 While the remarkable development of successful COVID vaccines is already allowing much of the rich world to return to something approximating normal life, the majority of the world's population living in the Global South are having to wait. That's because the vaccines, most of which are owned by Western pharmaceutical companies, have been snapped up by those governments most able to pay. So how can we resolve this inequality? Well, one option is to share the vaccines already being produced more fairly. This would mean donating mostly Western produced vaccines to the Global South. The other is to allow developing countries to produce their own. Now, this would require waiving patents on the vaccine. So anyone can get the recipe and no one can get fined or sued if they make a vaccine which someone else has originally developed. There is a broad coalition of people who want to waive patents on COVID-19 vaccines. This map is showing you the different positions which are across the globe when it comes to vaccine patents. So here you see in yellow countries who have come together to say there should be no patents on COVID-19 vaccines so that anyone can get the recipe and anyone can produce the vaccine. You can see there you've got China, India, most of Africa, much of South America, Indonesia. You've essentially got most of the Global South. Then the countries who are opposing is mainly the rich world. So you've got the United States, you've got all of Europe, you've got Australia, you've got Japan. There's a slight exception. You've got Brazil, which isn't a particularly rich country. Looking at this map you probably come to the conclusion that this is another situation where the rich world is exploiting the poor or at least not providing the world with the resources that would improve people's quality of life because they want to preserve their own right to make profit. That's probably what I think is going on here. Not everyone does, though. One man disagrees. Bill Gates was on sky this weekend to mark a year since the launch of the Access to COVID-19 Tools Accelerator. Now the Accelerator is also known as ACT, brings together government scientists and philanthropists to help develop and distribute technologies to fight COVID. In the interview, Bill Gates is talking about how we can get vaccines to people, but he's very, very clear this should not include waving patents on vaccines. I'm going to take a look at the interview, and this is his answer to the question, do you think it would be helpful for the vaccine recipes to be shared? No, why not? Well, there's only so many vaccine factories in the world, and people are very serious about the safety of vaccines. And so moving something that had never been done, moving a vaccine from, say, a J&J factory into a factory in India, that it's novel. It's only because of our grants and our expertise that can happen at all. The thing that's holding things back in this case is not intellectual property. There's not like some idle vaccine factory with regulatory approval that makes magically safe vaccines. You've got to do the trials on these things, and every manufacturing process has to be looked at in a very careful way. There's all sorts of issues around intellectual property having to do with medicines, but not in terms of how quickly we've been able to ramp up the volume here. I remember how shocked people were when we said we were going to do second sources in these developing country factories. That was the novel thing. We got all the rights from the vaccine companies. They didn't hold it back. They were participating. I do a regular phone call with the pharmaceutical CEOs to make sure that work is going at full speed. That was Bill Gates saying, look, there's no point in sharing the recipes. There are no idle factories. Any factory that can be making the vaccine is making the vaccine. Also, he adds, by the way, anyone that is making a vaccine in the global south is basically doing it because of our grant money. I'm joined by Stephen Burrani, a science journalist who's written extensively about the pharmaceutical industry and the development of COVID vaccines. What did you make of Bill Gates' argument in that particular clip? He's being purposely obtuse here. He's wrong on the face of it saying there aren't any idle factories. I published in The Guardian just the other day, a factory in Canada, a company called BioLyce that wants to make the J&J vaccine. They haven't heard back. They've got the bioreactors. They've got enough stuff to make about 20 million doses a year. Not a huge amount, but it puts the lie to the idea that nobody's going to do it. There's factories in Bangladesh that have come forward, things like this. The bigger issue is he basically says that there's no way to do it any faster. And he's being obtuse about how this works. I mean, there's no way that you could just waive the patents today and a factory will make vaccines tomorrow. But that's not what people are asking for. They're asking for a joined up international effort to build up production from the very base level, which basically deals with all of his critiques. There aren't enough materials. There aren't enough factories. I mean, what we're saying is we want something like there was in the past. We want something like there was for small box, where there's a global coordinating body and they help every country build up capacity to take on this thing. Would he not say that's what is ACT UP? What's not called ACT UP? Sorry, I've got that wrong. His accelerator, his COVID accelerator, was supposed to be to transfer technology, wasn't it? But it was while leaving all the power within the pharmaceutical industry. Yeah, exactly. And if he did that without the patents, it would be more effective. I mean, if he didn't do it at all, it would be more effective. If he let the WHO use their own accelerator, which is what they want to do. And he sort of jumped in front of them and said, oh, no, we're going to do it my way. And then nobody did either of the ways. So it just, it does seem like a big distraction. You want to read him in as good faith as possible, but he just does seem very purposely obtuse. He says, there's no capacity and we're saying we want to build capacity and no answer. And then you say, we want to joined up worldwide effort like we have in the past. And he says, I've got one. And then, you know, totally ignores the WHO trying to do the same thing. So it really does seem like he's just trying to sort of block the conversation. And he knows he's not going to get a follow up to that question, right? Yeah, I mean, it's super complex. And thank you for coming on here to explain that. I want you to interview Bill Gates next. Let's go back to the Gates interview because part of his complacency about the ownership of vaccine patents seems to stem from the view that he thinks that basically, I mean, if you add it to that previous clip, thanks to him, things are going pretty well right now anyway. Well, over the balance of the year, the US, the UK and others will be able to make sure that the vaccines are now going to the developing countries. Because many of the vaccines worked, you know, although we're looking at, you know, some of the side effects now and making sure we can treat those and that they're very rare. That good news means that we will be able to supply others. And the other good news is that the actual death rate from this epidemic in the poorest countries has actually been quite low. And so the places where, you know, you want to get everyone over 60 vaccinated, like South Africa, Brazil, you know, that that will become a priority just in the next, you know, three or four months is when the US will move into that excess position and take these Act A resources and use them to get those vaccination levels up as fast as we possibly can. You know, it is true that there's been about a four-month gap that depending on what happens to J&J could be over six months. Typically in global health, it takes a decade between when a vaccine comes into the rich world and when it gets to the poor countries. So there you saw the argument. He's basically saying, look, you know, normally it would take 10 years for people in poor countries to get the medicines we're using in the West. If it's four months to six months, I don't get why people are complaining. What did you make of that particular argument? His voice is really annoying. I mean, he's basically saying, you know, we used to do a terrible job at this. We're doing a better job. But even now that we're doing it faster, you'll get yours when we're done. You know, like we're going to do business as usual. We're going to let the pharmaceutical producers handle production all on their own in total secret. No transparency about production. No transparency about supply. It arrives when it does, first come, first served, and you can eat when we're done. And I mean, the way that I think I always think about this myself, and I encourage other people to think this way, is to ask yourself, like, do you think that they think this is a crisis? You know, because they're doing things with the same business model that they were before. It's just that the vaccine's got developed a bit faster. It's first come, first served. It's all secret. They're not sharing anything they're not doing tech transfer. You know, there's no, there's none of this idea of like, you know, war footing, where we're going to marshal every resource and profits and productivity be damned. You know, we're just going to beat this thing. They're approaching it as if it weren't a crisis. And I just think that's very telling, you know, we'll get ours. And then, you know, the rest of the world can have it when we're done. That's always the thing with Bill Gates. I mean, you know, he built this reputation because the cures that he wants to fund are, you know, that's good. He's a techno optimist. You know, that's the money he gives to science. You know, that's great. But he has a very narrow view of how the world and politics can work. And not only is it like very narrow, it's very historical. You know, it's this incredibly marketized. The private sector can have to do everything. And all you can possibly do is like slightly incentivize them or like fill the gaps where they can't produce. And he's never going to compromise that even even now, you know, in the middle of this crisis. One more clip of Bill Gates because this one is where I think the political analysis really shows through or at least the political assumptions really come through. He's pushed by the host on whether he thinks the gap between access to the vaccine for the rich world and the poor world is a problem at all. Yes. The reason our, you know, foundation funded Gavi, which the UK is also a huge back rub is to deal with these unbelievable health and equities. And as I said, in this case, it's about a four to six month Delta. That's not fair. But that's actually doing very well. You know, given that the funding that was provided, the fact that the rich countries have somewhat prioritized themselves, you know, that's not completely surprising. We don't have world government that sits there and, you know, ignores the US R&D money or UK R&D money and overrides that because the, you know, the fact of getting elderly people vaccinated in the rich countries, which actually had the pandemic worse than most of the developing countries, that was a good thing. The fact that now we're vaccinating 30 year olds in the UK and the US and we're not yet, we don't have all the 60 year olds in Brazil and South Africa. That's not fair. But, you know, within three or four months, the vaccine allocation will be getting to all the countries that have the very severe epidemic. And so Act A, you know, it doesn't get a perfect grade, but it does get a very high grade that the second source deals did happen. And now, you know, it's going, we're going to get to the point of equity. He's basically saying it's either this system we have now, which is based on, you know, national governments, corporations, and the odd philanthropist, or it's world government. That's the sort of the options he's presenting towards. You've got the status quo, or you've got world government. I mean, how would you respond to that particular argument from Bill Gates? Yeah, it's, I mean, yeah, it's the centrist motto, man. You know, things cannot be better, you know, but we can't we can't imagine any sort of better world. It's the same thing as always. It's it's it's stalling. It's sort of false equivalencies. And it's all sort of based around continuing to do things the way we currently are, which is which is just business as usual. And I mean, the reason I keep saying that it's a historical is that, you know, there were previously in the past joined up efforts to to take on global epidemics, you know, against smallpox, against polio, you have the WHO, which is far from world government, you know, it's it's a it's an institution that is bought into by its member states, created coordinating bodies that that allowed countries to build up capacity to make vaccines. And, you know, that worked really well in the 1950s, 60s, and 70s. And so to say that, you know, it's this or some some one world government, you know, again, it's just like a it's a false equivalency. It's totally historical. The point that I think that standing out from what you're saying is that, you know, what you're proposing isn't even actually that radical. It's just what happened in the 50s or 60s in the 70s, which was that patents weren't so defensively protected. And you could have coordination between different countries and countries could say, look, we're making this vaccine. Sorry, it's an emergency. You can't stop us. Yeah. I mean, basically, and it's not to say that that, you know, pharma companies got thrown out to dry, or even that they didn't fight for their patents. It's just that like countries actually stood up, you know, it's it's it's within living memory. And sometimes it seems like a lost world.