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The Optimist

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Twenty years in the making: The foundation’s response to COVID-19

This year marks the twentieth anniversary of the Bill & Melinda Gates Foundation. With a pandemic bringing painful human, social, and economic costs, it’s not a time for celebration. But it does feel that the investments we’ve made, expertise we’ve built, and experience we’ve gained over the last two decades has prepared us for this moment.

From day one, the foundation has embraced a data-led, evidence-based approach to improving health, reducing poverty, and expanding opportunity. We rely on scientific and technical expertise. Together, these building blocks mean that in addition to our financial resources, we have the capacity and capability to play a significant role in the COVID-19 response.

This is a unique situation; we are in a unique position to help. And today, we are announcing additional funding of $150 million that brings our total commitment so far to more than $250 million. [Editor’s note: Since publication, the foundation’s total commitment now comes to more than $350 million.]

Even in an emergency like this, the starting point for how to use our resources is where it’s always been: Our fundamental belief that all lives have equal value. And since we know that epidemics hit the poorest and most vulnerable communities hardest, that’s where our funding is chiefly directed.

At its best, philanthropy can take risks that governments can’t, and corporations won’t. It can put wind in the sails of ideas, innovations, and initiatives with the potential to save lives. Governments and industry can then take the successful ones forward at scale. In this way, philanthropy doesn’t supplant the public and private sectors, it supports them.

It’s a concept led by Bill and Melinda known as “catalytic philanthropy.” The idea is that organizations like the foundation become the investor. The difference for non-profits is that they neither expect nor receive a share of the benefits. Instead, those go to vulnerable people—or to society in general. To put it another way, our bottom line is lives saved.

This approach, underpinned by our core belief, has guided our entire response to COVID-19. Taken together, most of our work to date has focused on supporting countries in Africa and South Asia, developing and delivering treatments and vaccines, accelerating detection and containment of the virus, and protecting vulnerable communities in the United States.

Strengthening the response in Africa and South Asia

The poorest communities in Africa and South Asia already struggle to access even the most basic health care. And an epidemic can quickly overwhelm overstretched health systems, meaning the potential for death and disruption is strikingly more pronounced than in wealthier countries.

So, even before the first cases were reported in Africa and South Asia, we took immediate steps to help countries prepare. And as the crisis increases, so does our support to help save as many lives as possible, and prevent vulnerable communities falling back into hunger and poverty.

This won’t just help people in those countries because what is now crystal clear to the world is that an epidemic anywhere is a threat everywhere. The only way we can prevent a resurgence of this disease is to help the poorest countries strengthen their ability to stop the virus.

Developing and delivering treatments and vaccines

While R&D has the potential to consign humankind’s biggest health threats to the history books, we need to unwind the pandemic paradox that viruses spread rapidly, but developing treatments and vaccines moves slowly.

The speed with which companies have begun work on a vaccine—the only way to definitively end the pandemic—is partly a result of the rapid action of the Coalition for Epidemic Preparedness Innovations (CEPI), which we co-founded in 2017 and continue to support. Through the COVID-19 Therapeutics Accelerator, trials of potential treatments are also already underway.

But even vaccines and the most effective treatments are useless if they never leave the lab. So, we are working to ensure that when they are developed, they can be mass-produced quickly, and—most important—are accessible, available, and affordable. Achieving that, requires a commitment to international cooperation across governments, the private sector, and multilateral institutions on an unprecedented scale.

Strengthening the response in Africa and South Asia  Developing treatments and a vaccine

Accelerating detection and containment of the virus

To start to turn back the tide of this disease, we urgently need to answer two crucial questions: How many cases are there? Where is the virus being transmitted? The number and source of COVID-19 cases are the two most important data points informing the response. They can help determine where governments and health bodies should focus their resources, and the actions needed to stop the spread.

That’s why we are funding modeling to help predict the course of the virus, and providing technical assistance and funding to develop more effective diagnostics. For example, an easy-to-use swab that could lead the way to home-testing. We’re also looking at different approaches to physical distancing and stay-at-home policies in those places where such measures are less practical.

Protecting vulnerable communities in the United States

Our commitment to equality extends to our work at home. And as the virus not only threatens people’s lives but their livelihoods, we are supporting organizations local to our hometown of Seattle, which are helping protect those most likely to suffer disproportionate social and economic costs. At the same time, our foundation employs incredibly knowledgeable professionals in the public health field. So, we’re taking a two-pronged approach by deploying both our dollars and expertise.

Nationally, we’ve focused on the virus’s impact on education. As part of a first wave of measures announced last month, we’re providing funding that will enable emergency aid to help mitigate the impact of campus closures on students—particularly low-income students who could be losing their access to housing, food, and wages. In our K-12 work, we’re supporting the development of online learning and support for students who rely on schools for day-to-day services. We’re also thinking about the consequences of this pandemic on students over the longer term.

Accelerating detection and containment of the virus  Protecting vulnerable communities in the United States

Beyond these four broad areas, the foundation is also leveraging the financial instruments of its Strategic Investment Fund in the form of equity investments, loans, and volume guarantees to catalyze the rapid procurement of essential medical supplies for low- and middle-income countries, and to help pharmaceutical companies produce COVID-19 products. 

It’s not just our financial resources and technical expertise that we’re deploying. We’re also providing knowledge and assistance to industry, multilateral institutions, and governments around the world—and making the case for global cooperation and coordination. For example, last month leadership from 15 global pharmaceutical companies convened and decided to open access to their antiviral compound libraries for screening against the virus. The more compounds we can test, the greater our chances of success.

We also have set up ways to allow anyone to contribute to the fight against COVID-19.

This crisis is testing us. And individuals and institutions are stepping up in some astonishing ways. It’s also clear that much of what the foundation has done over our history, from building healthcare capacity in developing countries, to reducing the impact of preventable diseases, to establishing and supporting the Global Fund, CEPI, and Gavi, is now all part of the solution to this crisis. 

But philanthropy is just one part of the response. Only when all sectors work together and do their part, do results come faster and reach more people. And it’s that which is ultimately our way out of this pandemic.

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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