PoliticoPolitico

To health leaders across the globe, reaching the World Health Organization's goal of vaccinating 70 percent of the planet's population by mid-2022 is crucial to stave off future Covid-19 surge.

To Bill Gates, the target represents a top-down approach to fighting the coronaviruses that ignores the reality on the ground.

We will never get to 70 percent. Who is saying that? We live in a world where countries spend thousands of dollars per year on medicine and countries spend hundreds of dollars per year on vaccine, according to Gates.

Gates sat down with POLITICO in Munich to discuss how to better prepare and respond to the next public health crisis, as well as finding more effective ways of combatting Covid-19. He said that the two are connected. Find solutions to the first, including improved production of Covid-19 vaccine and the distribution of it, as well as a future Pandemic that becomes easier to handle.

Optimizing vaccine distribution is part of the preparedness puzzle. COVAX, the world's vaccine facility, has enough vaccine to distribute to countries. In low- and middle-income countries with weak health systems, COVAX is struggling to quickly put shots in arms.

The process should be based on each country's preferences, according to Gates. He said it was possible that nations like the 30 that are still recording 10 percent immunization rates only want to target vulnerable populations.

It is up to the countries. What does Ethiopia want? What do Nigeria want? The billionaire philanthropist said that the real benefit is where you can get any decent dollars per year of life saved.

Improving distribution in the next Pandemic is dependent on the health systems in poorer countries being strengthened. More resources are available to target vaccine hesitancy in well- structured health systems.

Gates said vaccine hesitancy would create an upper bound way below 95 percent coverage. You don't see the same thing if you are a very young population that is very thin. If you get the trust hierarchy, which is the religious leaders, you can overcome some of that.

The fight against Covid-19 is funded by the Gates Foundation. Billions of dollars have been given to support the distribution of vaccines. $120 million was donated to shore up country-specific and regional responses in sub-Saharan Africa and South Asia.

Gates said that he is starting to think about how the world can prepare for future disease outbreaks. He has a book coming out in May.

Over the past two years, the global health community has grappled with the virus. The world might be able to think more broadly about future response now that Omicron cases are declining in dozens of countries.

Dozens of global health leaders gathered at the Munich Security Conference to discuss that.

In 2015, a lot of people talked about what it would take to stop a disease. Gates said the formula hasn't changed. The R&D needs to be funded for better diagnostics. The cost to fund the new tools is almost nothing, given the deaths, economic damage, and other negative things that came out of the Pandemic.

Gates and others want to make vaccine production and administration more efficient, including using a vaccine to protect against Covid-19, the flu and respiratory syncytial virus. Gates said that the vaccine mechanism could change.

We don't want to use a needle in the future. If you take your first dose as a micro-patch and your second as an inhalation, you'll be able to prevent infections because you want secretory antibodies in the nose. He said that they have never been good at that. You could even think about eradication if we came along with an infection blocker. We are far away from that.

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