The Gates factor
As ever, the most lurid of conspiracy theories provide a distraction from the more humdrum ways in which corporate power causes human harm.
In the case of billionaire Bill Gates, outside those who believe he has a secret plan to microchip us all through vaccines, he has cultivated a saintly philanthropic image. One whose manufacture is lubricated by the millions his foundation sloshes at many of the world’s most prominent media organizations.
First, the good. The Bill and Melinda Gates Foundation is a significant funder of the vaccine alliance Gavi and the Coalition for Epidemic Preparedness (CEPI), which together with the World Health Organization are leading Covax (or Covid-19 Vaccines Global Access) – a programme to bring inoculation to countries around the world.
The scheme supported building manufacturing capabilities and secured advanced supply agreements for vaccine candidates, with bulk purchasing expected to achieve better prices collectively.
Rich and poor countries can participate, with the 92 lowest-income countries that are unable to fully cover their own costs receiving extra support through development aid in the Covax Advanced Market Commitment (AMC).
As of January, Covax had agreements in place to deliver at least two billion doses by the end of 2021, ‘including at least 1.3 billion doses to 92 lower-income economies’.
But the scheme also has significant drawbacks. Low-income, funded countries will only receive enough vaccine for up to 20 per cent of their populations through Covax.
Meanwhile rich countries have been cutting their own deals directly with manufacturers, jumping the queue and squeezing supply.
Current rates of rollout could see it take until 2023 or 2024 before everyone can be vaccinated, estimated Clare Wenham, assistant professor of global health at the London School of Economics in January.
Business as usual
As with previous schemes run by Gavi, Covax will funnel billions into pharmaceutical companies but will not require the handing over of intellectual property in return, and contracts and decision-making remain opaque.
Alternative proposals (including the Covid-19 Technology Access Pool) to share intellectual property and make vaccines available around the world, faster and more equitably, have been given short shrift by both the Gates Foundation and the richer countries.
It is ‘not effective and not necessary,’ said Richard Wilder, CEPI’s general legal counsel, who is the former associate general counsel for intellectual property policy at Microsoft. Pfizer chief executive Albert Bourla went further, branding it as ‘dangerous’.
Waiving intellectual property restrictions would allow vaccines to be produced at cost in all suitable facilities, enabling countries in the Global South to protect their own populations rather than be left at the mercy of a market which saw South Africa charged almost two-and-a-half times more than most European countries for the Oxford-AstraZeneca jab.
The AstraZeneca vaccine is a prime example of the role the Gates Foundation has had in pushing a model of public-private partnerships – like Gavi itself – which rely on public subsidies but preserve corporate interests.
Oxford University originally pledged in April 2020 to make non-exclusive and royalty-free rights to the vaccine available to any manufacturer to ensure it could be obtained free of charge or at a low cost around the world.
But a few weeks later, apparently at the Gates Foundation’s instigation, it changed course, signing an exclusive deal with AstraZeneca, whose shares later soared when results from clinical trials were released.
The university needed to ‘team up’ with a big pharmaceutical partner ‘with expertise’, Bill Gates said. The vaccine has received over $1 billion of public funding.
A failed ideology
A charitable take is that Gavi’s work, including Covax, bridges a gap – enabling the pharmaceuticals market to serve the needs of the poorest.
But its model also props up that market, simultaneously bolstering an ideology of protection for intellectual property that socializes research and development risks but privatizes profits and control.
Intellectual property restrictions have created monopolies in both pharmaceuticals and software, crucial for the massive profits of Microsoft, where Gates made his billions.
Meanwhile the Gates Foundation also has its own investments in Big Pharma, including Pfizer, and has funded organizations lobbying for industry-friendly regulations, such as the Drug Information Association and American Legislative Exchange Council.
Beyond this there is the issue of the outsized role Gates and his foundation – itself supported by tax breaks on charitable donations, which one expert estimated at $14 billion – has in the global health landscape.
After the US, it is the largest contributor to the WHO’s budget, covering 10 per cent in 2019, with earmarked funds giving it leverage over the organization’s agenda. The foundation’s overall spending on global health stood at $1.5 billion that year, compared to the WHO’s total budget of $4.4 billion.
Gates’ billions have certainly earned him influence, but his new model of philanthrocapitalism diverts us away from what is really needed to provide fair global access to vaccines and end the pandemic for us all.
Nick Dowson is a writer and investigative journalist who covers areas including health, technology, housing, transport and the environment.