The U.S. domestic response to the COVID-19 pandemic thus far has been “weak,” Bill Gates believes. The Bill and Melinda Gates Foundation co-chair and Microsoft co-founder told TIME senior health correspondent Alice Park during a TIME100 Talks discussion on Thursday that he’d give the U.S.’s COVID-19 response, “on a relative and absolute basis, not a passing grade.”
But, he added, the U.S.’s funding for vaccine and therapeutic research “has been the best in the world,” so if it coordinates to share resources globally, the U.S. could “potentially score the highest” in that realm.
During a global pandemic like COVID-19, Gates argued, governments must collaborate to ensure the virus is fully eradicated. The U.S. has historically led global responses to past health crises like smallpox or polio, he told Park, but has been less of a leader during COVID-19. Instead, countries that were exposed to SARS or MERS responded most quickly and “set a very strong model.”
“There’s about six countries that immediately went to the private sector and said okay, ‘how do we get mass testing? We’ll commit to buy tests’,” he said. “That never happened in the U.S.”
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The U.S. continues to face huge delays that make many tests “a waste of money,” he continued, adding that while the responsibility for testing has been delegated to the states, they “don’t have enough power” to speed up testing.
“The more you know about this, the more you wish experts were taking charge,” Gates continued.
If the U.S. can get its COVID-19 numbers down in the next few months, he noted, that will make a “huge difference” in terms of the death rate “going into the fall,” which “could be a challenge because people are indoors more, it’s colder and the flu symptoms will be confusing.”
Fall could also bring new developments in vaccine and therapeutic research, however. “Even within two months, we can have some new anti-virals and antibodies that could make a big difference,” Gates said, adding that countries will need to work together to distribute those resources globally.
Companies that create vaccines need to coordinate with those that have factory capacity and adopt tiered pricing “so the poorest countries get it for the lowest price,” he continued. And governments will also need to ensure that the vaccine is allocated equally—not only within countries but between countries. That can’t be done using only market forces, he said. “The private sector all by itself, would simply charge the highest price and only give to the very wealthy.”
As of yet, the U.S. hasn’t “shown up in the international forums where money to get these tools out to countries is being discussed,” he told Park. Still, he continued, “that still absolutely can be fixed.”
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Write to Madeleine Carlisle at madeleine.carlisle@time.com