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According to a seven-month investigation by journalists located in the U.S. and Europe and the German daily WELT, Bill Gates and partners used their clout to control the global COVID response with little oversight.

How Bill Gates And Partners Used Their Clout To Control The Global Covid Response — With Little Oversight 1

The world’s governments weren’t ready when Covid-19 struck.

They made misguided attempts to stop a viral spread that quickly expanded over the world from America to Europe to Asia, shifting from downplaying the threat to sealing their borders. Four non-governmental global health organisations started preparing for a life-or-death battle against a virus that would know no frontiers while the most powerful countries turned inward.

According to a seven-month investigation by POLITICO journalists located in the U.S. and Europe and the German daily WELT, what followed was a slow, almost inevitable transfer of authority from the overwhelmed governments to a collection of non-governmental groups. The four groups assumed functions frequently performed by governments, but without the accountability of governments. They did this with the help of knowledge, support from contacts at the highest levels of Western nations, and empowerment from well-groomed relationships with medication companies.

The organisations identified potential vaccine producers and focused funding in the development of tests, treatments, and shots while nations were still debating the severity of the pandemic. And although it would ultimately fall short of its initial promises, they leveraged their influence with the World Health Organization to help create an ambitious global distribution strategy for the provision of those Covid tools to underdeveloped countries.

The four organisations had previously collaborated, and three of them had a shared past. The Bill & Melinda Gates Foundation, one of the biggest philanthropies in the world, was the biggest and most influential. Then there was the Wellcome Trust, a British research foundation with a multibillion dollar endowment that had previously collaborated with the Gates Foundation, and Gavi, the international vaccination organisation that Gates assisted in founding to immunise people in low-income countries. The Coalition for Epidemic Preparedness Innovations (CEPI), a global organisation for vaccine research and development that Gates and Wellcome both contributed to founding in 2017, was the last.

Civil society organisations working in developing countries, such as Doctors Without Borders, raised concern over the idea that Western-dominated organisations led by elite teams of specialists would be influencing choices that would have a direct impact on people there. The Gates Foundation’s opposition to attempts to waive intellectual property rights, which some viewed as favouring pharmaceutical oligarchies over individuals living in developing countries, only served to exacerbate these tensions.

“What makes Bill Gates qualified to be giving advice and advising the U.S. government on where they should be putting the tremendous resources?” questioned Kate Elder, senior vaccines policy consultant for the Access Campaign of Doctors Without Borders.

How Bill Gates And Partners Used Their Clout To Control The Global Covid Response — With Little Oversight 2
Bill Gates (center), shown above with Britain’s Prince Charles (right) and Canada’s Prime Minister Justin Trudeau (left) in November 2021, co-founded one of the largest philanthropies in the world.

But soon, governments in the US and Europe started providing the four organisations with their own essential backing. According to a review of lobbying filings, the organisations spent at least $8.3 million lobbying the US and EU. According to documents and conversations with Capitol Hill staff, when the directors of CEPI attempted to replenish the organization’s funds this past spring, it spent $50,000 in part to push for $200 million in yearly financing from the U.S. government.

The groups have spent up to $10 billion since 2020, the same amount as the top U.S. agency tasked with battling Covid abroad, according to POLITICO and WELT’s analysis of meeting minutes along with thousands of pages of financial declarations and tax paperwork. One of the first thorough accountings of global health organisations’ spending on the pandemic’s global fight.

The effectiveness and equity of the organization’s response to the epidemic are now the subject of major criticism, as are the grave drawbacks of outsourcing the pandemic response to unelected, privately-funded organisations.

“I think we should be deeply concerned,” said Lawrence Gostin, a Georgetown University professor who specializes in public-health law. “Putting it in a very crass way, money buys influence. And this is the worst kind of influence. Not just because it’s money — although that’s important, because money shouldn’t dictate policy — but also, because it’s preferential access, behind closed doors.”

Even when backed by knowledge and well-intentioned motives, such power, according to Gostin, is “anti-democratic” since it “leaves behind ordinary people, communities, and civil society” and is “extraordinarily non-transparent, and opaque.”

Repeating past mistakes?

Millions of individuals in low- and middle-income nations still lacked proper access to medical countermeasures as the global distribution of vaccines stalled in the first months of 2022.

By the middle of 2021, ACT-A had committed to providing 500 million tests to low- and medium-income nations. According to the 2021 Dalberg report on the objectives of ACT-A, the therapeutics team established the goal of providing 100 million treatments to low-and middle-income nations by the end of the same year.

How Bill Gates And Partners Used Their Clout To Control The Global Covid Response — With Little Oversight 3
Without governments stepping in to take the lead on pandemic preparedness, the four organizations, along with their partners in the global health community, are the only entities that are in a position to lead in the world’s response to a devastating outbreak — again.

ACT-A had administered just over 140 million exams as of June 2022. WHO personnel claimed they were unable to precisely estimate the number of treatments that ACT-A has contributed to, but the initiative’s spokeswoman claimed that the consortium spent $9.9 million in total to provide the medicines to low- and middle-income nations worldwide. Additionally, oxygen supplies totaling $260 million were given.

Health activists are worried that the effort to get the globe ready for the next pandemic is already making the same errors that were made during the present crisis, such as skipping out on funding for public-health services to deliver doses.

“I think ACT-A was created — COVAX was created — with, I think, very good intentions. I worry that we will not take the time … to actually do the reflection of what worked and what didn’t and why,” said Smith, of the Biden administration.

Berkley stated that COVAX was limited in what it could accomplish without more robust health systems in place on the ground to absorb the doses and distribute them to the populace, which is why COVAX has had difficulty achieving some of its vaccination goals.

“There is a reason why coverage for vaccines in general in the developing world is lower than it is in the West,” Berkley said. “What’s very different in this circumstance is the health systems that we were using were already stretched to provide your basic services. They weren’t set up to do the billions and billions of doses, adult vaccinations, elderly vaccinations that were necessary for this pandemic. That’s a fundamental truth. And anybody who sits there and says, ‘the numbers weren’t the same’ is not being realistic about what is physically possible.”

A long-standing critique of the work of the Gates Foundation has been its lack of emphasis on strengthening conventional health systems. Gostin, a Georgetown University professor who specialises in public health law, claimed that the foundation “invests in silos or shiny things like polio eradication, they don’t invest in building hospitals, building primary care, laboratories, surveillance capacities, all of the things that are the important foundations for pandemic preparedness.”

The Gates Foundation says that its employees collaborate closely with local public health authorities and that during Covid, its officials pushed for increased funding for bolstering the health system. According to the foundation’s spokeswoman, it contributes to the funding of initiatives aimed at bolstering health systems via Gavi and the Global Fund.

“No question that not everybody agrees with how we or anybody approached the pandemic. About including low-income country voices and engaging with them from the beginning: That’s [at] the core of what we do,” said Scott Dowell, deputy director for surveillance and epidemiology at the foundation. “And I think it would be a misunderstanding of the way the foundation works if people came away thinking that we didn’t do that.”

Back to the future

The latest book by Bill Gates emphasises on the necessity of creating a unique task force that can go to various regions of the world where outbreaks are occurring to support local public health workers.

“At the global level, we need a group of experts whose full-time job is to help the world prevent pandemics,” Gates writes in his book. “It should be responsible for watching out for potential outbreaks, raising the alarm when they emerge, helping contain them … and organizing drills to look for weak spots in the system.”

The Gates Foundation, Wellcome, and CEPI have all announced financial commitments to promote cutting-edge technologies for the upcoming pandemic, such as new surveillance systems, vaccines, and diagnostics. Leaders in global health haven’t made many commitments to bolstering health systems yet.

Leaders of the four organisations are currently engaged in extensive discussions concerning funding options, such as the establishment of a new fund at the World Bank, to support the global response to the upcoming pandemic. Since the fund’s focus is still being debated, it is uncertain whether it might be used to the problem with the health system.

Despite all the lobbying for pandemic preparedness that has taken place in the U.S. and Europe recently, governments have been sluggish to commit funds. For instance, in the United States, a White House office last year created a $65 billion budget for how the federal government would start to scale back its programing in preparation for another significant outbreak of an infectious disease. However, as the administration strives to battle monkeypox, officials claim that plan is being implemented gradually.

Furthermore, as the number of Covid cases worldwide stabilises, Western governments are scaling back their international response efforts, scaring health activists that they will once again fail to improve both their own and low-income countries’ health systems.

How Bill Gates And Partners Used Their Clout To Control The Global Covid Response — With Little Oversight 4
As discussions increase about being better prepared for the next pandemic, few global health leaders have announced pledges specifically targeted at strengthening health systems.

Furthermore, as the number of Covid cases worldwide stabilises, Western governments are scaling back their international response efforts, scaring health activists that they will once again fail to improve both their own and low-income countries’ health systems.

“You need to have a reckoning on this. The way the G-7, and the G-20, showed up in the pandemic was pretty disappointing, to put it mildly,” said a person who works with one of the four organizations and requested to remain anonymous to speak more freely about the state of global health care. “There was a complete lack of leadership. On this issue of equitable access, people made big statements, but they didn’t follow through at all.”

The four organisations, along with their partners in the global health community, are the only ones in a position to take the lead in the global response to another deadly outbreak if governments don’t step up to take the initiative on pandemic preparedness.

“They’re funded by their own capabilities and or endowments and trusts. But when they step into multilateral affairs, then who keeps watch over them?” a former senior U.S. official said. “I don’t know the answer to that. That’s quite provocative.”

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