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Chris Anderson. Welcome, Bill Gates.

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Bill Gates: Thank you.

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CA: All right. It's great
to have you here, Bill.

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You know, we had a TED conversation

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about three months ago
about this pandemic,

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and back then I think fewer than --

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I think that was the end of March --

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back then, fewer than
a thousand people in the US had died,

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and fewer than 20,000 worldwide.

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I mean, the numbers now are,
like, 128,000 dead in the US

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and more than half a million worldwide.

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in three months.

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In three months.

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What is your diagnosis of what is possible
for the rest of this year?

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You look at a lot of models.

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What do you think best
and worst case scenarios might be?

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BG: Well, the range of scenarios, sadly,

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is quite large, including that,

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as we get into the fall,

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we could have death rates

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that rival the worst of what we had
in the April time period.

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If you get a lot of young people infected,

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eventually they will infect
old people again,

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and so you'll get into the nursing homes,

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the homeless shelters,

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the places where we've had
a lot of our deaths.

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The innovation track,
which probably we will touch on --

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diagnostics, therapeutics, vaccines --

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there's good progress there,

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but nothing that would
fundamentally alter the fact

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that this fall in the United States
could be quite bad,

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and that's worse than
I would have expected a month ago,

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the degree to which we're back
at high mobility,

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not wearing masks,

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and now the virus actually
has gotten into a lot of cities

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that it hadn't been in before

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in a significant way,

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so it's going to be a challenge.

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There's no case where we get
much below the current death rate,

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which is about 500 deaths a day,

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but there's a significant risk
we'd go back up

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to the even 2,000 a day
that we had before,

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because we don't have the distancing,

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the behavior change,

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to the degree that we had
in April and May,

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and we know this virus
is somewhat seasonal,

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so that the force of infection,

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both through temperature, humidity,
more time indoors,

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will be worse as we get into the fall.

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CA: So there are scenarios
where in the US,

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like, if you extrapolate
those numbers forward,

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we end up with, what,

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more than a quarter of a million deaths,

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perchance, even this year
if we're not careful,

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and worldwide I guess the death toll
could by the end of the year

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be well into the millions, with an s.

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Is there evidence that the hotter
temperatures of the summer

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actually have been helping us?

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BG: They're not absolutely sure,

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but certainly the ?? model
definitely wanted to use the season,

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including temperature and humidity,

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to try and explain why May
wasn't worse than it was.

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And so as we came out
and the mobility numbers got higher,

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the models expected more infections
and deaths to come out of that,

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and the model kept wanting to say,

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"But I need to use this seasonality

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to match why May wasn't worse,

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why June wasn't worse than it was."

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And we see in the Southern Hemisphere,

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you know, Brazil,

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which is the opposite season,

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all of South America
is having a huge epidemic.

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South Africa is having
a very fast-growing epidemic.

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Fortunately, Australia and New Zealand,

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the last countries
in the Southern Hemisphere,

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are at really tiny case counts,

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and so although they have
to keep knocking it down,

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they're talking about, oh,
we have 10 cases,

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that's a big deal,
let's go get rid of that.

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So they're one of these amazing countries

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that got the numbers so low

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that test, quarantine and trace

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is working to get them,

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keep them at very near zero.

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CA: Aided perhaps a bit
by being easier to isolate

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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

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goes a long ways.

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It's not a linear game.

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Contact tracing, if you have
the number of cases we have in the US,

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it's super-important to do,

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but it won't get you back down to zero.

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It'll help you be down,

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but it's too overwhelming.

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CA: OK, so in May and June in the US,

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the numbers were actually slightly better
than some of the models predicted,

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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

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as really quite alarming upticks
in case rates in the US?

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BG: That's right.

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In, say, the New York area,

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the cases continue to go down somewhat,

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but in other parts of the country,

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primarily the South right now,

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you have increases
that are offsetting that,

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and you have testing
positive rates in young people

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that are actually higher

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than what we saw even
in some of the tougher areas,

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and so clearly younger people
have come out of mobility

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more than older people
have increased their mobility,

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so the age structure

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is right now very young, but
because of multigenerational households,

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people work in nursing care homes,

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unfortunately that will work its way back,

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both the time lag and the transmission
back up into the elderly,

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will start to push the death rate back up,

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which it is down,

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way down from 2,000
to around 500 right now.

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CA: And is that partly because
there's a three-week lag

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between case numbers and fatality numbers?

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And also, perhaps, partly because

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there have been
some effective interventions

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and we're actually seeing the possibility

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that the overall fatality rate
is actually falling a bit

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now that we've gained
some extra knowledge?

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BG: Yeah, certainly
your fatality rate is always lower

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when you're not overloaded,

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and so Italy when they were overloaded,

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Spain, even New York at the start,

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certainly China,

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there you weren't even able
to provide the basics,

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the oxygen and things.

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A study that our foundation
funded in the UK

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found the only thing
other than remdesivir

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that is a proven therapeutic,

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which is the dexamethasone,

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that for serious patients

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is about a 20 percent death reduction,

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and there's still quite
a pipeline of those things.

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You know, hydroxychloroquine
never established positive data,

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so that's pretty much done.

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There's still a few trials ongoing,

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but the list of things being tried,

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including eventually
?? antibodies,

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we will have some additional
tools for the fall.

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And so when you talk about death rates,

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the good news is some
innovation we already have

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and we will have more

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even in the fall.

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We should start to have
monoclonal antibodies,

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which is the single therapeutic
that I'm most excited about.

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CA: I'll actually ask you to tell me
a bit more about that in one sec,

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but just putting the pieces
together on death rates:

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so in a well-functioning health system,

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so take the US when places
aren't overcrowded,

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what do you think

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the current fatality numbers
are approximately going forward,

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like as a percentage of total cases?

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Are we below one percent, perhaps?

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BG: If you found every case, yes,

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you're well below one percent.

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People argue, you know, 0.4, 0.5.

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By the time you bring in
the never symptomatics,

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it probably is below 0.5,

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and that's good news.

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This disease could have been
a five percent disease.

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The transmission dynamics of this disease

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are more difficult
than even the experts predicted.

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The amount of pre-symptomatic
and never symptomatic spread,

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and the fact that it's not coughing,

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where you would kind of notice,
hey, I'm coughing.

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Most respiratory diseases make you cough.

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This one, in its early stages,
it's not coughing,

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it's singing, laughing, talking,

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actually still particularly
for the super-spreaders,

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people with very high viral loads,

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causes that spread,

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and that's pretty novel,

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and so even experts have to say,
wow, this caught us by surprise.

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The amount of asymptomatic spread

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and the fact that there's not
a coughing element

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is not a major piece like the flu or TB.

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CA: Yeah, that is devilish cunning

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by the virus.

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I mean, how much is
that non-symptomatic transmission

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as a percentage of total transmission?

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I've heard numbers it could be
as much as half of all transmissions

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are basically pre-symptomatic.

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BG: Yeah, if you count pre-symptomatics,

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then most of the studies show
that's like at 40 percent,

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and we also have never symptomatics.

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The amount of virus you get
in your upper respiratory area

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is somewhat disconnected.

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Some people will have a lot here
and very little in their lungs,

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and what you get in your lungs

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causes the really bad symptoms,

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and other organs,

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but mostly the lungs,

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and so that's when you seek treatment.

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And so the worst case
in terms of spreading

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is somebody who's got a lot
in the upper respiratory tract

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but almost none in their lungs,

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so they're not care-seeking.

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CA: Right.

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And so if you add in the never symptomatic

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to the pre-symptomatic,

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do you get above 50 percent
of the transmission

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is actually from non-symptomatic people?

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BG: Yeah, transmission
is harder to measure.

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You know, we see certain
hotspots and things,

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but that's a huge question
with the vaccine:

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will it, besides avoiding
you getting sick,

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which is what the trial will test,

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will it also stop you
from being a transmitter?

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CA: So that vaccine,

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it's such an important question,
let's come on to that,

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but before we go there,

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any other surprises
in the last couple months

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that we've learned about this virus

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that really impact how
we should respond to it?

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BG: We're still not able to characterize
who the super-spreaders are

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in terms of what that profile is,

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and we may never.

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That may just be quite random.

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If you could identify them,

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they're responsible
for the majority of transmission,

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a few people who have
very high viral loads.

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But sadly, we haven't figured that out.

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This mode of transmission,

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if you're in a room and nobody talks,

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there's way less transmission.

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That's partly why,
although planes can transmit,

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it's less than you would expect
just in terms of time proximity measures,

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because unlike, say,
a choir or a restaurant,

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you're not exhaling in loud talking

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quite as much as in
other indoor environments.

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CA: What do you think about the ethics
of someone who would go on a plane

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and refuse to wear a mask?

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BG: If they own the plane,
that would be fine.

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If there's other people on the plane,

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that would be endangering
those other people.

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CA: Early on in the pandemic,

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the WHO did not advise
that people wear masks.

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They were worried about taking them away
from frontline medical providers.

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In retrospect, was that
a terrible mistake that they made?

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BG: Yes.

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All the experts feel bad

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that the value of masks,

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which ties back somewhat
to the asymptomatics,

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if people were very symptomatic,

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like in Ebola,

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then you know it and you isolate,

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and so you don't have
a need for a mask-like thing.

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The value of masks,

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the fact that the medical masks
was a different supply chain

257
99:59:59,999 --> 99:59:59,999
than the normal masks,

258
99:59:59,999 --> 99:59:59,999
the fact you could scale up
the normal masks so well,

259
99:59:59,999 --> 99:59:59,999
the fact that it would stop
that pre-symptomatic,

260
99:59:59,999 --> 99:59:59,999
never symptomatic transmission,

261
99:59:59,999 --> 99:59:59,999
it's a mistake,

262
99:59:59,999 --> 99:59:59,999
but it's not a conspiracy,

263
99:59:59,999 --> 99:59:59,999
it's something that we now know more.

264
99:59:59,999 --> 99:59:59,999
And even now, our error bars
on the benefit of masks

265
99:59:59,999 --> 99:59:59,999
are higher than we'd like to admit,

266
99:59:59,999 --> 99:59:59,999
but it's a significant benefit.

267
99:59:59,999 --> 99:59:59,999
CA: All right, I'm going to come in
with some questions

268
99:59:59,999 --> 99:59:59,999
from the community.

269
99:59:59,999 --> 99:59:59,999
Let's pull them up there.

270
99:59:59,999 --> 99:59:59,999
Jim Pitofsky: "Do you think reopening
efforts in the US have been premature,

271
99:59:59,999 --> 99:59:59,999
and if so how far should the US go
to responsibly confront this pandemic?"

272
99:59:59,999 --> 99:59:59,999
BG: Well, the question
of how you make tradeoffs

273
99:59:59,999 --> 99:59:59,999
between the benefits, say,
of going to school

274
99:59:59,999 --> 99:59:59,999
versus the risk of people getting sick
because they go to school,

275
99:59:59,999 --> 99:59:59,999
those are very tough questions

276
99:59:59,999 --> 99:59:59,999
that I don't think any single person

277
99:59:59,999 --> 99:59:59,999
can say, "I will tell you
how to make all these tradeoffs."

278
99:59:59,999 --> 99:59:59,999
The understanding of
where you have transmission,

279
99:59:59,999 --> 99:59:59,999
and the fact that young people
do get infected

280
99:59:59,999 --> 99:59:59,999
and are part of the multi-generational
transmission chain,

281
99:59:59,999 --> 99:59:59,999
we should get that out.

282
99:59:59,999 --> 99:59:59,999
If you just look at the health aspect,

283
99:59:59,999 --> 99:59:59,999
we have opened up too liberally.

284
99:59:59,999 --> 99:59:59,999
Now, opening up in terms of mental health

285
99:59:59,999 --> 99:59:59,999
and seeking normal health things

286
99:59:59,999 --> 99:59:59,999
like vaccines and other care,

287
99:59:59,999 --> 99:59:59,999
there are benefits.

288
99:59:59,999 --> 99:59:59,999
I think some of our opening up

289
99:59:59,999 --> 99:59:59,999
has created more risk than benefit.

290
99:59:59,999 --> 99:59:59,999
Opening the bars up
as quickly as they did,

291
99:59:59,999 --> 99:59:59,999
is that critical for mental health?

292
99:59:59,999 --> 99:59:59,999
Maybe not.

293
99:59:59,999 --> 99:59:59,999
So I don't think we've been
as tasteful about opening up

294
99:59:59,999 --> 99:59:59,999
as I'm sure, as we study it,

295
99:59:59,999 --> 99:59:59,999
that we'll realize some things
we shouldn't have opened up as fast,

296
99:59:59,999 --> 99:59:59,999
but then you have something like school,

297
99:59:59,999 --> 99:59:59,999
where even sitting here today,

298
99:59:59,999 --> 99:59:59,999
the exact plan, say,
for inner city schools for the fall,

299
99:59:59,999 --> 99:59:59,999
I wouldn't have a black-and-white view

300
99:59:59,999 --> 99:59:59,999
on the relative tradeoffs involved there.

301
99:59:59,999 --> 99:59:59,999
There are huge benefits

302
99:59:59,999 --> 99:59:59,999
to letting those kids go to school,

303
99:59:59,999 --> 99:59:59,999
and how do you weigh the risk?

304
99:59:59,999 --> 99:59:59,999
If you're in a city

305
99:59:59,999 --> 99:59:59,999
without many cases,

306
99:59:59,999 --> 99:59:59,999
I would say probably the benefit is there.

307
99:59:59,999 --> 99:59:59,999
Now that means that
you could get surprised.

308
99:59:59,999 --> 99:59:59,999
The cases could show up,
and then you'd have to change that,

309
99:59:59,999 --> 99:59:59,999
which is not easy.

310
99:59:59,999 --> 99:59:59,999
But I think around the US
there will be places

311
99:59:59,999 --> 99:59:59,999
where that won't be a good tradeoff.

312
99:59:59,999 --> 99:59:59,999
So almost any dimension and inequity,

313
99:59:59,999 --> 99:59:59,999
this disease has made worse:

314
99:59:59,999 --> 99:59:59,999
job type, internet connection,

315
99:59:59,999 --> 99:59:59,999
ability of your school
to do online learning.

316
99:59:59,999 --> 99:59:59,999
White collar workers,

317
99:59:59,999 --> 99:59:59,999
people are embarrassed to admit it,

318
99:59:59,999 --> 99:59:59,999
some of them are more productive

319
99:59:59,999 --> 99:59:59,999
and enjoying the flexibility
that the at-home thing has created,

320
99:59:59,999 --> 99:59:59,999
and that feels terrible

321
99:59:59,999 --> 99:59:59,999
when you know lots of people
are suffering in many ways,

322
99:59:59,999 --> 99:59:59,999
including their kids not going to school.

323
99:59:59,999 --> 99:59:59,999
CA: Indeed. Let's have the next question.

324
99:59:59,999 --> 99:59:59,999
"For us in Rwanda,

325
99:59:59,999 --> 99:59:59,999
early policy interventions
have made the difference.

326
99:59:59,999 --> 99:59:59,999
At this point, what policy interventions
do you suggest for the US now?"

327
99:59:59,999 --> 99:59:59,999
Bill, I dream of the day
where you are appointed

328
99:59:59,999 --> 99:59:59,999
the coronavirus czar

329
99:59:59,999 --> 99:59:59,999
with authority to actually
speak to the public.

330
99:59:59,999 --> 99:59:59,999
What would you do?

331
99:59:59,999 --> 99:59:59,999
BG: The innovation tools

332
99:59:59,999 --> 99:59:59,999
are where I and the foundation
probably has the most expertise.

333
99:59:59,999 --> 99:59:59,999
Clearly some of the policies
on opening up have been too generous,

334
99:59:59,999 --> 99:59:59,999
but I think everybody

335
99:59:59,999 --> 99:59:59,999
could engage in that.

336
99:59:59,999 --> 99:59:59,999
We need leadership

337
99:59:59,999 --> 99:59:59,999
in terms of admitting

338
99:59:59,999 --> 99:59:59,999
that we've still got a huge problem here,

339
99:59:59,999 --> 99:59:59,999
and not turning that
into almost a political thing

340
99:59:59,999 --> 99:59:59,999
of, oh, isn't it brilliant what we did.

341
99:59:59,999 --> 99:59:59,999
No, it's not brilliant,

342
99:59:59,999 --> 99:59:59,999
but there's many people,

343
99:59:59,999 --> 99:59:59,999
including the experts,

344
99:59:59,999 --> 99:59:59,999
where there's a lot
they didn't understand,

345
99:59:59,999 --> 99:59:59,999
and everybody wishes a week earlier
whatever action they took,

346
99:59:59,999 --> 99:59:59,999
they'd taken that a week earlier.

347
99:59:59,999 --> 99:59:59,999
The innovation tools,

348
99:59:59,999 --> 99:59:59,999
that's where the foundation's work

349
99:59:59,999 --> 99:59:59,999
on antibodies, vaccines,

350
99:59:59,999 --> 99:59:59,999
we have deep expertise,

351
99:59:59,999 --> 99:59:59,999
and it's outside of the private sector,

352
99:59:59,999 --> 99:59:59,999
and so we have kind of a neutral ability
to work with all the governments

353
99:59:59,999 --> 99:59:59,999
and the companies to pick.

354
99:59:59,999 --> 99:59:59,999
Particularly when you're doing
break-even products,

355
99:59:59,999 --> 99:59:59,999
which one should get the resources.

356
99:59:59,999 --> 99:59:59,999
There's no market signal for that.

357
99:59:59,999 --> 99:59:59,999
Experts have to say, OK,
this antibody deserves the manufacturing.

358
99:59:59,999 --> 99:59:59,999
This vaccine deserves the manufacturing.

359
99:59:59,999 --> 99:59:59,999
Because, we have very limited
manufacturing for both of those things,

360
99:59:59,999 --> 99:59:59,999
and it'll be cross-company,

361
99:59:59,999 --> 99:59:59,999
which never happens in the normal case,

362
99:59:59,999 --> 99:59:59,999
where one company invents it

363
99:59:59,999 --> 99:59:59,999
and then you're using
the manufacturing plants

364
99:59:59,999 --> 99:59:59,999
of many companies

365
99:59:59,999 --> 99:59:59,999
to get maximum scale of the best choice.

366
99:59:59,999 --> 99:59:59,999
So I would be coordinating those things,

367
99:59:59,999 --> 99:59:59,999
but we need a leader
who keeps us up to date,

368
99:59:59,999 --> 99:59:59,999
is realistic,

369
99:59:59,999 --> 99:59:59,999
and shows us the right behavior,

370
99:59:59,999 --> 99:59:59,999
as well as driving the innovation track.

371
99:59:59,999 --> 99:59:59,999
CA: I mean, you have to yourself
be a master diplomat

372
99:59:59,999 --> 99:59:59,999
in how you talk about this stuff.

373
99:59:59,999 --> 99:59:59,999
So I appreciate, almost,
the discomfort here,

374
99:59:59,999 --> 99:59:59,999
but you talk regularly with Anthony Fauci,

375
99:59:59,999 --> 99:59:59,999
who is a wise voice on this
by most people's opinion.

376
99:59:59,999 --> 99:59:59,999
But to what extent is he just hamstrung?

377
99:59:59,999 --> 99:59:59,999
He's not allowed to play the full role

378
99:59:59,999 --> 99:59:59,999
that he could play in the circumstance.

379
99:59:59,999 --> 99:59:59,999
BG: Dr. Fauci has emerged,

380
99:59:59,999 --> 99:59:59,999
where he was allowed to have some airtime,

381
99:59:59,999 --> 99:59:59,999
and even though he was stating
things that are realistic,

382
99:59:59,999 --> 99:59:59,999
his prestige has stuck.

383
99:59:59,999 --> 99:59:59,999
He can speak out in that way.

384
99:59:59,999 --> 99:59:59,999
Typically, the CDC would be
the primary voice here.

385
99:59:59,999 --> 99:59:59,999
It's not absolutely necessary,

386
99:59:59,999 --> 99:59:59,999
but in previous health crises,

387
99:59:59,999 --> 99:59:59,999
you let the experts inside the CDC

388
99:59:59,999 --> 99:59:59,999
be that voice.

389
99:59:59,999 --> 99:59:59,999
They're trained to do these things,

390
99:59:59,999 --> 99:59:59,999
and so it is a bit unusual here

391
99:59:59,999 --> 99:59:59,999
how much we've had to rely on Fauci

392
99:59:59,999 --> 99:59:59,999
as opposed to the CDC.

393
99:59:59,999 --> 99:59:59,999
It should be Fauci,
who is a brilliant researcher,

394
99:59:59,999 --> 99:59:59,999
so experienced, particularly in vaccines,

395
99:59:59,999 --> 99:59:59,999
in some ways he has become,
taking the broad advice

396
99:59:59,999 --> 99:59:59,999
that is the epidemiology advice

397
99:59:59,999 --> 99:59:59,999
and explaining it in the right way,

398
99:59:59,999 --> 99:59:59,999
where he'll admit,

399
99:59:59,999 --> 99:59:59,999
"OK, we may have a rebound here,

400
99:59:59,999 --> 99:59:59,999
and this is why we need
to behave that way."

401
99:59:59,999 --> 99:59:59,999
But it's fantastic that his voice
has been allowed to come through.

402
99:59:59,999 --> 99:59:59,999
CA: Sometimes.

403
99:59:59,999 --> 99:59:59,999
Let's have the next question.

404
99:59:59,999 --> 99:59:59,999
Nina Gregory: "How are you
and your foundation

405
99:59:59,999 --> 99:59:59,999
addressing the ethical questions
about which countries

406
99:59:59,999 --> 99:59:59,999
get the vaccine first,

407
99:59:59,999 --> 99:59:59,999
assuming you find one?"

408
99:59:59,999 --> 99:59:59,999
And maybe, Bill, use this as a moment

409
99:59:59,999 --> 99:59:59,999
to just talk about where
the quest for the vaccine is

410
99:59:59,999 --> 99:59:59,999
and what are just some of the key things
we should all be thinking about

411
99:59:59,999 --> 99:59:59,999
as we track the news on this.

412
99:59:59,999 --> 99:59:59,999
BG: There's three vaccines that are,

413
99:59:59,999 --> 99:59:59,999
if they work, are the earliest:

414
99:59:59,999 --> 99:59:59,999
the Moderna, which unfortunately
won't scale very easily,

415
99:59:59,999 --> 99:59:59,999
so if that works, it'll be mostly
a US-targeted thing;

416
99:59:59,999 --> 99:59:59,999
then you have the AstraZeneca,
which comes from Oxford;

417
99:59:59,999 --> 99:59:59,999
and the Johnson & Johnson.

418
99:59:59,999 --> 99:59:59,999
Those are the three early ones,

419
99:59:59,999 --> 99:59:59,999
and we have animal data

420
99:59:59,999 --> 99:59:59,999
that looks potentially good,

421
99:59:59,999 --> 99:59:59,999
but not definitive,

422
99:59:59,999 --> 99:59:59,999
particularly will it work in the elderly,

423
99:59:59,999 --> 99:59:59,999
and we'll have human data
over the next several months.

424
99:59:59,999 --> 99:59:59,999
Those three will be gated by
the safety and efficacy trial.

425
99:59:59,999 --> 99:59:59,999
That is, we'll be able
to manufacture those,

426
99:59:59,999 --> 99:59:59,999
although not as much as we want.

427
99:59:59,999 --> 99:59:59,999
We'll be able to manufacture those
before the end of the year.

428
99:59:59,999 --> 99:59:59,999
Whether the Phase 3 will succeed,

429
99:59:59,999 --> 99:59:59,999
and whether it'll complete
before the end of the year,

430
99:59:59,999 --> 99:59:59,999
I wouldn't be that optimistic about.

431
99:59:59,999 --> 99:59:59,999
Phase 3 is where you need
to really look at all the safety profile

432
99:59:59,999 --> 99:59:59,999
and efficacy,

433
99:59:59,999 --> 99:59:59,999
but those will get started.

434
99:59:59,999 --> 99:59:59,999
And then there's four or five vaccines

435
99:59:59,999 --> 99:59:59,999
that use different approaches

436
99:59:59,999 --> 99:59:59,999
that are maybe three
or four months behind that:

437
99:59:59,999 --> 99:59:59,999
Novavax, Sanofi, Merck.

438
99:59:59,999 --> 99:59:59,999
And so we're funding factory capacity
for a lot of these --

439
99:59:59,999 --> 99:59:59,999
some complex negotiations
are taking place right now on this --

440
99:59:59,999 --> 99:59:59,999
to get factories that will be dedicated
to the poorer countries,

441
99:59:59,999 --> 99:59:59,999
what's called low- and middle-income.

442
99:59:59,999 --> 99:59:59,999
And the very scalable constructs

443
99:59:59,999 --> 99:59:59,999
that include AstraZeneca
and Johnson & Johnson,

444
99:59:59,999 --> 99:59:59,999
we'll focus on those,

445
99:59:59,999 --> 99:59:59,999
the ones that are inexpensive

446
99:59:59,999 --> 99:59:59,999
and you can build a single factory
to make 600 million doses.

447
99:59:59,999 --> 99:59:59,999
So a number of the vaccine constructs

448
99:59:59,999 --> 99:59:59,999
are potential.

449
99:59:59,999 --> 99:59:59,999
I don't see anything
before the end of the year.

450
99:59:59,999 --> 99:59:59,999
That's really the best case,

451
99:59:59,999 --> 99:59:59,999
and it's down to a few constructs now,

452
99:59:59,999 --> 99:59:59,999
which typically you have
high failure rates.

453
99:59:59,999 --> 99:59:59,999
CA: Bill, is the case

454
99:59:59,999 --> 99:59:59,999
that you and your foundation
weren't in the picture here

455
99:59:59,999 --> 99:59:59,999
that market dynamics would likely
lead to a situation

456
99:59:59,999 --> 99:59:59,999
where as soon as a promising
vaccine candidate emerged,

457
99:59:59,999 --> 99:59:59,999
the richer countries
would basically snap up,

458
99:59:59,999 --> 99:59:59,999
gobble up all available initial supply --

459
99:59:59,999 --> 99:59:59,999
it just takes a while
to manufacture these --

460
99:59:59,999 --> 99:59:59,999
and there would be nothing
for the poorer countries,

461
99:59:59,999 --> 99:59:59,999
but that what effectively you're doing,

462
99:59:59,999 --> 99:59:59,999
by giving manufacturing guarantees

463
99:59:59,999 --> 99:59:59,999
and capability to some
of these candidates,

464
99:59:59,999 --> 99:59:59,999
you're making it possible that
at least some of the early vaccine units

465
99:59:59,999 --> 99:59:59,999
will go to poorer countries?

466
99:59:59,999 --> 99:59:59,999
Is that correct?

467
99:59:59,999 --> 99:59:59,999
BG: Well, it's not just us, but yes,

468
99:59:59,999 --> 99:59:59,999
we're in the central role there

469
99:59:59,999 --> 99:59:59,999
along with a group we created called CEPI,

470
99:59:59,999 --> 99:59:59,999
Coalition for Epidemic Preparedness,

471
99:59:59,999 --> 99:59:59,999
and the European leaders agree with this.

472
99:59:59,999 --> 99:59:59,999
Now we have the expertise
to look at each of the constructs

473
99:59:59,999 --> 99:59:59,999
and say, OK, where is there
a factory in the world

474
99:59:59,999 --> 99:59:59,999
that has capacity that can build that?

475
99:59:59,999 --> 99:59:59,999
Which one should we put
the early money into?

476
99:59:59,999 --> 99:59:59,999
What should the milestones be

477
99:59:59,999 --> 99:59:59,999
where we'll shift the money
over to a different one?

478
99:59:59,999 --> 99:59:59,999
Because the kind of private sector people

479
99:59:59,999 --> 99:59:59,999
who really understand that stuff,

480
99:59:59,999 --> 99:59:59,999
some of them work for us,

481
99:59:59,999 --> 99:59:59,999
and we're a trusted party on these things,

482
99:59:59,999 --> 99:59:59,999
we get to coordinate a lot,
particularly the manufacturing piece.

483
99:59:59,999 --> 99:59:59,999
Usually, you'd expect the US

484
99:59:59,999 --> 99:59:59,999
to think of this as
a global problem and be involved.

485
99:59:59,999 --> 99:59:59,999
So far, no activity
on that front has taken place.

486
99:59:59,999 --> 99:59:59,999
I am talking to people in the Congress
and the Administration

487
99:59:59,999 --> 99:59:59,999
about when the next
relief bill comes along

488
99:59:59,999 --> 99:59:59,999
that maybe one percent of that

489
99:59:59,999 --> 99:59:59,999
could go for the tools

490
99:59:59,999 --> 99:59:59,999
to help the entire world.

491
99:59:59,999 --> 99:59:59,999
And so it's possible,

492
99:59:59,999 --> 99:59:59,999
but it's unfortunate,

493
99:59:59,999 --> 99:59:59,999
and the vacuum here

494
99:59:59,999 --> 99:59:59,999
the world is not that used to

495
99:59:59,999 --> 99:59:59,999
and a lot of people are stepping in,

496
99:59:59,999 --> 99:59:59,999
including our foundation,

497
99:59:59,999 --> 99:59:59,999
to try and have a strategy,

498
99:59:59,999 --> 99:59:59,999
including for the poorer countries

499
99:59:59,999 --> 99:59:59,999
who will suffer a high percentage
of the deaths and negative effects,

500
99:59:59,999 --> 99:59:59,999
including their health systems
being overwhelmed.

501
99:59:59,999 --> 99:59:59,999
Most of the deaths will be
in developing countries,

502
99:59:59,999 --> 99:59:59,999
despite the huge deaths we've seen
in Europe and the US.

503
99:59:59,999 --> 99:59:59,999
CA: I mean, I wish I could be
a fly on the wall and hearing

504
99:59:59,999 --> 99:59:59,999
you and Melinda talk about this,

505
99:59:59,999 --> 99:59:59,999
because of all of
the ethical crimes, let's say,

506
99:59:59,999 --> 99:59:59,999
executed by leaders
who should know better,

507
99:59:59,999 --> 99:59:59,999
I mean, it's one thing
to not model mask-wearing,

508
99:59:59,999 --> 99:59:59,999
but to not play a role

509
99:59:59,999 --> 99:59:59,999
in helping the world when faced
with a common enemy,

510
99:59:59,999 --> 99:59:59,999
respond as one humanity

511
99:59:59,999 --> 99:59:59,999
and instead catalyze a really unseemly
scramble between nations

512
99:59:59,999 --> 99:59:59,999
to fight for vaccines, for example.

513
99:59:59,999 --> 99:59:59,999
That just seems that surely history
is going to judge that harshly.

514
99:59:59,999 --> 99:59:59,999
That is just sickening.

515
99:59:59,999 --> 99:59:59,999
Isn't it? Am I missing something?

516
99:59:59,999 --> 99:59:59,999
BG: Well, it's not quite
as black and white as that.

517
99:59:59,999 --> 99:59:59,999
The US has put more money out

518
99:59:59,999 --> 99:59:59,999
to fund the basic research
on these vaccines

519
99:59:59,999 --> 99:59:59,999
than any country by far,

520
99:59:59,999 --> 99:59:59,999
and that research is not restricted.

521
99:59:59,999 --> 99:59:59,999
There's not, like, some royalty
that says, "Hey, if you take our money,

522
99:59:59,999 --> 99:59:59,999
you have to pay the US a royalty."

523
99:59:59,999 --> 99:59:59,999
They do, to the degree they fund research,

524
99:59:59,999 --> 99:59:59,999
it's for everybody.

525
99:59:59,999 --> 99:59:59,999
To the degree they fund factories,
it's just for the US.

526
99:59:59,999 --> 99:59:59,999
The thing that makes this tough is that
in every other global health problem,

527
99:59:59,999 --> 99:59:59,999
the US totally leads smallpox eradication,

528
99:59:59,999 --> 99:59:59,999
the US is totally the leader
on polio eradication

529
99:59:59,999 --> 99:59:59,999
with key partners -- CDC, WHO,
Rotary, UNICEF, our foundation.

530
99:59:59,999 --> 99:59:59,999
So the world, and on HIV,

531
99:59:59,999 --> 99:59:59,999
what under President Bush's leadership,
but it was very bipartisan,

532
99:59:59,999 --> 99:59:59,999
this thing called PEPFAR was unbelievable.

533
99:59:59,999 --> 99:59:59,999
That has saved tens of millions of lives.

534
99:59:59,999 --> 99:59:59,999
And so it's that the world
always expected the US

535
99:59:59,999 --> 99:59:59,999
to at least be at the head of the table,

536
99:59:59,999 --> 99:59:59,999
financially, strategy, OK, how do you
get these factories for the world,

537
99:59:59,999 --> 99:59:59,999
even if it's just to avoid the infection
coming back to the US

538
99:59:59,999 --> 99:59:59,999
or to have the global economy working,

539
99:59:59,999 --> 99:59:59,999
which is good for US jobs

540
99:59:59,999 --> 99:59:59,999
to have demand outside the US.

541
99:59:59,999 --> 99:59:59,999
And so the world is kind of,
there's all this uncertainty

542
99:59:59,999 --> 99:59:59,999
about which thing will work,

543
99:59:59,999 --> 99:59:59,999
and there's, OK, who is in charge here?

544
99:59:59,999 --> 99:59:59,999
And so the worst thing,

545
99:59:59,999 --> 99:59:59,999
the withdrawal from WHO,

546
99:59:59,999 --> 99:59:59,999
that is a difficulty

547
99:59:59,999 --> 99:59:59,999
that hopefully will
get remedied at some point,

548
99:59:59,999 --> 99:59:59,999
because we need that coordination

549
99:59:59,999 --> 99:59:59,999
through WHO.

550
99:59:59,999 --> 99:59:59,999
CA: Let's take another question.

551
99:59:59,999 --> 99:59:59,999
Ali Kashani: "Are there any
particularly successful models

552
99:59:59,999 --> 99:59:59,999
of handling the pandemic
that you have seen around the world?"

553
99:59:59,999 --> 99:59:59,999
BG: Well, it's fascinating that,
besides early action,

554
99:59:59,999 --> 99:59:59,999
there are definitely things where
you take people who have tested positive

555
99:59:59,999 --> 99:59:59,999
and you monitor their ??,

556
99:59:59,999 --> 99:59:59,999
which is a oxygen saturation
level in their blood,

557
99:59:59,999 --> 99:59:59,999
which is a very cheap detector,

558
99:59:59,999 --> 99:59:59,999
and then you know to get them
to the hospitals fairly early.

559
99:59:59,999 --> 99:59:59,999
Weirdly, patients don't know
things are about to get severe.

560
99:59:59,999 --> 99:59:59,999
It's an interesting physiological reason
but I won't get into.

561
99:59:59,999 --> 99:59:59,999
And so Germany has
a quite a low case fatality rate

562
99:59:59,999 --> 99:59:59,999
that they've done through
that type of monitoring.

563
99:59:59,999 --> 99:59:59,999
And then, of course,
once you get into facilities,

564
99:59:59,999 --> 99:59:59,999
we've learned that the ventilator
actually, although extremely well-meaning,

565
99:59:59,999 --> 99:59:59,999
was actually overused
and used in the wrong mode

566
99:59:59,999 --> 99:59:59,999
in those early days.

567
99:59:59,999 --> 99:59:59,999
So the health, the doctors

568
99:59:59,999 --> 99:59:59,999
are way smarter about treatment today.

569
99:59:59,999 --> 99:59:59,999
Most of that I would say is global.

570
99:59:59,999 --> 99:59:59,999
Using this ??
as an early indicator,

571
99:59:59,999 --> 99:59:59,999
that'll probably catch on broadly,

572
99:59:59,999 --> 99:59:59,999
but Germany was a pioneer there.

573
99:59:59,999 --> 99:59:59,999
And now, of course, dexamethasone,

574
99:59:59,999 --> 99:59:59,999
fortunately, it's cheap, it's oral,

575
99:59:59,999 --> 99:59:59,999
we can ramp up manufacture.

576
99:59:59,999 --> 99:59:59,999
That'll go global as well.

577
99:59:59,999 --> 99:59:59,999
CA: Bill, I want to ask you

578
99:59:59,999 --> 99:59:59,999
something about

579
99:59:59,999 --> 99:59:59,999
what it's been like for you personally
through this whole process.

580
99:59:59,999 --> 99:59:59,999
Because, weirdly, even though
your passion and good intent on this topic

581
99:59:59,999 --> 99:59:59,999
seems completely bloody obvious to anyone
who has spent a moment with you,

582
99:59:59,999 --> 99:59:59,999
there are these crazy
conspiracy theories out there about you.

583
99:59:59,999 --> 99:59:59,999
I just checked in
with a company called Zignal

584
99:59:59,999 --> 99:59:59,999
that monitors social media spaces.

585
99:59:59,999 --> 99:59:59,999
They say that, to date,
I think on Facebook alone,

586
99:59:59,999 --> 99:59:59,999
more than four million posts
have taken place

587
99:59:59,999 --> 99:59:59,999
that associate you with some kind
of conspiracy theory around the virus.

588
99:59:59,999 --> 99:59:59,999
I read that there was a poll
that more than 40 percent of Republicans

589
99:59:59,999 --> 99:59:59,999
believe that the vaccine
that you would roll out

590
99:59:59,999 --> 99:59:59,999
would somehow plant a microchip
in people to track their location.

591
99:59:59,999 --> 99:59:59,999
I mean, I can't even believe
that poll number.

592
99:59:59,999 --> 99:59:59,999
And then some people
are taking this seriously enough,

593
99:59:59,999 --> 99:59:59,999
and some of them have even been
recirculated on Fox News and so forth,

594
99:59:59,999 --> 99:59:59,999
some people are taking this
seriously enough

595
99:59:59,999 --> 99:59:59,999
to make really quite horrible
threats and so forth.

596
99:59:59,999 --> 99:59:59,999
You seem to do a good job
sort of shrugging this off,

597
99:59:59,999 --> 99:59:59,999
but really, like, who else
has ever been in this position?

598
99:59:59,999 --> 99:59:59,999
How are you managing this?

599
99:59:59,999 --> 99:59:59,999
What on earth world are we in

600
99:59:59,999 --> 99:59:59,999
that this kind of misinformation
can be out there?

601
99:59:59,999 --> 99:59:59,999
What can we do to help correct it?

602
99:59:59,999 --> 99:59:59,999
BG: I'm not sure,

603
99:59:59,999 --> 99:59:59,999
and it's a new thing

604
99:59:59,999 --> 99:59:59,999
that there's conspiracy theories.

605
99:59:59,999 --> 99:59:59,999
I mean, Microsoft had
its share of controversy,

606
99:59:59,999 --> 99:59:59,999
but at least that related
to the real world, you know?

607
99:59:59,999 --> 99:59:59,999
Did Windows crash more than it should?

608
99:59:59,999 --> 99:59:59,999
We definitely had anti-trust problems.

609
99:59:59,999 --> 99:59:59,999
But at least I knew what that was.

610
99:59:59,999 --> 99:59:59,999
When this emerged, I have to say,

611
99:59:59,999 --> 99:59:59,999
my instinct was to joke about it.

612
99:59:59,999 --> 99:59:59,999
People have said
that's really inappropriate,

613
99:59:59,999 --> 99:59:59,999
because this is a very serious thing.

614
99:59:59,999 --> 99:59:59,999
It is going to make people
less willing to take a vaccine.

615
99:59:59,999 --> 99:59:59,999
And, of course, once we have that vaccine,

616
99:59:59,999 --> 99:59:59,999
it'll be like masks,

617
99:59:59,999 --> 99:59:59,999
where getting lots of people,

618
99:59:59,999 --> 99:59:59,999
particularly when it's
a transmission-blocking vaccine,

619
99:59:59,999 --> 99:59:59,999
there's this huge community benefit

620
99:59:59,999 --> 99:59:59,999
to widespread adoption of that vaccine.

621
99:59:59,999 --> 99:59:59,999
So I am caught a little bit,

622
99:59:59,999 --> 99:59:59,999
unsure of what to say or do,

623
99:59:59,999 --> 99:59:59,999
because the conspiracy piece
is a new thing for me,

624
99:59:59,999 --> 99:59:59,999
and what do you say

625
99:59:59,999 --> 99:59:59,999
that doesn't give credence to the thing?

626
99:59:59,999 --> 99:59:59,999
The fact that a Fox News commentator,

627
99:59:59,999 --> 99:59:59,999
Laura Ingraham, was saying
this stuff about me microchipping people,

628
99:59:59,999 --> 99:59:59,999
that survey isn't that surprising
because that's what they heard

629
99:59:59,999 --> 99:59:59,999
on the TV.

630
99:59:59,999 --> 99:59:59,999
It's wild.

631
99:59:59,999 --> 99:59:59,999
And people are clearly seeking
simpler explanations

632
99:59:59,999 --> 99:59:59,999
than going and studying virology.

633
99:59:59,999 --> 99:59:59,999
CA: I mean,

634
99:59:59,999 --> 99:59:59,999
TED is nonpolitical,

635
99:59:59,999 --> 99:59:59,999
but we believe in the truth.

636
99:59:59,999 --> 99:59:59,999
I would say this.

637
99:59:59,999 --> 99:59:59,999
Laura Ingraham, you owe Bill Gates
an apology and a retraction.

638
99:59:59,999 --> 99:59:59,999
You do.

639
99:59:59,999 --> 99:59:59,999
And anyone who is watching this

640
99:59:59,999 --> 99:59:59,999
who thinks for a minute

641
99:59:59,999 --> 99:59:59,999
that this man is involved
in some kind of conspiracy,

642
99:59:59,999 --> 99:59:59,999
you want your head examined.

643
99:59:59,999 --> 99:59:59,999
You are crazy.

644
99:59:59,999 --> 99:59:59,999
Enough of us know Bill over many years

645
99:59:59,999 --> 99:59:59,999
and have seen the passion
and engagement in this to know

646
99:59:59,999 --> 99:59:59,999
that you are crazy.

647
99:59:59,999 --> 99:59:59,999
So get over it,

648
99:59:59,999 --> 99:59:59,999
and let's look at the actual problem
of solving this pandemic.

649
99:59:59,999 --> 99:59:59,999
Honestly.

650
99:59:59,999 --> 99:59:59,999
If anyone in the chat here
has a suggestion,

651
99:59:59,999 --> 99:59:59,999
a positive suggestion for how you can,

652
99:59:59,999 --> 99:59:59,999
how do you get rid of conspiracies,
because they feed on each other.

653
99:59:59,999 --> 99:59:59,999
Now, oh, well I would say that,
because I'm part of the conspiracy,

654
99:59:59,999 --> 99:59:59,999
or whatever.

655
99:59:59,999 --> 99:59:59,999
Like, how do we get back to a world
where information can be trusted?

656
99:59:59,999 --> 99:59:59,999
We have to do better on it.

657
99:59:59,999 --> 99:59:59,999
Are there any other questions
out there from the community?

658
99:59:59,999 --> 99:59:59,999
Aria Bendix from New York City:

659
99:59:59,999 --> 99:59:59,999
"What are your personal recommendations
for those who want to reduce

660
99:59:59,999 --> 99:59:59,999
their risk of infection
amid an uptick in cases?"

661
99:59:59,999 --> 99:59:59,999
BG: Well, it's great if you have a job

662
99:59:59,999 --> 99:59:59,999
that you can stay at your house

663
99:59:59,999 --> 99:59:59,999
and do it through digital meetings,

664
99:59:59,999 --> 99:59:59,999
and even some of your social activities,

665
99:59:59,999 --> 99:59:59,999
you know, I do video calls
with lots of friends.

666
99:59:59,999 --> 99:59:59,999
I have friends in Europe that
who knows when I'll see them

667
99:59:59,999 --> 99:59:59,999
but we schedule regular calls to talk.

668
99:59:59,999 --> 99:59:59,999
If you stay fairly isolated,

669
99:59:59,999 --> 99:59:59,999
you don't run much risk,

670
99:59:59,999 --> 99:59:59,999
and it's when you're getting together
with lots of other people,

671
99:59:59,999 --> 99:59:59,999
either through work or socialization,

672
99:59:59,999 --> 99:59:59,999
that drives that risk,

673
99:59:59,999 --> 99:59:59,999
and particularly in these communities
where you have increased cases,

674
99:59:59,999 --> 99:59:59,999
even though it's not going to be mandated,

675
99:59:59,999 --> 99:59:59,999
hopefully the mobility numbers
will show people responding

676
99:59:59,999 --> 99:59:59,999
and minimizing those kind of
out of the house contacts.

677
99:59:59,999 --> 99:59:59,999
CA: Bill, I wonder if I could just ask you

678
99:59:59,999 --> 99:59:59,999
just a little bit about philanthropy.

679
99:59:59,999 --> 99:59:59,999
Obviously your foundation
has played a huge role in this,

680
99:59:59,999 --> 99:59:59,999
but philanthropy more generally.

681
99:59:59,999 --> 99:59:59,999
You know, you've started
this giving pledge movement,

682
99:59:59,999 --> 99:59:59,999
recruited all these billionaires

683
99:59:59,999 --> 99:59:59,999
who have pledged to give away
half their net worth

684
99:59:59,999 --> 99:59:59,999
before or after their death.

685
99:59:59,999 --> 99:59:59,999
But it's really hard to do.

686
99:59:59,999 --> 99:59:59,999
It's really hard to give away
that much money.

687
99:59:59,999 --> 99:59:59,999
You yourself, I think,

688
99:59:59,999 --> 99:59:59,999
since the giving pledge was started,

689
99:59:59,999 --> 99:59:59,999
what, 10 years ago or something,
I'm not sure when,

690
99:59:59,999 --> 99:59:59,999
but your own net worth I think
has doubled since that period

691
99:59:59,999 --> 99:59:59,999
despite being the world's
leading philanthropist.

692
99:59:59,999 --> 99:59:59,999
Is it just fundamentally hard

693
99:59:59,999 --> 99:59:59,999
to give away money effectively
to make the world better?

694
99:59:59,999 --> 99:59:59,999
Or should the world's donors,

695
99:59:59,999 --> 99:59:59,999
and especially the world's
really rich donors,

696
99:59:59,999 --> 99:59:59,999
start to almost commit to a schedule,

697
99:59:59,999 --> 99:59:59,999
like, here's a percentage
of my net worth each year

698
99:59:59,999 --> 99:59:59,999
that as I get older,

699
99:59:59,999 --> 99:59:59,999
maybe that goes up.

700
99:59:59,999 --> 99:59:59,999
If I'm to take this seriously,

701
99:59:59,999 --> 99:59:59,999
I have to give away, somehow,
I've got to find a way

702
99:59:59,999 --> 99:59:59,999
of doing that effectively.

703
99:59:59,999 --> 99:59:59,999
Is that an unfair and crazy question?

704
99:59:59,999 --> 99:59:59,999
BG: Well, it'd be great to up the rate,

705
99:59:59,999 --> 99:59:59,999
and our goal, both as the Gates Foundation
or through the giving pledge,

706
99:59:59,999 --> 99:59:59,999
is to help people find causes
they connect to.

707
99:59:59,999 --> 99:59:59,999
People give through passion.

708
99:59:59,999 --> 99:59:59,999
Yes, numbers are important,

709
99:59:59,999 --> 99:59:59,999
but there's so many causes out there.

710
99:59:59,999 --> 99:59:59,999
The way you're going to pick
is you see somebody who is sick,

711
99:59:59,999 --> 99:59:59,999
you see somebody who is not
getting social services.

712
99:59:59,999 --> 99:59:59,999
You see something
that helps reduce racism.

713
99:59:59,999 --> 99:59:59,999
And you're very passionate,
and so you give to that.

714
99:59:59,999 --> 99:59:59,999
And, of course,

715
99:59:59,999 --> 99:59:59,999
some philanthropic gifts won't work out.

716
99:59:59,999 --> 99:59:59,999
We do need to up the ambition level

717
99:59:59,999 --> 99:59:59,999
of philanthropists.

718
99:59:59,999 --> 99:59:59,999
Now, collaborative philanthropy

719
99:59:59,999 --> 99:59:59,999
that you're helping to facilitate
through Audacious,

720
99:59:59,999 --> 99:59:59,999
there's four or five other groups
that are getting philanthropists together,

721
99:59:59,999 --> 99:59:59,999
that is fantastic,

722
99:59:59,999 --> 99:59:59,999
because then they learn from each other,

723
99:59:59,999 --> 99:59:59,999
they get confidence from each other,

724
99:59:59,999 --> 99:59:59,999
they feel like, hey, I put in x

725
99:59:59,999 --> 99:59:59,999
and the four other people put money in,

726
99:59:59,999 --> 99:59:59,999
so I'm getting more impact,

727
99:59:59,999 --> 99:59:59,999
and hopefully it can be made for them

728
99:59:59,999 --> 99:59:59,999
even when they find out,

729
99:59:59,999 --> 99:59:59,999
OK, that particular gift
didn't work out that well,

730
99:59:59,999 --> 99:59:59,999
but let's keep going.

731
99:59:59,999 --> 99:59:59,999
So philanthropy, yes,

732
99:59:59,999 --> 99:59:59,999
I would like to see the rate go up,

733
99:59:59,999 --> 99:59:59,999
and people who do get going,

734
99:59:59,999 --> 99:59:59,999
it is fun,

735
99:59:59,999 --> 99:59:59,999
it's fulfilling,

736
99:59:59,999 --> 99:59:59,999
you pick which of the family members
are partnered in doing it.

737
99:59:59,999 --> 99:59:59,999
In my case, Melinda and I
love doing this stuff together,

738
99:59:59,999 --> 99:59:59,999
learning together.

739
99:59:59,999 --> 99:59:59,999
Some families, it will even
involve the kids in the activities.

740
99:59:59,999 --> 99:59:59,999
Sometimes the kids are pushing.

741
99:59:59,999 --> 99:59:59,999
When you have lots of money,

742
99:59:59,999 --> 99:59:59,999
you still think of million dollars
as a lot of money,

743
99:59:59,999 --> 99:59:59,999
but if you have billions,

744
99:59:59,999 --> 99:59:59,999
you should be giving hundreds of millions.

745
99:59:59,999 --> 99:59:59,999
So it's kind of charming that,
in terms of your personal expenditure,

746
99:59:59,999 --> 99:59:59,999
you stay at the level you were at before.

747
99:59:59,999 --> 99:59:59,999
That's societally quite appropriate.

748
99:59:59,999 --> 99:59:59,999
But on your giving, you need to scale up

749
99:59:59,999 --> 99:59:59,999
or else it will be your will,

750
99:59:59,999 --> 99:59:59,999
and you won't get to shape it
and enjoy it quite that same way.

751
99:59:59,999 --> 99:59:59,999
And so without,

752
99:59:59,999 --> 99:59:59,999
we don't want to mandate it,

753
99:59:59,999 --> 99:59:59,999
but yes, both you and I
want to inspire philanthropists

754
99:59:59,999 --> 99:59:59,999
to see that passion,

755
99:59:59,999 --> 99:59:59,999
to see those opportunities,

756
99:59:59,999 --> 99:59:59,999
significantly faster than in the past,

757
99:59:59,999 --> 99:59:59,999
because whether it's race or disease

758
99:59:59,999 --> 99:59:59,999
or all the other social ills,

759
99:59:59,999 --> 99:59:59,999
the innovation of what philanthropy
can go to and do quickly

760
99:59:59,999 --> 99:59:59,999
that, if it works, government
can come in behind it and scale it up,

761
99:59:59,999 --> 99:59:59,999
God knows we need solutions,

762
99:59:59,999 --> 99:59:59,999
we need that kind of hope and progress

763
99:59:59,999 --> 99:59:59,999
that expectations are high

764
99:59:59,999 --> 99:59:59,999
that will solve very tough problems.

765
99:59:59,999 --> 99:59:59,999
CA: I mean, most philanthropists,

766
99:59:59,999 --> 99:59:59,999
even the best of them,

767
99:59:59,999 --> 99:59:59,999
find it hard to give away more than about
a percent of their net worth every year,

768
99:59:59,999 --> 99:59:59,999
and yet the world's richest
often have access

769
99:59:59,999 --> 99:59:59,999
to great investment opportunities.

770
99:59:59,999 --> 99:59:59,999
Many of them are gaining wealth
at seven to 10 percent plus per year.

771
99:59:59,999 --> 99:59:59,999
Isn't it the case that
to have a real chance

772
99:59:59,999 --> 99:59:59,999
of giving away half your fortune,

773
99:59:59,999 --> 99:59:59,999
at some point you have to plan
to give away five, six, seven, eight,

774
99:59:59,999 --> 99:59:59,999
10 percent of your net worth annually?

775
99:59:59,999 --> 99:59:59,999
And that is, isn't that the logic
of what should be happening?

776
99:59:59,999 --> 99:59:59,999
BG: Yeah, there are people
like Chuck Feeney,

777
99:59:59,999 --> 99:59:59,999
who set a good example

778
99:59:59,999 --> 99:59:59,999
and gave away all of his money.

779
99:59:59,999 --> 99:59:59,999
Even Melinda and I are talking about,

780
99:59:59,999 --> 99:59:59,999
should we up the rate that we give at?

781
99:59:59,999 --> 99:59:59,999
As you say, we've been very lucky
on the investment side

782
99:59:59,999 --> 99:59:59,999
through a variety of things.

783
99:59:59,999 --> 99:59:59,999
Tech fortunes in general have done well,

784
99:59:59,999 --> 99:59:59,999
even this year,

785
99:59:59,999 --> 99:59:59,999
which is one of those great contrasts

786
99:59:59,999 --> 99:59:59,999
in what's going on in the world.

787
99:59:59,999 --> 99:59:59,999
And I do think there's an expectation

788
99:59:59,999 --> 99:59:59,999
that we should speed up,

789
99:59:59,999 --> 99:59:59,999
and there's a reason to speed up,

790
99:59:59,999 --> 99:59:59,999
and government is going
to miss a lot of needs.

791
99:59:59,999 --> 99:59:59,999
Yes, there's tons of government
money out there,

792
99:59:59,999 --> 99:59:59,999
but helping it be spent well,

793
99:59:59,999 --> 99:59:59,999
helping find places it's not stepping up,

794
99:59:59,999 --> 99:59:59,999
and if people are willing to give
to the developing world,

795
99:59:59,999 --> 99:59:59,999
they don't have governments

796
99:59:59,999 --> 99:59:59,999
that can print checks
for 15 percent of GDP,

797
99:59:59,999 --> 99:59:59,999
and so the suffering there broadly,
just the economic stuff alone,

798
99:59:59,999 --> 99:59:59,999
put aside the pandemic,

799
99:59:59,999 --> 99:59:59,999
is tragic.

800
99:59:59,999 --> 99:59:59,999
It's about a five year setback

801
99:59:59,999 --> 99:59:59,999
in terms of these countries
moving forward,

802
99:59:59,999 --> 99:59:59,999
and in a few cases it's tough enough
that the very stability of the country

803
99:59:59,999 --> 99:59:59,999
is in question.

804
99:59:59,999 --> 99:59:59,999
CA: Well, Bill,

805
99:59:59,999 --> 99:59:59,999
I'm in awe of what you
and Melinda have done.

806
99:59:59,999 --> 99:59:59,999
You walk this narrow path

807
99:59:59,999 --> 99:59:59,999
of trying to juggle
so many different things,

808
99:59:59,999 --> 99:59:59,999
and the amount of time that you dedicate
to the betterment of the world at large,

809
99:59:59,999 --> 99:59:59,999
and definitely the amount of money

810
99:59:59,999 --> 99:59:59,999
and the amount of passion you put into it,

811
99:59:59,999 --> 99:59:59,999
I mean, it's pretty awesome,

812
99:59:59,999 --> 99:59:59,999
and I'm really grateful to you
for spending this time with us now.

813
99:59:59,999 --> 99:59:59,999
Thank you so much,

814
99:59:59,999 --> 99:59:59,999
and honestly the rest of this year

815
99:59:59,999 --> 99:59:59,999
your skills and resources
are going to be needed more than ever,

816
99:59:59,999 --> 99:59:59,999
so good luck.

817
99:59:59,999 --> 99:59:59,999
BG: Well, thanks.

818
99:59:59,999 --> 99:59:59,999
It's fun work and I'm optimistic,

819
99:59:59,999 --> 99:59:59,999
so thanks, Chris.