9:59:59.000 CA: Aided perhaps a bit[br]by being easier to isolate 9:59:59.000,9:59:59.000 and by less density,[br]less population density, 9:59:59.000,9:59:59.000 but nonetheless smart policies down there. 9:59:59.000,9:59:59.000 BG: Yeah. Everything is so exponential[br]that a little bit of good work 9:59:59.000,9:59:59.000 goes a long ways. 9:59:59.000,9:59:59.000 It's not a linear game. 9:59:59.000,9:59:59.000 Contact tracing, if you have[br]the number of cases we have in the US, 9:59:59.000,9:59:59.000 it's super-important to do, 9:59:59.000,9:59:59.000 but it won't get you back down to zero. 9:59:59.000,9:59:59.000 It'll help you be down, 9:59:59.000,9:59:59.000 but it's too overwhelming. 9:59:59.000,9:59:59.000 CA: OK, so in May and June in the US, 9:59:59.000,9:59:59.000 the numbers were actually slightly better[br]than some of the models predicted, 9:59:59.000,9:59:59.000 and it's hypothesized that that might be[br]partly because of the warmer weather. 9:59:59.000,9:59:59.000 Now we're seeing, really,[br]would you describe it 9:59:59.000,9:59:59.000 as really quite alarming upticks[br]in case rates in the US? 9:59:59.000,9:59:59.000 BG: That's right. 9:59:59.000,9:59:59.000 In, say, the New York area, 9:59:59.000,9:59:59.000 the cases continue to go down somewhat, 9:59:59.000,9:59:59.000 but in other parts of the country, 9:59:59.000,9:59:59.000 primarily the South right now, 9:59:59.000,9:59:59.000 you have increases[br]that are offsetting that, 9:59:59.000,9:59:59.000 and you have testing[br]positive rates in young people 9:59:59.000,9:59:59.000 that are actually higher 9:59:59.000,9:59:59.000 than what we saw even[br]in some of the tougher areas, 9:59:59.000,9:59:59.000 and so clearly younger people[br]have come out of mobility 9:59:59.000,9:59:59.000 more than older people[br]have increased their mobility, 9:59:59.000,9:59:59.000 so the age structure 9:59:59.000,9:59:59.000 is right now very young, but[br]because of multigenerational households, 9:59:59.000,9:59:59.000 people work in nursing care homes, 9:59:59.000,9:59:59.000 unfortunately that will work its way back, 9:59:59.000,9:59:59.000 both the time lag and the transmission[br]back up into the elderly, 9:59:59.000,9:59:59.000 will start to push the death rate back up, 9:59:59.000,9:59:59.000 which it is down, 9:59:59.000,9:59:59.000 way down from 2,000[br]to around 500 right now. 9:59:59.000,9:59:59.000 CA: And is that partly because[br]there's a three-week lag 9:59:59.000,9:59:59.000 between case numbers and fatality numbers? 9:59:59.000,9:59:59.000 And also, perhaps, partly because 9:59:59.000,9:59:59.000 there have been[br]some effective interventions 9:59:59.000,9:59:59.000 and we're actually seeing the possibility 9:59:59.000,9:59:59.000 that the overall fatality rate[br]is actually falling a bit 9:59:59.000,9:59:59.000 now that we've gained[br]some extra knowledge? 9:59:59.000,9:59:59.000 BG: Yeah, certainly[br]your fatality rate is always lower 9:59:59.000,9:59:59.000 when you're not overloaded, 9:59:59.000,9:59:59.000 and so Italy when they were overloaded, 9:59:59.000,9:59:59.000 Spain, even New York at the start, 9:59:59.000,9:59:59.000 certainly China, 9:59:59.000,9:59:59.000 there you weren't even able[br]to provide the basics, 9:59:59.000,9:59:59.000 the oxygen and things. 9:59:59.000,9:59:59.000 A study that our foundation[br]funded in the UK 9:59:59.000,9:59:59.000 found the only thing[br]other than remdesivir 9:59:59.000,9:59:59.000 that is a proven therapeutic, 9:59:59.000,9:59:59.000 which is the dexamethasone, 9:59:59.000,9:59:59.000 that for serious patients 9:59:59.000,9:59:59.000 is about a 20 percent death reduction, 9:59:59.000,9:59:59.000 and there's still quite[br]a pipeline of those things. 9:59:59.000,9:59:59.000 You know, hydroxychloroquine[br]never established positive data, 9:59:59.000,9:59:59.000 so that's pretty much done. 9:59:59.000,9:59:59.000 There's still a few trials ongoing, 9:59:59.000,9:59:59.000 but the list of things being tried, 9:59:59.000,9:59:59.000 including eventually[br]?? antibodies, 9:59:59.000,9:59:59.000 we will have some additional[br]tools for the fall. 9:59:59.000,9:59:59.000 And so when you talk about death rates, 9:59:59.000,9:59:59.000 the good news is some[br]innovation we already have 9:59:59.000,9:59:59.000 and we will have more 9:59:59.000,9:59:59.000 even in the fall. 9:59:59.000,9:59:59.000 We should start to have[br]monoclonal antibodies, 9:59:59.000,9:59:59.000 which is the single therapeutic[br]that I'm most excited about. 9:59:59.000,9:59:59.000 CA: I'll actually ask you to tell me[br]a bit more about that in one sec, 9:59:59.000,9:59:59.000 but just putting the pieces[br]together on death rates: 9:59:59.000,9:59:59.000 so in a well-functioning health system, 9:59:59.000,9:59:59.000 so take the US when places[br]aren't overcrowded, 9:59:59.000,9:59:59.000 what do you think 9:59:59.000,9:59:59.000 the current fatality numbers[br]are approximately going forward, 9:59:59.000,9:59:59.000 like as a percentage of total cases? 9:59:59.000,9:59:59.000 Are we below one percent, perhaps? 9:59:59.000,9:59:59.000 BG: If you found every case, yes, 9:59:59.000,9:59:59.000 you're well below one percent. 9:59:59.000,9:59:59.000 People argue, you know, 0.4, 0.5. 9:59:59.000,9:59:59.000 By the time you bring in[br]the never symptomatics, 9:59:59.000,9:59:59.000 it probably is below 0.5, 9:59:59.000,9:59:59.000 and that's good news. 9:59:59.000,9:59:59.000 This disease could have been[br]a five percent disease. 9:59:59.000,9:59:59.000 The transmission dynamics of this disease 9:59:59.000,9:59:59.000 are more difficult[br]than even the experts predicted. 9:59:59.000,9:59:59.000 The amount of pre-symptomatic[br]and never symptomatic spread, 9:59:59.000,9:59:59.000 and the fact that it's not coughing, 9:59:59.000,9:59:59.000 where you would kind of notice,[br]hey, I'm coughing. 9:59:59.000,9:59:59.000 Most respiratory diseases make you cough. 9:59:59.000,9:59:59.000 This one, in its early stages,[br]it's not coughing, 9:59:59.000,9:59:59.000 it's singing, laughing, talking, 9:59:59.000,9:59:59.000 actually still particularly[br]for the super-spreaders, 9:59:59.000,9:59:59.000 people with very high viral loads, 9:59:59.000,9:59:59.000 causes that spread, 9:59:59.000,9:59:59.000 and that's pretty novel, 9:59:59.000,9:59:59.000 and so even experts have to say,[br]wow, this caught us by surprise. 9:59:59.000,9:59:59.000 The amount of asymptomatic spread 9:59:59.000,9:59:59.000 and the fact that there's not[br]a coughing element 9:59:59.000,9:59:59.000 is not a major piece like the flu or TB. 9:59:59.000,9:59:59.000 CA: Yeah, that is devilish cunning 9:59:59.000,9:59:59.000 by the virus. 9:59:59.000,9:59:59.000 I mean, how much is[br]that non-symptomatic transmission 9:59:59.000,9:59:59.000 as a percentage of total transmission? 9:59:59.000,9:59:59.000 I've heard numbers it could be[br]as much as half of all transmissions 9:59:59.000,9:59:59.000 are basically pre-symptomatic. 9:59:59.000,9:59:59.000 BG: Yeah, if you count pre-symptomatics, 9:59:59.000,9:59:59.000 then most of the studies show[br]that's like at 40 percent, 9:59:59.000,9:59:59.000 and we also have never symptomatics. 9:59:59.000,9:59:59.000 The amount of virus you get[br]in your upper respiratory area 9:59:59.000,9:59:59.000 is somewhat disconnected. 9:59:59.000,9:59:59.000 Some people will have a lot here[br]and very little in their lungs, 9:59:59.000,9:59:59.000 and what you get in your lungs 9:59:59.000,9:59:59.000 causes the really bad symptoms, 9:59:59.000,9:59:59.000 and other organs, 9:59:59.000,9:59:59.000 but mostly the lungs, 9:59:59.000,9:59:59.000 and so that's when you seek treatment. 9:59:59.000,9:59:59.000 And so the worst case[br]in terms of spreading 9:59:59.000,9:59:59.000 is somebody who's got a lot[br]in the upper respiratory tract 9:59:59.000,9:59:59.000 but almost none in their lungs, 9:59:59.000,9:59:59.000 so they're not care-seeking. 9:59:59.000,9:59:59.000 CA: Right. 9:59:59.000,9:59:59.000 And so if you add in the never symptomatic 9:59:59.000,9:59:59.000 to the pre-symptomatic, 9:59:59.000,9:59:59.000 do you get above 50 percent[br]of the transmission 9:59:59.000,9:59:59.000 is actually from non-symptomatic people? 9:59:59.000,9:59:59.000 BG: Yeah, transmission[br]is harder to measure. 9:59:59.000,9:59:59.000 You know, we see certain[br]hotspots and things, 9:59:59.000,9:59:59.000 but that's a huge question[br]with the vaccine: 9:59:59.000,9:59:59.000 will it, besides avoiding[br]you getting sick, 9:59:59.000,9:59:59.000 which is what the trial will test, 9:59:59.000,9:59:59.000 will it also stop you[br]from being a transmitter? 9:59:59.000,9:59:59.000 CA: So that vaccine, 9:59:59.000,9:59:59.000 it's such an important question,[br]let's come on to that, 9:59:59.000,9:59:59.000 but before we go there, 9:59:59.000,9:59:59.000 any other surprises[br]in the last couple months 9:59:59.000,9:59:59.000 that we've learned about this virus 9:59:59.000,9:59:59.000 that really impact how[br]we should respond to it? 9:59:59.000,9:59:59.000 BG: We're still not able to characterize[br]who the super-spreaders are 9:59:59.000,9:59:59.000 in terms of what that profile is, 9:59:59.000,9:59:59.000 and we may never. 9:59:59.000,9:59:59.000 That may just be quite random. 9:59:59.000,9:59:59.000 If you could identify them, 9:59:59.000,9:59:59.000 they're responsible[br]for the majority of transmission, 9:59:59.000,9:59:59.000 a few people who have[br]very high viral loads. 9:59:59.000,9:59:59.000 But sadly, we haven't figured that out. 9:59:59.000,9:59:59.000 This mode of transmission, 9:59:59.000,9:59:59.000 if you're in a room and nobody talks, 9:59:59.000,9:59:59.000 there's way less transmission. 9:59:59.000,9:59:59.000 That's partly why,[br]although planes can transmit, 9:59:59.000,9:59:59.000 it's less than you would expect[br]just in terms of time proximity measures, 9:59:59.000,9:59:59.000 because unlike, say,[br]a choir or a restaurant, 9:59:59.000,9:59:59.000 you're not exhaling in loud talking 9:59:59.000,9:59:59.000 quite as much as in[br]other indoor environments. 9:59:59.000,9:59:59.000 CA: What do you think about the ethics[br]of someone who would go on a plane 9:59:59.000,9:59:59.000 and refuse to wear a mask? 9:59:59.000,9:59:59.000 BG: If they own the plane,[br]that would be fine. 9:59:59.000,9:59:59.000 If there's other people on the plane, 9:59:59.000,9:59:59.000 that would be endangering[br]those other people. 9:59:59.000,9:59:59.000 CA: Early on in the pandemic, 9:59:59.000,9:59:59.000 the WHO did not advise[br]that people wear masks. 9:59:59.000,9:59:59.000 They were worried about taking them away[br]from frontline medical providers. 9:59:59.000,9:59:59.000 In retrospect, was that[br]a terrible mistake that they made? 9:59:59.000,9:59:59.000 BG: Yes. 9:59:59.000,9:59:59.000 All the experts feel bad 9:59:59.000,9:59:59.000 that the value of masks, 9:59:59.000,9:59:59.000 which ties back somewhat[br]to the asymptomatics, 9:59:59.000,9:59:59.000 if people were very symptomatic, 9:59:59.000,9:59:59.000 like in Ebola, 9:59:59.000,9:59:59.000 then you know it and you isolate, 9:59:59.000,9:59:59.000 and so you don't have[br]a need for a mask-like thing. 9:59:59.000,9:59:59.000 The value of masks, 9:59:59.000,9:59:59.000 the fact that the medical masks[br]was a different supply chain 9:59:59.000,9:59:59.000 than the normal masks, 9:59:59.000,9:59:59.000 the fact you could scale up[br]the normal masks so well, 9:59:59.000,9:59:59.000 the fact that it would stop[br]that pre-symptomatic, 9:59:59.000,9:59:59.000 never symptomatic transmission, 9:59:59.000,9:59:59.000 it's a mistake, 9:59:59.000,9:59:59.000 but it's not a conspiracy, 9:59:59.000,9:59:59.000 it's something that we now know more. 9:59:59.000,9:59:59.000 And even now, our error bars[br]on the benefit of masks 9:59:59.000,9:59:59.000 are higher than we'd like to admit, 9:59:59.000,9:59:59.000 but it's a significant benefit. 9:59:59.000,9:59:59.000 CA: All right, I'm going to come in[br]with some questions 9:59:59.000,9:59:59.000 from the community. 9:59:59.000,9:59:59.000 Let's pull them up there. 9:59:59.000,9:59:59.000 Jim Pitofsky: "Do you think reopening[br]efforts in the US have been premature, 9:59:59.000,9:59:59.000 and if so how far should the US go[br]to responsibly confront this pandemic?" 9:59:59.000,9:59:59.000 BG: Well, the question[br]of how you make tradeoffs 9:59:59.000,9:59:59.000 between the benefits, say,[br]of going to school 9:59:59.000,9:59:59.000 versus the risk of people getting sick[br]because they go to school, 9:59:59.000,9:59:59.000 those are very tough questions 9:59:59.000,9:59:59.000 that I don't think any single person 9:59:59.000,9:59:59.000 can say, "I will tell you[br]how to make all these tradeoffs." 9:59:59.000,9:59:59.000 The understanding of[br]where you have transmission, 9:59:59.000,9:59:59.000 and the fact that young people[br]do get infected 9:59:59.000,9:59:59.000 and are part of the multi-generational[br]transmission chain, 9:59:59.000,9:59:59.000 we should get that out. 9:59:59.000,9:59:59.000 If you just look at the health aspect, 9:59:59.000,9:59:59.000 we have opened up too liberally. 9:59:59.000,9:59:59.000 Now, opening up in terms of mental health 9:59:59.000,9:59:59.000 and seeking normal health things 9:59:59.000,9:59:59.000 like vaccines and other care, 9:59:59.000,9:59:59.000 there are benefits. 9:59:59.000,9:59:59.000 I think some of our opening up 9:59:59.000,9:59:59.000 has created more risk than benefit. 9:59:59.000,9:59:59.000 Opening the bars up[br]as quickly as they did, 9:59:59.000,9:59:59.000 is that critical for mental health? 9:59:59.000,9:59:59.000 Maybe not. 9:59:59.000,9:59:59.000 So I don't think we've been[br]as tasteful about opening up 9:59:59.000,9:59:59.000 as I'm sure, as we study it, 9:59:59.000,9:59:59.000 that we'll realize some things[br]we shouldn't have opened up as fast, 9:59:59.000,9:59:59.000 but then you have something like school, 9:59:59.000,9:59:59.000 where even sitting here today, 9:59:59.000,9:59:59.000 the exact plan, say,[br]for inner city schools for the fall, 9:59:59.000,9:59:59.000 I wouldn't have a black-and-white view 9:59:59.000,9:59:59.000 on the relative tradeoffs involved there. 9:59:59.000,9:59:59.000 There are huge benefits 9:59:59.000,9:59:59.000 to letting those kids go to school, 9:59:59.000,9:59:59.000 and how do you weigh the risk? 9:59:59.000,9:59:59.000 If you're in a city 9:59:59.000,9:59:59.000 without many cases, 9:59:59.000,9:59:59.000 I would say probably the benefit is there. 9:59:59.000,9:59:59.000 Now that means that[br]you could get surprised. 9:59:59.000,9:59:59.000 The cases could show up,[br]and then you'd have to change that, 9:59:59.000,9:59:59.000 which is not easy. 9:59:59.000,9:59:59.000 But I think around the US[br]there will be places 9:59:59.000,9:59:59.000 where that won't be a good tradeoff. 9:59:59.000,9:59:59.000 So almost any dimension and inequity, 9:59:59.000,9:59:59.000 this disease has made worse: 9:59:59.000,9:59:59.000 job type, internet connection, 9:59:59.000,9:59:59.000 ability of your school[br]to do online learning. 9:59:59.000,9:59:59.000 White collar workers, 9:59:59.000,9:59:59.000 people are embarrassed to admit it, 9:59:59.000,9:59:59.000 some of them are more productive 9:59:59.000,9:59:59.000 and enjoying the flexibility[br]that the at-home thing has created, 9:59:59.000,9:59:59.000 and that feels terrible 9:59:59.000,9:59:59.000 when you know lots of people[br]are suffering in many ways, 9:59:59.000,9:59:59.000 including their kids not going to school. 9:59:59.000,9:59:59.000 CA: Indeed. Let's have the next question. 9:59:59.000,9:59:59.000 "For us in Rwanda, 9:59:59.000,9:59:59.000 early policy interventions[br]have made the difference. 9:59:59.000,9:59:59.000 At this point, what policy interventions[br]do you suggest for the US now?" 9:59:59.000,9:59:59.000 Bill, I dream of the day[br]where you are appointed 9:59:59.000,9:59:59.000 the coronavirus czar 9:59:59.000,9:59:59.000 with authority to actually[br]speak to the public. 9:59:59.000,9:59:59.000 What would you do? 9:59:59.000,9:59:59.000 BG: The innovation tools 9:59:59.000,9:59:59.000 are where I and the foundation[br]probably has the most expertise. 9:59:59.000,9:59:59.000 Clearly some of the policies[br]on opening up have been too generous, 9:59:59.000,9:59:59.000 but I think everybody 9:59:59.000,9:59:59.000 could engage in that. 9:59:59.000,9:59:59.000 We need leadership 9:59:59.000,9:59:59.000 in terms of admitting 9:59:59.000,9:59:59.000 that we've still got a huge problem here, 9:59:59.000,9:59:59.000 and not turning that[br]into almost a political thing 9:59:59.000,9:59:59.000 of, oh, isn't it brilliant what we did. 9:59:59.000,9:59:59.000 No, it's not brilliant, 9:59:59.000,9:59:59.000 but there's many people, 9:59:59.000,9:59:59.000 including the experts, 9:59:59.000,9:59:59.000 where there's a lot[br]they didn't understand, 9:59:59.000,9:59:59.000 and everybody wishes a week earlier[br]whatever action they took, 9:59:59.000,9:59:59.000 they'd taken that a week earlier. 9:59:59.000,9:59:59.000 The innovation tools, 9:59:59.000,9:59:59.000 that's where the foundation's work 9:59:59.000,9:59:59.000 on antibodies, vaccines, 9:59:59.000,9:59:59.000 we have deep expertise, 9:59:59.000,9:59:59.000 and it's outside of the private sector, 9:59:59.000,9:59:59.000 and so we have kind of a neutral ability[br]to work with all the governments 9:59:59.000,9:59:59.000 and the companies to pick. 9:59:59.000,9:59:59.000 Particularly when you're doing[br]break-even products, 9:59:59.000,9:59:59.000 which one should get the resources. 9:59:59.000,9:59:59.000 There's no market signal for that. 9:59:59.000,9:59:59.000 Experts have to say, OK,[br]this antibody deserves the manufacturing. 9:59:59.000,9:59:59.000 This vaccine deserves the manufacturing. 9:59:59.000,9:59:59.000 Because, we have very limited[br]manufacturing for both of those things, 9:59:59.000,9:59:59.000 and it'll be cross-company, 9:59:59.000,9:59:59.000 which never happens in the normal case, 9:59:59.000,9:59:59.000 where one company invents it 9:59:59.000,9:59:59.000 and then you're using[br]the manufacturing plants 9:59:59.000,9:59:59.000 of many companies 9:59:59.000,9:59:59.000 to get maximum scale of the best choice. 9:59:59.000,9:59:59.000 So I would be coordinating those things, 9:59:59.000,9:59:59.000 but we need a leader[br]who keeps us up to date, 9:59:59.000,9:59:59.000 is realistic, 9:59:59.000,9:59:59.000 and shows us the right behavior, 9:59:59.000,9:59:59.000 as well as driving the innovation track. 9:59:59.000,9:59:59.000 CA: I mean, you have to yourself[br]be a master diplomat 9:59:59.000,9:59:59.000 in how you talk about this stuff. 9:59:59.000,9:59:59.000 So I appreciate, almost,[br]the discomfort here, 9:59:59.000,9:59:59.000 but you talk regularly with Anthony Fauci, 9:59:59.000,9:59:59.000 who is a wise voice on this[br]by most people's opinion. 9:59:59.000,9:59:59.000 But to what extent is he just hamstrung? 9:59:59.000,9:59:59.000 He's not allowed to play the full role 9:59:59.000,9:59:59.000 that he could play in the circumstance. 9:59:59.000,9:59:59.000 BG: Dr. Fauci has emerged, 9:59:59.000,9:59:59.000 where he was allowed to have some airtime, 9:59:59.000,9:59:59.000 and even though he was stating[br]things that are realistic, 9:59:59.000,9:59:59.000 his prestige has stuck. 9:59:59.000,9:59:59.000 He can speak out in that way. 9:59:59.000,9:59:59.000 Typically, the CDC would be[br]the primary voice here. 9:59:59.000,9:59:59.000 It's not absolutely necessary, 9:59:59.000,9:59:59.000 but in previous health crises, 9:59:59.000,9:59:59.000 you let the experts inside the CDC 9:59:59.000,9:59:59.000 be that voice. 9:59:59.000,9:59:59.000 They're trained to do these things, 9:59:59.000,9:59:59.000 and so it is a bit unusual here 9:59:59.000,9:59:59.000 how much we've had to rely on Fauci 9:59:59.000,9:59:59.000 as opposed to the CDC. 9:59:59.000,9:59:59.000 It should be Fauci,[br]who is a brilliant researcher, 9:59:59.000,9:59:59.000 so experienced, particularly in vaccines, 9:59:59.000,9:59:59.000 in some ways he has become,[br]taking the broad advice 9:59:59.000,9:59:59.000 that is the epidemiology advice 9:59:59.000,9:59:59.000 and explaining it in the right way, 9:59:59.000,9:59:59.000 where he'll admit, 9:59:59.000,9:59:59.000 "OK, we may have a rebound here, 9:59:59.000,9:59:59.000 and this is why we need[br]to behave that way." 9:59:59.000,9:59:59.000 But it's fantastic that his voice[br]has been allowed to come through. 9:59:59.000,9:59:59.000 CA: Sometimes. 9:59:59.000,9:59:59.000 Let's have the next question. 9:59:59.000,9:59:59.000 Nina Gregory: "How are you[br]and your foundation 9:59:59.000,9:59:59.000 addressing the ethical questions[br]about which countries 9:59:59.000,9:59:59.000 get the vaccine first, 9:59:59.000,9:59:59.000 assuming you find one?" 9:59:59.000,9:59:59.000 And maybe, Bill, use this as a moment 9:59:59.000,9:59:59.000 to just talk about where[br]the quest for the vaccine is 9:59:59.000,9:59:59.000 and what are just some of the key things[br]we should all be thinking about 9:59:59.000,9:59:59.000 as we track the news on this. 9:59:59.000,9:59:59.000 BG: There's three vaccines that are, 9:59:59.000,9:59:59.000 if they work, are the earliest: 9:59:59.000,9:59:59.000 the Moderna, which unfortunately[br]won't scale very easily, 9:59:59.000,9:59:59.000 so if that works, it'll be mostly[br]a US-targeted thing; 9:59:59.000,9:59:59.000 then you have the AstraZeneca,[br]which comes from Oxford; 9:59:59.000,9:59:59.000 and the Johnson & Johnson. 9:59:59.000,9:59:59.000 Those are the three early ones, 9:59:59.000,9:59:59.000 and we have animal data 9:59:59.000,9:59:59.000 that looks potentially good, 9:59:59.000,9:59:59.000 but not definitive, 9:59:59.000,9:59:59.000 particularly will it work in the elderly, 9:59:59.000,9:59:59.000 and we'll have human data[br]over the next several months. 9:59:59.000,9:59:59.000 Those three will be gated by[br]the safety and efficacy trial. 9:59:59.000,9:59:59.000 That is, we'll be able[br]to manufacture those, 9:59:59.000,9:59:59.000 although not as much as we want. 9:59:59.000,9:59:59.000 We'll be able to manufacture those[br]before the end of the year. 9:59:59.000,9:59:59.000 Whether the Phase 3 will succeed, 9:59:59.000,9:59:59.000 and whether it'll complete[br]before the end of the year, 9:59:59.000,9:59:59.000 I wouldn't be that optimistic about. 9:59:59.000,9:59:59.000 Phase 3 is where you need[br]to really look at all the safety profile 9:59:59.000,9:59:59.000 and efficacy, 9:59:59.000,9:59:59.000 but those will get started. 9:59:59.000,9:59:59.000 And then there's four or five vaccines 9:59:59.000,9:59:59.000 that use different approaches 9:59:59.000,9:59:59.000 that are maybe three[br]or four months behind that: 9:59:59.000,9:59:59.000 Novavax, Sanofi, Merck. 9:59:59.000,9:59:59.000 And so we're funding factory capacity[br]for a lot of these -- 9:59:59.000,9:59:59.000 some complex negotiations[br]are taking place right now on this -- 9:59:59.000,9:59:59.000 to get factories that will be dedicated[br]to the poorer countries, 9:59:59.000,9:59:59.000 what's called low- and middle-income. 9:59:59.000,9:59:59.000 And the very scalable constructs 9:59:59.000,9:59:59.000 that include AstraZeneca[br]and Johnson & Johnson, 9:59:59.000,9:59:59.000 we'll focus on those, 9:59:59.000,9:59:59.000 the ones that are inexpensive 9:59:59.000,9:59:59.000 and you can build a single factory[br]to make 600 million doses. 9:59:59.000,9:59:59.000 So a number of the vaccine constructs 9:59:59.000,9:59:59.000 are potential. 9:59:59.000,9:59:59.000 I don't see anything[br]before the end of the year. 9:59:59.000,9:59:59.000 That's really the best case, 9:59:59.000,9:59:59.000 and it's down to a few constructs now, 9:59:59.000,9:59:59.000 which typically you have[br]high failure rates. 9:59:59.000,9:59:59.000 CA: Bill, is the case 9:59:59.000,9:59:59.000 that you and your foundation[br]weren't in the picture here 9:59:59.000,9:59:59.000 that market dynamics would likely[br]lead to a situation 9:59:59.000,9:59:59.000 where as soon as a promising[br]vaccine candidate emerged, 9:59:59.000,9:59:59.000 the richer countries[br]would basically snap up, 9:59:59.000,9:59:59.000 gobble up all available initial supply -- 9:59:59.000,9:59:59.000 it just takes a while[br]to manufacture these -- 9:59:59.000,9:59:59.000 and there would be nothing[br]for the poorer countries, 9:59:59.000,9:59:59.000 but that what effectively you're doing, 9:59:59.000,9:59:59.000 by giving manufacturing guarantees 9:59:59.000,9:59:59.000 and capability to some[br]of these candidates, 9:59:59.000,9:59:59.000 you're making it possible that[br]at least some of the early vaccine units 9:59:59.000,9:59:59.000 will go to poorer countries? 9:59:59.000,9:59:59.000 Is that correct? 9:59:59.000,9:59:59.000 BG: Well, it's not just us, but yes, 9:59:59.000,9:59:59.000 we're in the central role there 9:59:59.000,9:59:59.000 along with a group we created called CEPI, 9:59:59.000,9:59:59.000 Coalition for Epidemic Preparedness, 9:59:59.000,9:59:59.000 and the European leaders agree with this. 9:59:59.000,9:59:59.000 Now we have the expertise[br]to look at each of the constructs 9:59:59.000,9:59:59.000 and say, OK, where is there[br]a factory in the world 9:59:59.000,9:59:59.000 that has capacity that can build that? 9:59:59.000,9:59:59.000 Which one should we put[br]the early money into? 9:59:59.000,9:59:59.000 What should the milestones be 9:59:59.000,9:59:59.000 where we'll shift the money[br]over to a different one? 9:59:59.000,9:59:59.000 Because the kind of private sector people 9:59:59.000,9:59:59.000 who really understand that stuff, 9:59:59.000,9:59:59.000 some of them work for us, 9:59:59.000,9:59:59.000 and we're a trusted party on these things, 9:59:59.000,9:59:59.000 we get to coordinate a lot,[br]particularly the manufacturing piece. 9:59:59.000,9:59:59.000 Usually, you'd expect the US 9:59:59.000,9:59:59.000 to think of this as[br]a global problem and be involved. 9:59:59.000,9:59:59.000 So far, no activity[br]on that front has taken place. 9:59:59.000,9:59:59.000 I am talking to people in the Congress[br]and the Administration 9:59:59.000,9:59:59.000 about when the next[br]relief bill comes along 9:59:59.000,9:59:59.000 that maybe one percent of that 9:59:59.000,9:59:59.000 could go for the tools 9:59:59.000,9:59:59.000 to help the entire world. 9:59:59.000,9:59:59.000 And so it's possible, 9:59:59.000,9:59:59.000 but it's unfortunate, 9:59:59.000,9:59:59.000 and the vacuum here 9:59:59.000,9:59:59.000 the world is not that used to 9:59:59.000,9:59:59.000 and a lot of people are stepping in, 9:59:59.000,9:59:59.000 including our foundation, 9:59:59.000,9:59:59.000 to try and have a strategy, 9:59:59.000,9:59:59.000 including for the poorer countries 9:59:59.000,9:59:59.000 who will suffer a high percentage[br]of the deaths and negative effects, 9:59:59.000,9:59:59.000 including their health systems[br]being overwhelmed. 9:59:59.000,9:59:59.000 Most of the deaths will be[br]in developing countries, 9:59:59.000,9:59:59.000 despite the huge deaths we've seen[br]in Europe and the US. 9:59:59.000,9:59:59.000 CA: I mean, I wish I could be[br]a fly on the wall and hearing 9:59:59.000,9:59:59.000 you and Melinda talk about this, 9:59:59.000,9:59:59.000 because of all of[br]the ethical crimes, let's say, 9:59:59.000,9:59:59.000 executed by leaders[br]who should know better, 9:59:59.000,9:59:59.000 I mean, it's one thing[br]to not model mask-wearing, 9:59:59.000,9:59:59.000 but to not play a role 9:59:59.000,9:59:59.000 in helping the world when faced[br]with a common enemy, 9:59:59.000,9:59:59.000 respond as one humanity 9:59:59.000,9:59:59.000 and instead catalyze a really unseemly[br]scramble between nations 9:59:59.000,9:59:59.000 to fight for vaccines, for example. 9:59:59.000,9:59:59.000 That just seems that surely history[br]is going to judge that harshly. 9:59:59.000,9:59:59.000 That is just sickening. 9:59:59.000,9:59:59.000 Isn't it? Am I missing something? 9:59:59.000,9:59:59.000 BG: Well, it's not quite[br]as black and white as that. 9:59:59.000,9:59:59.000 The US has put more money out 9:59:59.000,9:59:59.000 to fund the basic research[br]on these vaccines 9:59:59.000,9:59:59.000 than any country by far, 9:59:59.000,9:59:59.000 and that research is not restricted. 9:59:59.000,9:59:59.000 There's not, like, some royalty[br]that says, "Hey, if you take our money, 9:59:59.000,9:59:59.000 you have to pay the US a royalty." 9:59:59.000,9:59:59.000 They do, to the degree they fund research, 9:59:59.000,9:59:59.000 it's for everybody. 9:59:59.000,9:59:59.000 To the degree they fund factories,[br]it's just for the US. 9:59:59.000,9:59:59.000 The thing that makes this tough is that[br]in every other global health problem, 9:59:59.000,9:59:59.000 the US totally leads smallpox eradication, 9:59:59.000,9:59:59.000 the US is totally the leader[br]on polio eradication 9:59:59.000,9:59:59.000 with key partners -- CDC, WHO,[br]Rotary, UNICEF, our foundation. 9:59:59.000,9:59:59.000 So the world, and on HIV, 9:59:59.000,9:59:59.000 what under President Bush's leadership,[br]but it was very bipartisan, 9:59:59.000,9:59:59.000 this thing called PEPFAR was unbelievable. 9:59:59.000,9:59:59.000 That has saved tens of millions of lives. 9:59:59.000,9:59:59.000 And so it's that the world[br]always expected the US 9:59:59.000,9:59:59.000 to at least be at the head of the table, 9:59:59.000,9:59:59.000 financially, strategy, OK, how do you[br]get these factories for the world, 9:59:59.000,9:59:59.000 even if it's just to avoid the infection[br]coming back to the US 9:59:59.000,9:59:59.000 or to have the global economy working, 9:59:59.000,9:59:59.000 which is good for US jobs 9:59:59.000,9:59:59.000 to have demand outside the US. 9:59:59.000,9:59:59.000 And so the world is kind of,[br]there's all this uncertainty 9:59:59.000,9:59:59.000 about which thing will work, 9:59:59.000,9:59:59.000 and there's, OK, who is in charge here? 9:59:59.000,9:59:59.000 And so the worst thing, 9:59:59.000,9:59:59.000 the withdrawal from WHO, 9:59:59.000,9:59:59.000 that is a difficulty 9:59:59.000,9:59:59.000 that hopefully will[br]get remedied at some point, 9:59:59.000,9:59:59.000 because we need that coordination 9:59:59.000,9:59:59.000 through WHO. 9:59:59.000,9:59:59.000 CA: Let's take another question. 9:59:59.000,9:59:59.000 Ali Kashani: "Are there any[br]particularly successful models 9:59:59.000,9:59:59.000 of handling the pandemic[br]that you have seen around the world?" 9:59:59.000,9:59:59.000 BG: Well, it's fascinating that,[br]besides early action, 9:59:59.000,9:59:59.000 there are definitely things where[br]you take people who have tested positive 9:59:59.000,9:59:59.000 and you monitor their ??, 9:59:59.000,9:59:59.000 which is a oxygen saturation[br]level in their blood, 9:59:59.000,9:59:59.000 which is a very cheap detector, 9:59:59.000,9:59:59.000 and then you know to get them[br]to the hospitals fairly early. 9:59:59.000,9:59:59.000 Weirdly, patients don't know[br]things are about to get severe. 9:59:59.000,9:59:59.000 It's an interesting physiological reason[br]but I won't get into. 9:59:59.000,9:59:59.000 And so Germany has[br]a quite a low case fatality rate 9:59:59.000,9:59:59.000 that they've done through[br]that type of monitoring. 9:59:59.000,9:59:59.000 And then, of course,[br]once you get into facilities, 9:59:59.000,9:59:59.000 we've learned that the ventilator[br]actually, although extremely well-meaning, 9:59:59.000,9:59:59.000 was actually overused[br]and used in the wrong mode 9:59:59.000,9:59:59.000 in those early days. 9:59:59.000,9:59:59.000 So the health, the doctors 9:59:59.000,9:59:59.000 are way smarter about treatment today. 9:59:59.000,9:59:59.000 Most of that I would say is global. 9:59:59.000,9:59:59.000 Using this ??[br]as an early indicator, 9:59:59.000,9:59:59.000 that'll probably catch on broadly, 9:59:59.000,9:59:59.000 but Germany was a pioneer there. 9:59:59.000,9:59:59.000 And now, of course, dexamethasone, 9:59:59.000,9:59:59.000 fortunately, it's cheap, it's oral, 9:59:59.000,9:59:59.000 we can ramp up manufacture. 9:59:59.000,9:59:59.000 That'll go global as well. 9:59:59.000,9:59:59.000 CA: Bill, I want to ask you 9:59:59.000,9:59:59.000 something about 9:59:59.000,9:59:59.000 what it's been like for you personally[br]through this whole process. 9:59:59.000,9:59:59.000 Because, weirdly, even though[br]your passion and good intent on this topic 9:59:59.000,9:59:59.000 seems completely bloody obvious to anyone[br]who has spent a moment with you, 9:59:59.000,9:59:59.000 there are these crazy[br]conspiracy theories out there about you. 9:59:59.000,9:59:59.000 I just checked in[br]with a company called Zignal 9:59:59.000,9:59:59.000 that monitors social media spaces. 9:59:59.000,9:59:59.000 They say that, to date,[br]I think on Facebook alone, 9:59:59.000,9:59:59.000 more than four million posts[br]have taken place 9:59:59.000,9:59:59.000 that associate you with some kind[br]of conspiracy theory around the virus. 9:59:59.000,9:59:59.000 I read that there was a poll[br]that more than 40 percent of Republicans 9:59:59.000,9:59:59.000 believe that the vaccine[br]that you would roll out 9:59:59.000,9:59:59.000 would somehow plant a microchip[br]in people to track their location. 9:59:59.000,9:59:59.000 I mean, I can't even believe[br]that poll number. 9:59:59.000,9:59:59.000 And then some people[br]are taking this seriously enough, 9:59:59.000,9:59:59.000 and some of them have even been[br]recirculated on Fox News and so forth, 9:59:59.000,9:59:59.000 some people are taking this[br]seriously enough 9:59:59.000,9:59:59.000 to make really quite horrible[br]threats and so forth. 9:59:59.000,9:59:59.000 You seem to do a good job[br]sort of shrugging this off, 9:59:59.000,9:59:59.000 but really, like, who else[br]has ever been in this position? 9:59:59.000,9:59:59.000 How are you managing this? 9:59:59.000,9:59:59.000 What on earth world are we in 9:59:59.000,9:59:59.000 that this kind of misinformation[br]can be out there? 9:59:59.000,9:59:59.000 What can we do to help correct it? 9:59:59.000,9:59:59.000 BG: I'm not sure, 9:59:59.000,9:59:59.000 and it's a new thing 9:59:59.000,9:59:59.000 that there's conspiracy theories. 9:59:59.000,9:59:59.000 I mean, Microsoft had[br]its share of controversy, 9:59:59.000,9:59:59.000 but at least that related[br]to the real world, you know? 9:59:59.000,9:59:59.000 Did Windows crash more than it should? 9:59:59.000,9:59:59.000 We definitely had anti-trust problems. 9:59:59.000,9:59:59.000 But at least I knew what that was. 9:59:59.000,9:59:59.000 When this emerged, I have to say, 9:59:59.000,9:59:59.000 my instinct was to joke about it. 9:59:59.000,9:59:59.000 People have said[br]that's really inappropriate, 9:59:59.000,9:59:59.000 because this is a very serious thing. 9:59:59.000,9:59:59.000 It is going to make people[br]less willing to take a vaccine. 9:59:59.000,9:59:59.000 And, of course, once we have that vaccine, 9:59:59.000,9:59:59.000 it'll be like masks, 9:59:59.000,9:59:59.000 where getting lots of people, 9:59:59.000,9:59:59.000 particularly when it's[br]a transmission-blocking vaccine, 9:59:59.000,9:59:59.000 there's this huge community benefit 9:59:59.000,9:59:59.000 to widespread adoption of that vaccine. 9:59:59.000,9:59:59.000 So I am caught a little bit, 9:59:59.000,9:59:59.000 unsure of what to say or do, 9:59:59.000,9:59:59.000 because the conspiracy piece[br]is a new thing for me, 9:59:59.000,9:59:59.000 and what do you say 9:59:59.000,9:59:59.000 that doesn't give credence to the thing? 9:59:59.000,9:59:59.000 The fact that a Fox News commentator, 9:59:59.000,9:59:59.000 Laura Ingraham, was saying[br]this stuff about me microchipping people, 9:59:59.000,9:59:59.000 that survey isn't that surprising[br]because that's what they heard 9:59:59.000,9:59:59.000 on the TV. 9:59:59.000,9:59:59.000 It's wild. 9:59:59.000,9:59:59.000 And people are clearly seeking[br]simpler explanations 9:59:59.000,9:59:59.000 than going and studying virology. 9:59:59.000,9:59:59.000 CA: I mean, 9:59:59.000,9:59:59.000 TED is nonpolitical, 9:59:59.000,9:59:59.000 but we believe in the truth. 9:59:59.000,9:59:59.000 I would say this. 9:59:59.000,9:59:59.000 Laura Ingraham, you owe Bill Gates[br]an apology and a retraction. 9:59:59.000,9:59:59.000 You do. 9:59:59.000,9:59:59.000 And anyone who is watching this 9:59:59.000,9:59:59.000 who thinks for a minute 9:59:59.000,9:59:59.000 that this man is involved[br]in some kind of conspiracy, 9:59:59.000,9:59:59.000 you want your head examined. 9:59:59.000,9:59:59.000 You are crazy. 9:59:59.000,9:59:59.000 Enough of us know Bill over many years 9:59:59.000,9:59:59.000 and have seen the passion[br]and engagement in this to know 9:59:59.000,9:59:59.000 that you are crazy. 9:59:59.000,9:59:59.000 So get over it, 9:59:59.000,9:59:59.000 and let's look at the actual problem[br]of solving this pandemic. 9:59:59.000,9:59:59.000 Honestly. 9:59:59.000,9:59:59.000 If anyone in the chat here[br]has a suggestion, 9:59:59.000,9:59:59.000 a positive suggestion for how you can, 9:59:59.000,9:59:59.000 how do you get rid of conspiracies,[br]because they feed on each other. 9:59:59.000,9:59:59.000 Now, oh, well I would say that,[br]because I'm part of the conspiracy, 9:59:59.000,9:59:59.000 or whatever. 9:59:59.000,9:59:59.000 Like, how do we get back to a world[br]where information can be trusted? 9:59:59.000,9:59:59.000 We have to do better on it. 9:59:59.000,9:59:59.000 Are there any other questions[br]out there from the community? 9:59:59.000,9:59:59.000 Aria Bendix from New York City: 9:59:59.000,9:59:59.000 "What are your personal recommendations[br]for those who want to reduce 9:59:59.000,9:59:59.000 their risk of infection[br]amid an uptick in cases?" 9:59:59.000,9:59:59.000 BG: Well, it's great if you have a job 9:59:59.000,9:59:59.000 that you can stay at your house 9:59:59.000,9:59:59.000 and do it through digital meetings, 9:59:59.000,9:59:59.000 and even some of your social activities, 9:59:59.000,9:59:59.000 you know, I do video calls[br]with lots of friends. 9:59:59.000,9:59:59.000 I have friends in Europe that[br]who knows when I'll see them 9:59:59.000,9:59:59.000 but we schedule regular calls to talk. 9:59:59.000,9:59:59.000 If you stay fairly isolated, 9:59:59.000,9:59:59.000 you don't run much risk, 9:59:59.000,9:59:59.000 and it's when you're getting together[br]with lots of other people, 9:59:59.000,9:59:59.000 either through work or socialization, 9:59:59.000,9:59:59.000 that drives that risk, 9:59:59.000,9:59:59.000 and particularly in these communities[br]where you have increased cases, 9:59:59.000,9:59:59.000 even though it's not going to be mandated, 9:59:59.000,9:59:59.000 hopefully the mobility numbers[br]will show people responding 9:59:59.000,9:59:59.000 and minimizing those kind of[br]out of the house contacts. 9:59:59.000,9:59:59.000 CA: Bill, I wonder if I could just ask you 9:59:59.000,9:59:59.000 just a little bit about philanthropy. 9:59:59.000,9:59:59.000 Obviously your foundation[br]has played a huge role in this, 9:59:59.000,9:59:59.000 but philanthropy more generally. 9:59:59.000,9:59:59.000 You know, you've started[br]this giving pledge movement, 9:59:59.000,9:59:59.000 recruited all these billionaires 9:59:59.000,9:59:59.000 who have pledged to give away[br]half their net worth 9:59:59.000,9:59:59.000 before or after their death. 9:59:59.000,9:59:59.000 But it's really hard to do. 9:59:59.000,9:59:59.000 It's really hard to give away[br]that much money. 9:59:59.000,9:59:59.000 You yourself, I think, 9:59:59.000,9:59:59.000 since the giving pledge was started, 9:59:59.000,9:59:59.000 what, 10 years ago or something,[br]I'm not sure when, 9:59:59.000,9:59:59.000 but your own net worth I think[br]has doubled since that period 9:59:59.000,9:59:59.000 despite being the world's[br]leading philanthropist. 9:59:59.000,9:59:59.000 Is it just fundamentally hard 9:59:59.000,9:59:59.000 to give away money effectively[br]to make the world better? 9:59:59.000,9:59:59.000 Or should the world's donors, 9:59:59.000,9:59:59.000 and especially the world's[br]really rich donors, 9:59:59.000,9:59:59.000 start to almost commit to a schedule, 9:59:59.000,9:59:59.000 like, here's a percentage[br]of my net worth each year 9:59:59.000,9:59:59.000 that as I get older, 9:59:59.000,9:59:59.000 maybe that goes up. 9:59:59.000,9:59:59.000 If I'm to take this seriously, 9:59:59.000,9:59:59.000 I have to give away, somehow,[br]I've got to find a way 9:59:59.000,9:59:59.000 of doing that effectively. 9:59:59.000,9:59:59.000 Is that an unfair and crazy question? 9:59:59.000,9:59:59.000 BG: Well, it'd be great to up the rate, 9:59:59.000,9:59:59.000 and our goal, both as the Gates Foundation[br]or through the giving pledge, 9:59:59.000,9:59:59.000 is to help people find causes[br]they connect to. 9:59:59.000,9:59:59.000 People give through passion. 9:59:59.000,9:59:59.000 Yes, numbers are important, 9:59:59.000,9:59:59.000 but there's so many causes out there. 9:59:59.000,9:59:59.000 The way you're going to pick[br]is you see somebody who is sick, 9:59:59.000,9:59:59.000 you see somebody who is not[br]getting social services. 9:59:59.000,9:59:59.000 You see something[br]that helps reduce racism. 9:59:59.000,9:59:59.000 And you're very passionate,[br]and so you give to that. 9:59:59.000,9:59:59.000 And, of course, 9:59:59.000,9:59:59.000 some philanthropic gifts won't work out. 9:59:59.000,9:59:59.000 We do need to up the ambition level 9:59:59.000,9:59:59.000 of philanthropists. 9:59:59.000,9:59:59.000 Now, collaborative philanthropy 9:59:59.000,9:59:59.000 that you're helping to facilitate[br]through Audacious, 9:59:59.000,9:59:59.000 there's four or five other groups[br]that are getting philanthropists together, 9:59:59.000,9:59:59.000 that is fantastic, 9:59:59.000,9:59:59.000 because then they learn from each other, 9:59:59.000,9:59:59.000 they get confidence from each other, 9:59:59.000,9:59:59.000 they feel like, hey, I put in x 9:59:59.000,9:59:59.000 and the four other people put money in, 9:59:59.000,9:59:59.000 so I'm getting more impact, 9:59:59.000,9:59:59.000 and hopefully it can be made for them 9:59:59.000,9:59:59.000 even when they find out, 9:59:59.000,9:59:59.000 OK, that particular gift[br]didn't work out that well, 9:59:59.000,9:59:59.000 but let's keep going. 9:59:59.000,9:59:59.000 So philanthropy, yes, 9:59:59.000,9:59:59.000 I would like to see the rate go up, 9:59:59.000,9:59:59.000 and people who do get going, 9:59:59.000,9:59:59.000 it is fun, 9:59:59.000,9:59:59.000 it's fulfilling, 9:59:59.000,9:59:59.000 you pick which of the family members[br]are partnered in doing it. 9:59:59.000,9:59:59.000 In my case, Melinda and I[br]love doing this stuff together, 9:59:59.000,9:59:59.000 learning together. 9:59:59.000,9:59:59.000 Some families, it will even[br]involve the kids in the activities. 9:59:59.000,9:59:59.000 Sometimes the kids are pushing. 9:59:59.000,9:59:59.000 When you have lots of money, 9:59:59.000,9:59:59.000 you still think of million dollars[br]as a lot of money, 9:59:59.000,9:59:59.000 but if you have billions, 9:59:59.000,9:59:59.000 you should be giving hundreds of millions. 9:59:59.000,9:59:59.000 So it's kind of charming that,[br]in terms of your personal expenditure, 9:59:59.000,9:59:59.000 you stay at the level you were at before. 9:59:59.000,9:59:59.000 That's societally quite appropriate. 9:59:59.000,9:59:59.000 But on your giving, you need to scale up 9:59:59.000,9:59:59.000 or else it will be your will, 9:59:59.000,9:59:59.000 and you won't get to shape it[br]and enjoy it quite that same way. 9:59:59.000,9:59:59.000 And so without, 9:59:59.000,9:59:59.000 we don't want to mandate it, 9:59:59.000,9:59:59.000 but yes, both you and I[br]want to inspire philanthropists 9:59:59.000,9:59:59.000 to see that passion, 9:59:59.000,9:59:59.000 to see those opportunities, 9:59:59.000,9:59:59.000 significantly faster than in the past, 9:59:59.000,9:59:59.000 because whether it's race or disease 9:59:59.000,9:59:59.000 or all the other social ills, 9:59:59.000,9:59:59.000 the innovation of what philanthropy[br]can go to and do quickly 9:59:59.000,9:59:59.000 that, if it works, government[br]can come in behind it and scale it up, 9:59:59.000,9:59:59.000 God knows we need solutions, 9:59:59.000,9:59:59.000 we need that kind of hope and progress 9:59:59.000,9:59:59.000 that expectations are high 9:59:59.000,9:59:59.000 that will solve very tough problems. 9:59:59.000,9:59:59.000 CA: I mean, most philanthropists, 9:59:59.000,9:59:59.000 even the best of them, 9:59:59.000,9:59:59.000 find it hard to give away more than about[br]a percent of their net worth every year, 9:59:59.000,9:59:59.000 and yet the world's richest[br]often have access 9:59:59.000,9:59:59.000 to great investment opportunities. 9:59:59.000,9:59:59.000 Many of them are gaining wealth[br]at seven to 10 percent plus per year. 9:59:59.000,9:59:59.000 Isn't it the case that[br]to have a real chance 9:59:59.000,9:59:59.000 of giving away half your fortune, 9:59:59.000,9:59:59.000 at some point you have to plan[br]to give away five, six, seven, eight, 9:59:59.000,9:59:59.000 10 percent of your net worth annually? 9:59:59.000,9:59:59.000 And that is, isn't that the logic[br]of what should be happening? 9:59:59.000,9:59:59.000 BG: Yeah, there are people[br]like Chuck Feeney, 9:59:59.000,9:59:59.000 who set a good example 9:59:59.000,9:59:59.000 and gave away all of his money. 9:59:59.000,9:59:59.000 Even Melinda and I are talking about, 9:59:59.000,9:59:59.000 should we up the rate that we give at? 9:59:59.000,9:59:59.000 As you say, we've been very lucky[br]on the investment side 9:59:59.000,9:59:59.000 through a variety of things. 9:59:59.000,9:59:59.000 Tech fortunes in general have done well, 9:59:59.000,9:59:59.000 even this year, 9:59:59.000,9:59:59.000 which is one of those great contrasts 9:59:59.000,9:59:59.000 in what's going on in the world. 9:59:59.000,9:59:59.000 And I do think there's an expectation 9:59:59.000,9:59:59.000 that we should speed up, 9:59:59.000,9:59:59.000 and there's a reason to speed up, 9:59:59.000,9:59:59.000 and government is going[br]to miss a lot of needs. 9:59:59.000,9:59:59.000 Yes, there's tons of government[br]money out there, 9:59:59.000,9:59:59.000 but helping it be spent well, 9:59:59.000,9:59:59.000 helping find places it's not stepping up, 9:59:59.000,9:59:59.000 and if people are willing to give[br]to the developing world, 9:59:59.000,9:59:59.000 they don't have governments 9:59:59.000,9:59:59.000 that can print checks[br]for 15 percent of GDP, 9:59:59.000,9:59:59.000 and so the suffering there broadly,[br]just the economic stuff alone, 9:59:59.000,9:59:59.000 put aside the pandemic, 9:59:59.000,9:59:59.000 is tragic. 9:59:59.000,9:59:59.000 It's about a five year setback 9:59:59.000,9:59:59.000 in terms of these countries[br]moving forward, 9:59:59.000,9:59:59.000 and in a few cases it's tough enough[br]that the very stability of the country 9:59:59.000,9:59:59.000 is in question. 9:59:59.000,9:59:59.000 CA: Well, Bill, 9:59:59.000,9:59:59.000 I'm in awe of what you[br]and Melinda have done. 9:59:59.000,9:59:59.000 You walk this narrow path 9:59:59.000,9:59:59.000 of trying to juggle[br]so many different things, 9:59:59.000,9:59:59.000 and the amount of time that you dedicate[br]to the betterment of the world at large, 9:59:59.000,9:59:59.000 and definitely the amount of money 9:59:59.000,9:59:59.000 and the amount of passion you put into it, 9:59:59.000,9:59:59.000 I mean, it's pretty awesome, 9:59:59.000,9:59:59.000 and I'm really grateful to you[br]for spending this time with us now. 9:59:59.000,9:59:59.000 Thank you so much, 9:59:59.000,9:59:59.000 and honestly the rest of this year 9:59:59.000,9:59:59.000 your skills and resources[br]are going to be needed more than ever, 9:59:59.000,9:59:59.000 so good luck. 9:59:59.000,9:59:59.000 BG: Well, thanks. 9:59:59.000,9:59:59.000 It's fun work and I'm optimistic, 9:59:59.000,9:59:59.000 so thanks, Chris.