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Relentless pursuit of an equitable world

The Optimist

Man receiving hand sanitizer

A down payment on a COVID-free future

Some dates are etched into the global conscious as the moment everything changed: September 11, 2001; November 9, 1989. Others carry less instant recognition but no less weight: Nelson Mandela’s inauguration as South Africa’s first black president on May 10, 1994, or April 2, 2009, when world leaders agreed a $1 trillion rescue package amid the Great Recession.

When historians come to write about the coronavirus pandemic, what will be the date they look back on as the moment the tide began to turn? An early contender is May 4, 2020—the day a virtual summit secured an $8 billion down payment to fight COVID-19.

What made the day so significant wasn’t the larger than expected sum pledged, but the fact that it came from a wide range of nations, companies, and nonprofits—including a further $50 million from our foundation.

It was the first sign, in other words, that the world was mobilizing a coordinated response to the disease. And in the context of past pandemics, it happened remarkably fast.

May 4 is less than six months from the first reported case of this new coronavirus. Contrast such a relatively rapid response with the world’s other ongoing pandemic (officially now a “global epidemic”) that continues to bring misery to millions: HIV/AIDS.

With HIV, the first cases were identified about 40 years ago. I wrote about the looming crisis in South Africa a decade after that, and it took another 10 years and millions of deaths before HIV was declared a pandemic. Effective treatments weren’t widely available until at least the mid-2000s, and the search for a vaccine goes on to this day.

There are many complex reasons behind the world’s slow response to HIV/AIDS—not least a lack of urgency because of stigma, taboos, denial, and discrimination. But among the others was the absence of the kind of international cooperation and coordination that we are now seeing with COVID-19.

It was not until 2002, that the multilateral Global Fund to Fight AIDS, Tuberculosis, and Malaria was created with the help of the foundation. Four years after that, AIDS deaths peaked. And since then, they have fallen by more than halfsaving an estimated 32 million lives.

The Global Fund was among those participating in the Coronavirus Global Response Summit on Monday, which brought together a unique set of contributors, with a variety of experience and expertise—a group that we hope others will join in the months ahead.

What this week’s participation and pledges spoke to were three broad principles that the foundation and other partners believe should be at the heart of the response to COVID-19.

First, is recognition that any tests, treatments, or vaccines developed to address the disease are essential global goods. Even as individual countries focus on the needs of their own citizens, many are now starting to think about how nations can—and should—work together on these elements.

The fact that the Coalition for Epidemic Preparedness Innovations (CEPI) is now in position to coordinate the search for a vaccine, with companies and research bodies bringing their best science together and sharing information, is marked progress. And it’s a clear appreciation that until we solve this crisis globally, it will not be solved nationally anywhere.

Second, is recognition that any effective response needs to involve all the key players in global health. That includes governments because they have the resources and the responsibility to do this for their citizens, and at the scale needed globally. But beyond that, having the existing multilateral health institutions, and representatives from industry involved on Monday was highly significant. Indeed, a consortium of leading life sciences companies are already collaborating as never before.

Third, is recognition that when diagnostics, therapeutics, and vaccines are developed, global access is front of mind. Ensuring that whatever product it is, is accessible to poor people in poor countries, and to the neediest in rich countries, is always going to be our foundation’s central focus.

The world already has the means to do it.

Gavi, the Vaccine Alliance, has two decades of experience bringing down the price of vaccines and delivering them equitably. And like Gavi, the Global Fund is a well-oiled machine for delivering drugs and other essential tools effectively and efficiently on an unrivalled scale.

Making sure a vaccine reaches everyone is not just an argument for fairness, it’s also fundamental to stopping COVID-19 in its tracks because if it exists somewhere, it’s a threat anywhere.

Tragically, none of these three factors happened until we lost too many lives to the HIV/AIDS epidemic. So, it’s good news that world leaders are taking the first steps to ensure they are front and center—not least by involving those multilateral health bodies primed to respond to COVID-19.

Along with other initiatives, such as the COVID-19 Therapeutics Accelerator, these institutions provide readymade platforms to coalesce the large pools of money directed at ending this pandemic. At the same time, the Access to COVID-19 Tools Accelerator, or ACT Accelerator, which involves the foundation, will help ensure all the tools to defeat COVID-19 are available to all the people who need them.

Our involvement with these institutions and initiatives, and how we’re thinking about research, manufacturing, and delivery, illustrates how the foundation’s response goes far beyond our financial contribution, which has now reached more than $300 million.

That’s because we also have a wealth of expertise built up over the last 20 years that we’re applying to the fight against COVID-19. From science and technology, to policy and politics, to relationships with the private sector, and the specific challenges of reaching those most in need.

With the pandemic wreaking human tragedy, economic misery, and social disruption, fighting COVID-19 remains the foundation’s priority. That’s not to say that we are stepping back from our other areas of work. The goals for our core strategies are not going to change—whether it's in U.S. education, agricultural development, malaria, or anything else.

But billions of people are in lockdown today because there is currently no way to medically prevent or treat COVID-19. To return life to normal and make the world safe from further outbreaks, we must urgently develop and deliver more tests for those suspected of having it, drugs to treat those who contract it, and ultimately a vaccine to stop people from catching the virus in the first place.

No one knows yet who will discover the first effective coronavirus vaccine, or where it will be made. What we do know is that governments, corporations, multilateral institutions and philanthropic organizations need to work with each other to meld their unique resources into a collective effort.

Just as with HIV/AIDS, this crisis demands an urgent and truly global response. May 4 was just the start. But it is, at least, a start.

About the Author

Mark Suzman
Mark Suzman, the CEO of the Bill & Melinda Gates Foundation, leads the foundation's efforts to promote equity for all people around the world.

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