SCOTT DETROW, HOST:
It is a precarious time for global health efforts and for the United States' role in those global health efforts. The Trump administration has ground to a halt the work being done by the United States Agency for International Development. Its nominees for key health positions have raised questions and skepticism about global vaccination efforts.
So when Bill Gates came by NPR to discuss his new memoir, I also asked him about this current moment in public health. That is because Gates is one of the most important players in the world on global health and vaccination efforts due to the work his Gates Foundation has done over the past few decades. And we should note, the foundation has also provided financial support to NPR. I began by asking Gates what he makes of Trump's attack on USAID.
BILL GATES: Well, I'm still very hopeful that work that's been done on, say, HIV or polio eradication - that that will be preserved. And you know, right now, we need to - even if USAID is going to be slimmed down somewhat and not do climate things and some other things - the basic humanitarian and health work, including the HIV, is a big part of that in talking to the people in the government, including President Trump himself, and say, no, even if we make it somewhat more efficient, this fits your value system. This fits morality, geopolitics. And if we innovate, we eventually can curate. So let's stay the course on what's called PEPFAR.
DETROW: So you're optimistic that funding will turn on again? - because as of right now, it's just been - the spigot has been turned off, and Trump and Elon Musk and others are saying pretty disparaging things about...
GATES: Yeah. We're in a scary transition state right now. So, you know, even if USAID is going to be slimmed down, it's a fantastic organization. These people agree to work in the field, and they need to be out there. The fact we stop mothers from giving their babies HIV - that has been so magnificent, and it's so tragic if we stop that. The people in the field and the people at the headquarters are a necessary part of it. And so we need to get those people engaged and maintain their jobs, their morale, even if we're going to slim down and get rid of a few aspects that, percentage wise, aren't more than 10- or 15%.
DETROW: Of course, the other big area that the Gates Foundation has really made its mark is the world of global vaccines. As we talk, Robert F. Kennedy Jr. has cleared a Senate Committee, is awaiting a final Senate confirmation vote, but he looks on track to be Health and Human Services Secretary. He's attacked your work. He's attacked you personally. He's questioned vaccines in a way that really worries experts. What do you see as the path forward for the world that cares about vaccinations, given this reality?
GATES: Well, it's hard to overstate how miraculous vaccination is. I mean, the reason we're down from 10 million childhood deaths a year to below 5 million a year - the biggest reason is that we rolled out new vaccines - rotavirus, pneumococcus, quite a few. And there's an incredible pipeline of vaccines - a TB vaccine, HIV, malaria. So I'm, you know, excited about that pipeline. I will meet with Robert Kennedy and work to find common ground. You know, I think...
DETROW: Is there a meeting on the books, or is that - just you're happy to meet with him?
GATES: No, I'm - there's no specific one. But I have four days later this month where I'm coming back into town, thinking that the key people will be in place - Secretary Rubio, Secretary Kennedy, you know, NIH, FDA - you know, all the people that the Gates Foundation has partnered with throughout every administration. And, you know, I'm hopeful we can find common ground. I start with an optimistic attitude.
DETROW: Kennedy talked about vaccines a lot differently in his confirmation hearing than he has in the past. What did you make of those statements?
GATES: You know, I don't think he's going to do anything precipitous against vaccines. I'll be very interested in what he goes after because the immune system and the research around it turns out to be important not just for HIV, but, you know, we now have cancer vaccines coming that - the U.S. want to lead on that. You know, we have ways of doing gene editing that things like sickle cell cure and HIV can be done.
So I hope to get him excited about the pipeline. You know, when Gates Foundation does innovation, we have to do very low-cost innovation because we want it to work in all countries. And that often can save massive health care costs even in the richest countries. So, you know, I know he'll have some interest in that pipeline.
DETROW: I think it's pretty clear you're a data guy. What are the metrics you'll be looking at to see if vaccine progress - all the progress you just laid out - is backsliding or moving forward or staying on the same pace?
GATES: Well, there's NIH research money - will be a big part of that. There's the funding for the Global Alliance for Vaccines, where the U.S. is about 20% of all the money, very similar to the Gates Foundation in the U.K. government - those are the three biggest funders - that buys inexpensive vaccines for all the world's children. And so we have a five-year fundraising for Gavi coming up in the spring. And, you know, we'll look to the U.S. commitment to maintain the incredible generosity that's saved millions of lives.
(SOUNDBITE OF TOMMY GUERRERO'S "IN MY HEAD")
DETROW: That's Bill Gates. You can tune into ALL THINGS CONSIDERED this weekend to hear a conversation about how, as a teenager, Gates snuck out of his bedroom in the middle of the night to write code and how, in the process, he helped create the modern computing world we all live in.
GATES: Even the big companies, particularly IBM, didn't see what we saw. So, you always - when you have lots of companies, you have to find a flaw in their thinking.
DETROW: That's on Saturday on ALL THINGS CONSIDERED.
(SOUNDBITE OF TOMMY GUERRERO'S "IN MY HEAD") Transcript provided by NPR, Copyright NPR.
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