Bill Gates The World's Public Health Czar Staunchly Defends Big Pharma Pandemic Profits

TNR  |  In April, Bill Gates launched a bold bid to manage the world’s scientific response to the pandemic. Gates’s Covid-19 ACT-Accelerator expressed a status quo vision for organizing the research, development, manufacture, and distribution of treatments and vaccines. Like other Gates-funded institutions in the public health arena, the Accelerator was a public-private partnership based on charity and industry enticements. Crucially, and in contrast to the C-TAP, the Accelerator enshrined Gates’s long-standing commitment to respecting exclusive intellectual property claims. Its implicit arguments—that intellectual property rights won’t present problems for meeting global demand or ensuring equitable access, and that they must be protected, even during a pandemic—carried the enormous weight of Gates’s reputation as a wise, beneficent, and prophetic leader.

How he’s developed and wielded this influence over two decades is one of the more consequential and underappreciated shapers of the failed global response to the Covid-19 pandemic. Entering year two, this response has been defined by a zero-sum vaccination battle that has left much of the world on the losing side.

Gates’s marquee Covid-19 initiative started relatively small. Two days before the WHO declared a pandemic on March 11, 2020, the Bill & Melinda Gates Foundation announced something called the Therapeutics Accelerator, a joint initiative with Mastercard and the charity group the Wellcome Trust to identify and develop potential treatments for the novel coronavirus. Doubling as a social branding exercise for a giant of global finance, the Accelerator reflected Gates’s familiar formula of corporate philanthropy, which he has applied to everything from malaria to malnutrition. In retrospect, it was a strong indicator that Gates’s dedication to monopoly medicine would survive the pandemic, even before he and his foundation’s officers began to say so publicly.  

This was confirmed when a bigger version of the Accelerator was unveiled the following month at the WHO. The Access to Covid-19 Tools Accelerator, or ACT-Accelerator, was Gates’s bid to organize the development and distribution of everything from therapeutics to testing. The biggest and most consequential arm, COVAX, proposed to subsidize vaccine deals with poor countries through donations by, and sales to, richer ones. The goal was always limited: It aimed to provide vaccines for up to 20 percent of the population in low-to-middle-income countries. After that, governments would largely have to compete on the global market like everyone else. It was a partial demand-side solution to what the movement coalescing around a call for a “people’s vaccine” warned would be a dual crisis of supply and access, with intellectual property at the center of both.

Gates not only dismissed these warnings but actively sought to undermine all challenges to his authority and the Accelerator’s intellectual property–based charity agenda. 

“Early on, there was space for Gates to have a major impact in favor of open models,” says Manuel Martin, a policy adviser to the Médecins Sans Frontières Access Campaign. “But senior people in the Gates organization very clearly sent out the message: Pooling was unnecessary and counterproductive. They dampened early enthusiasm by saying that I.P. is not an access barrier in vaccines. That’s just demonstratively false.”

Few have observed Bill Gates’s devotion to monopoly medicine more closely than James Love, founder and director of Knowledge Ecology International, a Washington, D.C.–based group that studies the broad nexus of federal policy, the pharmaceutical industry, and intellectual property. Love entered the world of global public health policy around the same time Gates did, and for two decades has watched him scale its heights while reinforcing the system responsible for the very problems he claims to be trying to solve. The through-line for Gates has been his unwavering commitment to drug companies’ right to exclusive control over medical science and the markets for its products.