What would happen if coronavirus vaccines were distributed based on population, instead of going to the richest countries first?

According to research at Northeastern University, cited by the Bill and Melinda Gates Foundation in its new annual report, about half as many people around the world would ultimately die from Covid-19.

But Bill Gates told our colleague Donald McNeil Jr. that the optimum solution was not likely to happen any time soon — in part because the Trump administration refused to join the international consortium designed to make sure both rich and poor countries receive new coronavirus vaccines simultaneously.

Realistically, Gates said, “You’re not going to succeed in getting the U.S. to treat itself as just a random 5 percent of the world’s population.” American taxpayers, he noted, have paid two-thirds of the costs of the clinical trials and of manufacturing doses even as the trials continue.

Still, if just half of the vaccines backed by the Trump administration succeeded, the U.S. would end up with a surplus of doses that could be shared with other nations. And Gates holds out hope that by early next year, regardless of who wins the presidential election, the U.S. will come around to paying much of the estimated $4 billion needed to get vaccines to all of the world’s poor.

He noted that Congress had repeatedly kept funds for AIDS, malaria and childhood vaccines in the foreign aid budget, despite numerous attempts by the White House over the past decade to slash those items; the programs are popular with both liberals and Christian conservatives.

Doing so wouldn’t just serve a humanitarian cause: Once borders reopen, a nation’s safety can be ensured only by halting the spread of the virus elsewhere.

Doubts about F.D.A. and C.D.C.: Gates told Bloomberg News he had doubts about the leadership of the Food and Drug Administration and the Centers for Disease Control and Prevention: “When you start pressuring people to say optimistic things, they go completely off the rails,” he said. “Historically, just like the C.D.C. was viewed as the best in the world, the F.D.A. had that same reputation as a top-notch regulator. But there’s been some cracks with some of the things they’ve said at the commissioner level.”

The latest from China: A senior Chinese health official said a coronavirus vaccine might be available to the public in China as early as November, the state news media reported today. In a vote of confidence, the United Arab Emirates has become the first foreign country to approve the vaccine for emergency use.


With infections on the rise, European countries are taking a different approach to the virus as they face a possible second wave this fall.

They’re trying to avoid the harsh lockdown measures they enacted when the crisis began. But they’ve also abandoned hope of eradicating the virus or quickly developing a vaccine, and instead are trying to live with the virus.

Europeans have largely gone back to work and school and are trying to lead their lives as normally as possible. They’ve mostly recognized the importance of wearing masks, social distancing, contact tracing and reacting nimbly and locally to outbreaks.

The European path differs widely from those of many Asian countries, including China and South Korea, where even one case can prompt an aggressive campaign of testing, tracing and isolation. In those countries, infections rates have been persistently low, allowing huge portions of the population to live pre-pandemic lives, although cases have been ticking up recently in South Korea.

The approach also contrasts sharply with that of the U.S., where virus restrictions have been politically divisive, and where many regions have reopened without having baseline protocols in place. The result, as our colleague David Leonhardt has noted, is that no large, rich country has suffered more.




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