Back society, the way to do that is to put women straight at the center, because guess what. Theyre already at the center. Ic with a pandtill raging and concerns it will get worse before it gets better, what does philanthropisty Melinda Gates w . Ri fing line with Margaret Hoover is made possible in part by. Corporate fundg is provided by. Welcome to firing line, Melinda Gates. Thanks for havinge, margaret. You cofoundethe bill two decades ago, ace thenion your foundation has worked to fight global poverty and to combat infectious disease, including hiv, tuberculosis, malaria, ebola. And now you have committed more than 300 millionhe to fightovid19 pandemic. My question just to startyo is work is so often gicused on global health. Could you have id that you would be battling a pandemic so close to home . No, theres no chance that wthought we would have a pandemic, you know, and that part of the start of it was here in seattle. So, no, this has been quite t a surprius. We knew eventually there would be some pandemic, ink we certainly didnt it was going to be of this magnitude and scale at this time. Nobody could have predicted that. Well, were at the sixmonth anniversary of the first known case of vid19 in the United States from january 20th. And right at this moment, covid19 cases are spiking dramatically in a majority of states. A few months ago, did you think we would be back to square one . No, i think we all thought just listening to the data and looking at the disease modeling, that we woulhave a reprieve here during the summer. But, you know, i think its beei esly challenging because we dont have a National Testing program with approprte testing, contact tracing, and so i think its gotten much more difficult that people are going out more and not doing the appropriate social distancing and masks. And so we are almost already in a second wave that really wasnt predicted to happenal until this and you think this is a second wave rather than the continuation of the first wave spreadingdi througerent states . Its hard to say, quite honestly, but, you know, even in some places where weve already had covid, you know, we are starting r to seee again. And so really, it doesnt matter wat you call it. We need to dwhknow works, which is we need practice safe social distancing and Wearing Masks and staying home as much as we possibly can. Well, so your foundation is working on a lot of different areas to fight the virus from vaccinec to therape providing protection to lowIncome Countries. You in particular, though, are focused on a group of people that you warn is being left behind, and thats women. Now, we know lookinge data that covid19 actually kills rre men than women. So tell us why y so concerned about women being left behind. Well, because we know that covid is not only wreaking havoc on our health and our dies, but its also exposing the fault lines in society. Its having a profound effect on the poor, on women, on people of color. At those issues anre out what do we do about it. Women are losing their job f atter rate than men are. Women are the ones often who are at home caring for the elderly, trying to help the chi continue to learn online or taking care of thyoung and trying to get on the bus and go to their job. I mean, its jt its its almost impossible what were asking women to do during this time. W and need to lookt that. Ig so youve just published a paper in foaffairs. Its title is the pandemics toll on women,and it details the silent to that the epidemic and pandemics you write. Ve on women. Explain. How do you know this . Well, we know from the ebola in the four affected countries in west africa, you had a silent pandemic that tracked right along with it, and when you get mnal deaths. Maternal deaths, you also get more childhood deaths. And so there are things c do to keep that system up and running. A perft example, not very expensive, but in ethiopia, they said, okay, wenow women are going to have more trouble now coming to the Health System to deliver babies. So theyre sending home clean birth kits so that if you give birthwi in your villag a midwife, you have a very inexpensive but clean home birth kit. Sa we know thos lives. You can also say, hey, ambulances are an esstial service. Some countries are saying if you cant get to a hospital by ambance, we will instead provide a subsidy for your transport. That makes a huge fference in terms of saving a womans life. And you say that one of the solutions iso consider Reproductive Healthcare an essential service. Inther wds, changing the classification to Reproductive Healthcare as an essential service will also help save lives. Absolutely. Otherwise, aga,no wefrom the ebola crisis, more unintended pries. E millions women will tell you all over the world, and space their pries, they are healthierdr and their ch are more likely to be healthy and to stay safe. Te youve wrextensively in your book the moment of lift, and also inng the wasn post and other places about the unpaid work burden placed on women, that covid19 exacerbates in low and middle Income Countries but also in the United States as well. You say en though most women now work full time outside the home, they still spend t hours or more each day on household tasks and caregiving. Theyre 10 times more likely to stay at home with their sick children, and theyre nearly three timesel as las fathers to quit their jobs and take care of their families. W do you have the data thats swing that covid is increasing this trend . El l, im glad you asked that becae data is fundamental. We have to be able to collect data to actually speak the truth and then know where to invest. But there are states, luckily in the United Statesex that collect disaggregated data so we can actually look at it. We, as a foundation with many partners, have finally been investingin in datow and middle Income Countries. Soe can actually collectco thismic data from women and we can look at it and see exactly whathe trends are. On the flip side, you can use the data then to make investments. That is smart policy. How is your foundation or mitigate some of the effects of the disparities against women in the covid19 paemic . Well, we are both trying to call out, as im doing here, what the issues e. Were talking to governments about smart policies. As well, i think youen me use in the United States my voice against paid family medical leave. Were the only country, the only industrlizedco try in the world that doesnt have it. And if you want a woman to be ab to care for a sick loved one or lets say she gets covid e and shes ential worker, she needs to stay home for 14 days to take care of herself and to keep others around her safe. You have to have the rht licies to take care of that. You also write. N now,normal year, schools would be opening within the next couple of weeks, but many schools may not be reopening and theyre dialing back their plans to reopen t all ov country. What does this mean for gender equity . T concerning. Its deeply concerning because if a woman cant see that her kids are cared for, she has no one to leave them with, how can she get on the bus and go to that job . Or how can she make sure her mother oher father, who are elderly, are being cared for while shes caring for children and trying to keep a job . Make re that were not setting women and thats why we need to have sensible government policy and good stimulus packages. You know, its so interesting about this virus, how where were learning about itn real time. And early on, we thought that children were vectors of this virus and that they were the ones who are silently spreading covid19. And that thinking is changing a bit. Youve seen denmark and finland reopen their schools onthout major spikes in covid19 and their popula and so how do you think about and how should we think about as a as a country, a reopening and a return to school, but then balancing that against what is a very real spike well, i think you see the countries that are opening their schools have a declining epidemic. They have done sensible policies early on where people actually stayed home, a declining epidemic. Then theyre opening very slowly and carefully and safely. And i think what you need to do is to look at your epidemic and follow tcience, but follow the measurements in your own county this is local Health Commissioners have to work with governors and mayors and superintendents to make wi decisions. There will be places in the United States where the epidemi is sloing down, where it probably you can safely reopen the schools and you keep measuring and watching. There are other places where youre having a spike in cases. You have a spi in cases, a rising epidemic thats rising quickly and overrunningar the healthsystem, thats not a time to reopen your schools, but you can only make those a decisions ocal basis with reay good data. Y a weve seen again and again, i will tell you, we have had mayors, weave had governors on this program where you see they are not coordinating. Does it seem to u that there is a deficiency in coordination atvery level of government or are there places that are doing it right . There are some states that i would say are doing it right and doing it right between the governors and the mayors and the Health Commissioners. Look, i think, first of all, we have to say this is difficult. You saidt right to begin with, which is we are learning new information s almost evegle day about this pandemic, how it spreads, where it spreads, what we should do. We dont have all the tools yeti does take incredible coordination. Of course, the united ates would have helped if we had used our cdc properlyh cdc was set up for exactly this type of situation. The cdc was set up originally to give guidance to local health departments. C so if wed hadrdinated response from top to bottom, what would have ppened was we would have done appropriate testing very quickly in a coordinated way you would have done isolation until you got the results of youtest, contact tracing, and quarantining. I think when it doesnt come together at the t, its very difficult to have it come from the bottom up or the middldown. And so thats the situation the United States is in, unfortunately. And its why were seeing overwhelmed Health Systemssh that jusldnt be overwhelmed at this stage of this pandemic. L ten, moving on to how were going to tackle this, yoand one of the areas tha all have invested heavily in is a vaccine. And i want to ask you, ist your view that a vacci is ultimately the only way out of this crisis . Well, i think a vaccine would be the quickest way out of this crisis. That is, if we can get a vaccine that is obviously safe and efficacious. I do think a medicine would help as well. If we d a medicine that as soon as you got the disease, it helped tamp it down lyry, very quickly. That would certaelp. But i think probably ultimatelyhe safest tool or the quickest tool is going to be a vaccine. Ou but,now, both routes are being tried. We and many, many, many others are investing in bots. You have to in many, and many medicine candidates to see which ones, you know, are safe and efficacious. So help us understand. I mean, the New York Times points out that the record timing for the creaon of a vaccine from scratch was with the mumps, and it took four years. Why is there so much optimism that, in the context of this covid19 pandemic, were going to beat that record . Well, its the first time youve seen global coordination over vaccine at the scale were seeing it. And normally you do,ow you the vaccine testing, all the various stages and phases and trials,ne which stil to be done, and then when you have a candidate that you know is going to work, then you start investing in the manufacturing. E this ts being done in parallel. And theres so much fundingti going into me routes of a vaccine and multiple paths for manufacturing up front, some of which will be dead ends. Flow so quicklyng so much money and so much global coordination. I think thats what gives people optimm. So President Trump recently predicted that a vaccine or an effectivdrug would be here long before the end of the year. So if everything goes right, what is the soonest you think at we could have a vaccine just an efficacious vaccine, maybe not scaled, but just to have one . More than likely early next year, first half of next year. I think thats probably our very best case. Thats the hopeful case. You know, you get an efficacious vaccine, but then there are many logistics into ramping it up to sling it. What are some of the challenges to the production and the distribution that have to be thought through . Well, you have to have the bioreactors to produce the vaccine and to produce it at scale. And then luckily,i in most hiome countries, we actually have very good supply chains. And th middleIncome Countries have their supply chain issues. LowIncome Countries alsoave supply chain issues, but we have a global coordinated effort. It called gavi, the ce for vaccines and immunizations. Because of that syst, we do know how to get vaccines out to all corners of the earth. The thing that we need to do that the Global Leaders need to do is to ensure first that healthcare workers get this vaccine, and there are more than 60 million healthcare workers around the world. Theyre the ones who are utaking care of the rest theyre the ones who are going to make sure, okay, we help stop this disease. People are taken care of and it doesnt keep spreading. So first you have to go there and then each country needs to eok at their most vulnera populations and figure out how to get the vaccine out tito their vulnerable popus next. As we develop a vaccine,ne once we havei presume there will be a rush to get oned how shovernments figure out, after healthcare workers, who gets it first . I think in place by place, countrafter country, governments need to look at their most vulnerable populations. Affected the most,hos being and they need to make sure that they get the vaccine t out se people the most quickly. You are well aware of, moderna, which is based in cambridge, massachusetts, and it is working on an mrna vaccine. And early trials show that it is safe and efftive. The an early funder of moder backd when you bacv therapies as well as a zika vaccine. Are you working on their covid19 vaccine as well . Were working on nine different vaccines with covid, yes. Of them, which makes you mose l . You know, its hard to say. Different data comes out in different weeks. And so there are, again, of these nine candidates were looking at, there are three or four that look quite promising. Obviously, i cant talk about specific data, but, you know, as the datcomes out, science is looking at it and papers are being published. And, you know, all of that keeps moving forward. The Trump Administration support vaccine developmtan they call it operation warp speed. They have spent half a billion m erna, half a billion on johnson johnson, 1. 2 billion on oxfords astrazeneca. The right role of thropyabout versus public dollars in the context of the raceci to develop a v. What is the most effective balance between public and private dollars ner this kind of innovation . Well, i thinkf the things we have to realize is in the United States, you know,uc we are in the sense that the government is willing to put in largescale research money, and thats appropriate. Thats how many vaccines have come foard before european governments as well put in research money. I think the role for philanthropy, though, is tmake sure that this vaccineets purchased and distributed equitably. The worst thing that could happen for the world is thathe vaccine first goes out to the highest bidder. And so philanthropys role is to sa we have global mechanisms for getting these vaccines t safely and efficacious and to everybody. Th would be gavi, the alliance for vaccines and immunization. Theres also another Global Coalition called the cente for epidemic preparedness. It also has money flowingth ugh it and Research Dollars and manufacturing dollars make sure we get a vaccine and that it doesnt go to the highest bidder but we ge many millions of doses to cover the whole world. Who would suggest, though, that for the highrisk, highreward portion of this, public dollars probably shouldnt be spent. Bl it proshould be private dollars, philanthropic dollars, because if there are 100 trials goi on, some of them are going to work, some of them arent. Be spenthe publics money on these highrisk prospects or is that a better use of philanthropic dollars . I think it is a very appropriate role for government and i think theres a role for philanthropic dollars. But look, no matter who theth philpic dollars come from, theyre never of the scale of government dollars. The role of philthropy is to be catalytic. Where governments risk but its to come alongside government a say, ay, these are other places that we should be taking risks and taking them on behalf of everybody, not just for one country. So, this program is a revival of william f. Buckley jr. s firing linethat aired for 33 years from 1966 to 1999. And buckley talked about this question about the federal dollars versus philanthropy and the role that philanthropy can play with william e. Simon, who is a former treasury secretary and a was aleading philanthropist in his day. At this clip to take a look and then ill ask you on the back side about the role of philanthropy. When Government Funds are used for philanthropic reasons, then they have to scrutinize everything, and to scrutinize they have to write regulations, and they have to dechoe youre going to give it, who youre going to give it to. And thats the way it would go. And do we want government control over that area . I dont think so. Well, let me ask you this. Why is the inbuilt assumption there that in order to geto more moneyilanthropy, it has to go from the people to washington to philanthropy . Isnt that a round trip that would seem to be unnecessary . T mfinitely unnecessary. And i think a dollar spent by government, maybe 10 cents or 20 cents is effective at the most. And a dollar spent by an individual, he