The fight against the coronavirus pandemic will yield the fastest-developed and most rapidly distributed vaccine in human history, the head of the Bill & Melinda Gates Foundation has said, adding that research into the treatment could bear fruit in as little as 12 months.
"We are very confident that there will be a vaccine. It will be the fastest vaccine ever created in human history, and it will go to people faster than ever," Mark Suzman, the CEO of the U.S.-based philanthropic organization, said Friday in an exclusive interview with Caixin.
His comments come as scientists across the world race to develop treatments for COVID-19, the disease caused by the novel coronavirus that has officially infected about 3 million people and killed more than 200,000, according to a tally kept by Johns Hopkins University in the U.S.
While governments, businesses and individuals are funding promising projects, in many cases charitable organizations are also stepping in to provide money and other resources. Earlier this month, the Gates Foundation committed a further $150 million to the battle against the pandemic, in addition to the $100 million it had previously pledged.
Much of that money will go toward developing a vaccine, but a portion of it will also fund COVID-19 testing and prevention in developing countries where healthcare resources are scarce, Suzman said.
That's important for regions in the southern hemisphere that are only now moving into the winter flu season, he said, citing the examples of Latin America, sub-Saharan Africa, and parts of Southeast Asia. "Until you have testing at scale, we're sort of flying blind."
Key to where the money ends up is what Suzman calls "global access" -- ensuring that the solutions to the crisis are directed to all countries around the world, not just the most developed ones.
"For a global pandemic, we need to have global solutions," he said. "That means when there is a vaccine, we're going to have to manufacture 7 billion doses of that vaccine. That's pretty unprecedented."
Despite his optimism that an effective treatment will be found, Suzman cautioned that any potential vaccine remains up to a year away.
"Twelve months [is] likely. That's probably our best case," he said. "Maybe ... if everything goes well, it'll be a little faster than that."
Read on to enjoy Caixin's full interview with Mark Suzman. The dialogue has been edited for clarity.
Caixin: What's the thinking behind the additional $150 million investment in the fight against the virus?
Suzman: Well, there are obviously significant resources now being put in by governments around the world, as well as the private sector and other partners. But we still see some critical areas where, as philanthropy, we can be catalytic.
It's really using our resources in smart ways on things, for example, expanding what we call a therapeutics accelerator. That's the race to find safe, effective treatments that we can [use to] provide some direct support in developing countries in smart ways to help them with testing and prevention, because they have not yet seen the wave in sub-Saharan Africa and parts of South Asia. And of course, [it's] the search for a vaccine, which is going to be the key to a long-term solution where we work with some partners like the Coalition for Epidemic Preparedness Innovation.
We felt that, hopefully, our resources will come in and help align other partners, including governments and the private sector, in important ways, and that's why we made the additional announcement.
How does the foundation predict COVID-19 will spread in the short to medium term?
We have a partner group called the Institute for Health Metrics and Evaluations, which has been looking at a lot of global efforts, and also a group called the Institute for Disease Modeling, both of which we support financially and are providing broader advice to governments around the world.
There's still so much we don't know about the disease. It makes it difficult to track. We know that the broad policies of social distancing and contact tracing and others can help bring it down, as China and other countries are showing, but we don't yet have effective treatments, and obviously we don't yet have a vaccine. Until testing is at sufficient scale, it's very difficult to predict and understand what is going to be happening, especially in those big, densely populated developing countries where social distancing is really impossible, in big urban slums -- in places like Nigeria, for example, or Bangladesh.
We're nervous. We think that we're starting to bend the curve and be able [to control it] in some of the wealthier countries in Europe and here in the United States. ... But we're very nervous about what might happen in some of those bigger developing countries.
More than 100 potential vaccines for COVID-19 are currently being developed. How does the foundation choose which ones to sponsor?
Well, we do two things. As the foundation, we're not a company racing to find our own vaccine. There's this kind of race that's underway among many companies, including several Chinese companies, trying to do that.
We simply have a lot of very smart scientists on our own staff and we support efforts like ... the Coalition for Epidemic Preparedness Innovations, which actually has a number of partners, and our hope is actually that China might in the future become a partner as well. It has a number of governments, as well as private philanthropy supporting it.
What that does is it both looks across all of those efforts ... and just tries to track [them] and say, well, which ones do we think might have the best chance, might be most effective? Then it directly funds a subset, based on their best science.
The condition of that funding, when it comes through CEPI or any direct funding from us, is that it must have what we call "global access." Most governments are trying to fund issues for their own citizens. We understand that; that's very important. But for a global pandemic, we need to have global solutions. That means when there is a vaccine, we're going to have to manufacture 7 billion doses of that vaccine. That's pretty unprecedented. You need to actually think ahead and say, "Well, what are the ways we can bring a whole set of partners along and make sure that we're focusing on the most effective of the vaccines?"
It's better than a guessing game -- we're not guessing -- but we know that the vast majority of those trials will fail. We're really just trying to find which of the subset have the most likelihood of success, and then can we help support [them]. Even if it's not in the direct funding, we might be looking to support on the long-term manufacturing or other efforts to try and get something safe and effective to people as quickly as possible.
Why does the foundation focus more on the vaccine than a wonder drug [that could cure the disease]?
Well, we're doing all of that. [Part] of it is, we have long experience in vaccines. The foundation is 20 years old and ... our largest component work is in global health and in infectious diseases that disproportionately affect the poorest.
One of our biggest partnerships is with a group called the GAVI Vaccine Alliance. We've spent many billions of dollars funding them over the last two decades, [and they have] probably been the group that's most responsible for reducing preventable childhood deaths in Africa and Asia. We've seen preventable childhood deaths dropped from 10 million a year to under 5 million a year.
And that's through vaccinations: Vaccinations against pneumonia; against rotavirus that causes diarrhea; against measles and rubella; and ... against polio. We see the power of vaccines. We have a lot of direct experience. We fund a lot of work in vaccines. It's just an area where we have significant expertise.
But we're also working on the diagnostics and the treatment. We're definitely not exclusively on vaccines. I've mentioned funding this thing we call the Global Therapeutics Accelerator, which has actually tried to get lots of big pharmaceutical companies around the world to share their compound libraries. These are the medications they already have proof are safe for humans, and can we run very rapid testing and see if any of those might be suitable to treat the coronavirus, because we would be able to use those very quickly. They don't have to go through all the complicated trials.
And similarly, we're also working on whether we can get very rapid, cheap diagnostic tests, which aren't yet available at scale, because you need those again in these poor countries that don't have the kind of access to significant testing that you might have in China or wealthier countries in the West.
Do you think the additional money will speed up the creation and production of the vaccine?
Yes. We are very confident that there will be a vaccine. It will be the fastest vaccine ever created in human history, and it will go to people faster than ever.
But even that still means 12 months [is] likely [before it comes out]. That's probably our best case. Maybe, maybe, maybe if everything goes well, it'll be a little faster than that.
We hope our resources now, and bringing in all these partners, will help accelerate that. But we need to think in parallel about the manufacturing and the distribution. Who's going to get the vaccine first? What are the priorities? It should go to frontline health care workers first. It should go to the vulnerable and elderly. How do we make sure that rich people or rich countries don't just buy up all the vaccine themselves and don't make it available far more broadly, globally?
Those are the kinds of questions we hope putting our resources in right now actually helps the world think about, because it's got to be a global solution to what is a global problem, even though at the moment we have many, many different national efforts.
Considering the lack of medical supplies and equipment in many of the world's poorest countries, do you think COVID-19 will soon spread widely in Africa or South Asia?
That's what we're very worried about. There's still, again, so much we don't know about the coronavirus. How seasonal is it? Might there be a big wave coming into the southern hemisphere [as it moves] into its flu season? [That] would affect parts of Latin America and sub-Saharan Africa and a little bit of Southeast Asia. In which case, for those of us in the northern hemisphere, are we going to have a second wave coming when the flu season comes again in the autumn, in the winter?
Until you have testing at scale, we're sort of flying blind, if you like. You just don't know: Are we just missing lots of tests? Are there deaths happening that we just don't know [about] in these countries? What are the steps you might take to help with social isolation [and] social distancing when you're in very densely populated slum areas? Could you find and build -- and we're actually working with some African countries and a couple of states in India on some pilots to see -- could you create ... large field hospital tents outside these slums, which would actually allow you to quickly get a patient able to isolate in a way they wouldn't be able to do at home? Because if you're living three or four people to a room, you cannot do that.
Those are the planning and the steps that we have underway, but it's both building the testing capacity and putting in place the basic treatment. As you say, they don't have the facilities.
But we do know some very important things, like even if you don't have enough ventilators, simple oxygen supply is very effective for most COVID-19 illnesses, all except the very severely ill. Yet we have big challenges in just basic oxygen supply in Africa. If we can get that right, that not only helps the coronavirus response, it actually will help with all our regular work on, say, maternal and child health, because the provision of oxygen is critical often for that when you have complicated births or other things like that.
Bill Gates warned of a coming pandemic back in 2015. Why did he sound the alarm then?
Lots of people have seen the potential for threats like this and talked about it. But I think because we as a foundation do work so much on infectious diseases and we can see those challenges, and actually his big call ... came after the Ebola crisis in West Africa, where we were very lucky with Ebola. Ebola is very difficult to catch. You actually have to touch someone who's infected in the late stages of the disease. It's not very transmissible and it was very hard to reach parts of the world. Even then, it was devastating.
If you just simply think what would happen if you had a respiratory disease that could be caught much more quickly and could be spread by people who weren't yet showing symptoms, that would be the nightmare scenario that could spread rapidly around the world and that we should put in place now -- and now was five years ago -- preventative measures for surveillance, tracking, protective gear, [and] have the machinery in place to rapidly put together a vaccine or treatment.
By calling for that, we were hoping that would be put in place. Clearly, that didn't happen. Our hope and belief is that next time around, it will. We wish it didn't have to be as a result of a crisis like the current COVID-19 crisis, but it shows just how serious preparing for that needs to be and why it cannot be any one country doing it.
Some right-wing opinion leaders claim that Gates plans to use the pandemic to control the global health system. What do you make of that?
It's always very distressing for us when we see people making crude allegations like that. As a foundation that is focused on doing nothing but helping the poorest and neediest around the world, we are very transparent and open about absolutely all of our work and investments. We have nothing to hide. There's no such thing and it's completely ridiculous and absolutely offensive often when you hear allegations like that about what we're trying to do and how we're trying to help.
And it's dangerous, because that kind of misinformation actually can deter the kind of collaboration we need in order to get these accelerated treatments and work around the vaccines and other steps.
All we can do is just be honest and open about our work and our partnerships and say that everything we do is based on the best available science, and hope that facts and the work we do will speak for itself.
History shows that health crises tend to lead to wealth redistribution and political reconstruction. What's your perspective?
Yes, well, that's going well beyond the health issues into the wider socioeconomic impacts that are being felt across the world and will still be reverberating -- [the] impact on education, impacts on wider health care.
There's a phrase that's already being used by partners: "Build back better." Can we use something like the COVID-19 crisis to think about [being] better at every level? Are there ways we can use this artificial acceleration into online learning -- because so many millions upon millions of students have had to shift to doing everything online -- to actually transform opportunities so that smart, strong online platforms might actually help provide education for many, many underprivileged students who haven't historically had access to really good education?
Similarly, are there smart ways now where what we're doing health consultation or construction or other things like that, where we can use and take advantage of this crisis to think about a more balanced and equitable set of priorities and institutions that will help ensure that every person gets that chance to have a healthy and productive life, which is exactly what our mission as a foundation is to try and help provide?
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