Melinda Gates: ‘Life will change forever… we will build back in a better way’
Bill and Melinda Gates Foundation (BMGF) launched three innovations around emerging technologies at the Grand Challenges Annual Meeting earlier this week. These include integrating tradition and technology for fermented foods for maternal nutrition, new approaches to integrating molecular surveillance into malaria control, and smart farming for small-scale crop and livestock producers.
Melinda Gates, the co-chair of BMGF, spoke to Sanchita Sharma about innovation, livelihoods, and how coronavirus disease (Covid-19) will change the world. Excerpts from the interview:
Four women won the Nobel Prize this year; three for their work in physics and chemistry. Do you think women’s leadership in science is finally getting global recognition?
I sure hope so, and I think the reason that is so important is little girls can only be what they can see. And so, when they see women winning Nobel Prizes in the sciences, they say, wow, I also can be a scientist. I aspire to do cutting-edge research. I can get there. And so, I sure hope it is a moniker and a marker in time of, wow, we really are turning the corner on women in the sciences.
How else can science be made more exciting for girls so they choose careers in research, engineering and technology?
We know that young girls and women are much more interested in the sciences if they’re working on a real problem that they see out in society. If they see anything that they know will benefit their community or benefit their family or it’s a real-world example instead of just a theoretical example, they’re much more likely to persist in the sciences.
So, they like to address real-world problems?
Exactly. They like to address real-world problems.
How can countries reopen their economies without health risks?
I think that’s a great question to ask the women’s self-help groups in India. As you know, there are millions of women in self-help groups in India who are out in the villages. They’re the ones who know, okay, how can people get a different life and livelihood here? What are the opportunities? Are there opportunities if they have access to digital? Are there different kinds of opportunities in terms of what they actually decide to grow on their small plot of land? Quite often, if they can get into a different type of agriculture, something that is more drought resistant or pest resistant or is more desired by people, sometimes switching their crops so that they’re meeting market need is a potential opportunity, or getting sometimes into poultry or livestock.
Can Covid-19 end without a vaccine?
We need a vaccine.
Has Covid-19 changed life as we know it forever?
I do think life as we knew it has changed, will change forever, but sometimes out of a crisis comes something beautiful. I look back at some of the wars and you think about what was rebuilt after the war to maintain peace and stability around the globe. Look at the World Health Organization that was formed to make sure that we have information about health and share that around the globe. I think we will have to build new institutions. We’ll have to do more to protect everybody and the vulnerable.
There are signs that people want something different. They already wanted something different before the pandemic. And I think the pandemic has exposed the cracks in all of our societies, the gaps and the people we don’t take care of, and now it’s in our face. Women’s unpaid work; no one can turn away from that. It’s in our home every single day, women taking care of the children or taking care of the elderly during the pandemic. I think there are ways that we will be able to build back and build back in a better way.
What differentiates the Grand Challenges from other initiatives to boost innovation?
Grand Challenges was set up to bring some of the most innovative ideas forward in global health and global development, which are the foci of our work. Other awards are quite often focused on other problems. We’re quite intent as well on making sure that it is a diverse set of voices bringing the ideas forward from many of the countries that aren’t high income countries, and there are a female scientists bringing ideas forward.
Is it safe to reopen schools?
Well, in terms of reopening schools, those are very local decisions that need to be made based on the number of Covid-19 cases that are in a particular community. You can really only decide on a local basis whether to reopen the schools. It doesn’t matter whether you’re in the United States or you’re in India or you’re in Europe, you have to make it with local data and local health authorities advising you. And then if the schools, if the health authorities say the schools are safe to open, it’s vitally important that people employ and use the only tools we have today, which are masks, hand washing and social distancing. Those messages have to be given very strongly and also enforced in the schools.
Which Sustainable Development Goals (SDGs) are worst impacted by the pandemic?
Well, that data is still being collected. If you go SDG by SDG, we don’t know in some of them, but I can tell you some of the ones we do know. We know that the global immunization rate dropped already 84% to 70%. That’s a 25-year setback in the global immunisation rate, and where we will probably see the impact in the years going forward is as we measure infant mortality, which is going to be really sad. I mean, the other places that we know we’ve lost gains are in malaria and tuberculosis. Five years of gains have been erased just since March. It’s pretty dire in area after area.
How has Covid-19 increased iniquities?
We know in country after country, domestic violence is up. When women don’t have safe spaces to go to or they’re locked in or a child is locked in with an abusive parent or a woman is locked in with an abusive partner, domestic violence rises, and we’re seeing that. You’re hearing the reports of it in Canada, in Europe, in South Africa.
One of the things I’ve been pleased to see is some of the really innovative programming that’s being done. Out of Africa put out more money to the local women’s organizations who are already fighting these issues. In France they decided to have safe spaces that women could come and report at a grocery store or at a pharmacy. Canada opened their hotels for domestic violence survivors. We’re seeing a huge increase in that, which is an enormous barrier for a woman.
The other impacts we’re seeing on Covid for women are these what we call shadow pandemics, more girls out of school and less likely to return at the same rate that maybe their brother might, interruptions in contraceptive supply chains, women not being able to get an ambulance to go into hospital or clinic to give birth. Those are all things that are affecting women.
And how do we take vaccines to reach everyone who needs it?
Well, you first make sure that your front-line health workers get it, right, and 70% of those are women. There are 15 million healthcare workers out around the world. They should get it first, because they’re the ones who are taking care of everybody else. Then you start to look at who are your most vulnerable populations, which people have chronic underlying illnesses, obviously, as you said, what’s the age cohort? And so, then that really takes government planning to decide, okay, how are we going to get it out to those people as the next tier and then out to the next tier and the tier below that who need it? In your country that will be the government of India. I think one of the fortunate things that India has is Serum Institute is incredibly good at making vaccines. They have the know-how and they have the capability and the manufacturing capability. I think India is going to be very lucky in that regard compared to some other countries.
Is the world better prepared for the next pandemic? Are partnerships the way forward?
Yes, we’re seeing global cooperation in a way we have never seen it before as a globe. I mean, look at how the scientific community is coming together to move as rapidly as they can to learn about vaccines, learn about medicines, figure out diagnostics. We’re trying to learn from each other in terms of countries of what works well for testing and tracing. How do you get good messages out about social distancing and mask wearing? We’re seeing global cooperation and partnership. It really is the only thing that’s not only going to get us out of this crisis, but get us prepared.
You asked earlier, you know, preparing for the next pandemic, there will be another pandemic sometime in the next hundred years. But there is a lot we can do with our data and information sharing, with stockpiling at times different types of vaccines, sharing information about what is known and alerting people as soon as there’s an outbreak. There’s a lot we can do, and I think global cooperation and partnership is finally on display in full force.
And yes, we were one of the founders of GAVI (The Vaccine Alliance) back in 2000. That has been an unbelievable institution that we are lucky to have as a world during this pandemic. It will be able to get vaccines out to countries into the far corners of the earth. That institution had to learn over time. It had to make some mistakes, come back from those mistakes, get better and better, make sure it constantly had a good governing board and good leadership. We need to build some institutions like that. We have one called the Coalition for Epidemic Preparedness Innovations. It was funded but not funded at a very high level. After this, I think you’re going to see country after country putting money in the Coalition for Epidemic Preparedness Innovations, so that we are prepared for the next pandemic.
You told BBC Radio some months ago that you’ve been storing food and water in your basement for years in preparation for a pandemic. What’s your advice to people with no basements?
Well, my advice actually to everybody is we ought to be investing in our primary healthcare system. I mean, if you have a robust primary healthcare system, it is the first line where people go. That is where their needs are met. We have to, have to, have to as a world invest in those, and we haven’t paid enough attention, quite honestly, to the primary healthcare. That’s my message to people.