https://newrepublic.com/article/162000/bill-gates-impeded-global-access-covid-vaccines

On February 11, 2020, public health and infectious disease experts gathered by the hundreds at the World Health Organization’s Geneva mothership. The official pronouncement of a pandemic was still a month out, but the agency’s international brain trust knew enough to be worried. Burdened by a sense of borrowed time, they spent two days furiously sketching an “R&D Blueprint” in preparation for a world upended by the virus then known as 2019-nCoV.

The resulting document summarized the state of coronavirus research and proposed ways to accelerate the development of diagnostics, treatments, and vaccines. The underlying premise was that the world would unite against the virus. The global research community would maintain broad and open channels of communication, since collaboration and information-sharing minimize duplication and accelerate discovery. The group also drew up plans for global comparative trials overseen by the WHO, to assess the merits of treatments and vaccines.

One issue not mentioned in the paper: intellectual property. If the worst came to pass, the experts and researchers assumed cooperation would define the global response, with the WHO playing a central role. That pharmaceutical companies and their allied governments would allow intellectual property concerns to slow things down—from research and development to manufacturing scale-up—does not seem to have occurred to them.

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They were wrong, but they weren’t alone. Battle-scarred veterans of the medicines-access and open-science movements hoped the immensity of the pandemic would override a global drug system based on proprietary science and market monopolies. By March, strange but welcome melodies could be heard from unexpected quarters. Anxious governments spoke of shared interests and global public goods; drug companies pledged “precompetitive” and “no-profit” approaches to development and pricing. The early days featured tantalizing glimpses of an open-science, cooperative pandemic response. In January and February 2020, a consortium led by the National Institutes of Health and the National Institute of Allergy and Infectious Diseases collaborated to produce atomic-level maps of the key viral proteins in record time. “Work that would normally have taken months—or possibly even years—has been completed in weeks,” noted the editors of Nature.

When the Financial Times editorialized on March 27 that “the world has an overwhelming interest in ensuring [Covid-19 drugs and vaccines] will be universally and cheaply available,” the paper expressed what felt like a hardening conventional wisdom. This sense of possibility emboldened forces working to extend the cooperative model. Grounding their efforts was a plan, started in early March, to create a voluntary intellectual property pool inside the WHO. Instead of putting up proprietary walls around research and organizing it as a “race,” public and private actors would collect research and associated intellectual property in a global knowledge fund for the duration of the pandemic. The idea became real in late May with the launch of the WHO Covid-19 Technology Access Pool, or C-TAP.

By then, however, the optimism and sense of possibility that defined the early days were long gone. Advocates for pooling and open science, who seemed ascendant and even unstoppable that winter, confronted the possibility they’d been outmatched and outmaneuvered by the most powerful man in global public health.

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.

Advocates for pooling and open science, who seemed ascendant and even unstoppable early in the crisis, have been outmatched and outmaneuvered by the most powerful man in global public health.

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.

“Things could have gone either way,” says Love, “but Gates wanted exclusive rights maintained. He acted fast to stop the push for sharing the knowledge needed to make the products—the know-how, the data, the cell lines, the tech transfer, the transparency that is critically important in a dozen ways. The pooling approach represented by C-TAP included all of that. Instead of backing those early discussions, he raced ahead and signaled support for business-as-usual on intellectual property by announcing the ACT-Accelerator in March.”