MS. SELLERS: Hello. I’m Frances Stead Sellers, a senior writer at The Washington Post. I’m pleased to welcome you today to the first in our new series, the Road to Recovery, in which we talk to influential leaders about charting a course from crisis to stability in the coronavirus pandemic. My inaugural guest is Melinda Gates. She’s the co-chair of the Bill and Melinda Gates Foundation. We sat down shortly before the foundation released its annual report, the Goalkeepers report.

A very warm welcome to you, Melinda Gates.

MS. GATES: Thanks for having me, Frances.

MS. SELLERS: We're thrilled. So, let's talk a little bit about the report to start with. It tracks the world's progress in terms of the United Nations Sustainable Development Goals. And although it hasn't been sort of blaringly optimistic over the years, it has tracked progress gradually, and this year you paint a very different picture. Can you tell us about the report's conclusions?

MS. GATES: Yes. Well, Bill and I felt it was important to really name the state of the world today, and there are a few really stark things coming out in that report; for instance, the number of people dropping back into poverty. We've been on a poverty decline for extreme poverty now for over 20 years, but this year, for the first time, 37 million people unfortunately are going to drop back into extreme poverty, which means they're going to live on less than $1.90 a day. That is really, really hard for a family to do.

MS. SELLERS: Were there specific failings that led to the 900,000 deaths that have been associated with the pandemic?

MS. GATES: Well, I think there are things that could have been done much more quickly, for sure. I think the countries that we're seeing that are doing well are ones that have national leadership and that are using data and the tools we have available, which is masks and social distancing. They're testing, they're contact tracing, and they're isolating and quarantining, all very effectively. But we're not seeing that in every single country, including our own, the United States. And when you don't apply the tools that are available today, yes, you absolutely get more deaths than we otherwise would have.

MS. SELLERS: Let me read to you a sentence from the report. It says that, "There's no such thing as a national solution to a global crisis. All countries must work together to end the pandemic." How do you envision a cohesive report--response like this taking place? How does it work?

MS. GATES: Well, we've seen in the last four months the global community come together. They've created something called the ACT Accelerator. It works on vaccines, diagnostics, therapeutics and PPE, to get the tools made and available and get them out to the world. So, the countries come together, they commit to global governance, to funding it, and to making sure that it's for everyone.

Now there's still a lot of work to do under that ACT-A plan. There's a lot more money needed. We still need a vaccine. But they are the coordinating mechanism for all of those pieces.

MS. SELLERS: Well, let's turn to our own country for a little bit. President Trump has moved to take the U.S. out of the WHO, the World Health Organization. Do you see this as a bad move?

MS. GATES: Absolutely. The WHO was created to deal with exactly things like this--a pandemic. So, while it's not a perfect institution, it definitely though should be well funded during the pandemic, and then alongside that a post-mortem should be run, which is happening now. There's an independent body that has been created that really is looking at, okay, where should WHO have acted sooner, how should they have acted differently. But you don't defund the major organization that helps with a pandemic during the middle of a pandemic. That just makes no sense.

MS. SELLERS: So, some people say that President Trump has been acting against collaboration. Do you agree with that?

MS. GATES: I do. I think that, you know, he has very much an "America First" agenda. That is what he has said. And, yet, when you have a pandemic, you need global cooperation.

MS. SELLERS: So, you've said that it's time to demand new kinds of leadership. Where are you seeing that happening around the world? You mentioned some countries are doing that better? Which ones? And why do you think they're doing so much better?

MS. GATES: Well, you've seen Germany has done quite well under Chancellor Angela Merkel. She has really listened to the scientists. She's made sure the data is there. They've done all the right steps in terms of testing, contract [sic] tracing, quarantining. You're seeing New Zealand do quite well under Prime Minister Jacinda Ardern. We're seeing Vietnam do well, a middle-income country, because of all their contact tracing. So, I think there's a number of exemplars out there that have very good and strong leadership.

MS. SELLERS: What are the three things you think the President should do now to turn things around in this country given the staggering deaths we've seen?

MS. GATES: I think he should have a national testing plan that can be run very efficiently. I think there should be good data collected and provided transparently; so we know exactly where the epidemic is breaking out, and we know how to then work on it. And then I think he should set up a national contact tracing organization that can trace the disease effectively and demand quarantining in the places where we need to do quarantining.

MS. SELLERS: So you, as I have, have seen the comments that--or heard the comments that--the President made to Bob Woodward, in writing his book, talking about knowing that the virus was far more deadly than he admitted to the public. What do you consider his role is in the staggering number of deaths we've had?

MS. GATES: Well, you know, I just know that a good leader makes a difference. As I said, you see it in Germany; you see it in New Zealand. And there's an old adage in business, that "the buck stops here," which is it stops with the CEO. So you know, I think the response in the U.S. is--should be laid at the feet of leadership, with President Trump, and so we have seen far more death than is necessary. And you can see that death in comparison to other countries of our size and wealth. It just should not be.

And, those are people's loved ones. They're not just deaths in the abstract. That's somebody's mother or father, brother, sister. That shouldn't happen.

MS. SELLERS: Let's talk a little bit about the economic fallout. We see it here around us in the closed stores and the closed restaurants and people losing jobs and increased lines at food banks. But help me to understand that a little bit more internationally, globally, what the fortunes of developing countries are and how those affect other countries, how interrelated we are.

MS. GATES: Well, we know the global economy is forecasted to be down $12 trillion, and that's despite 18 billion--18, sorry, trillion of economic stimulus from various governments. So, we're going to have this--we are having this retraction on the global level.

The issue is that the G-20 countries, many of them, can put stimulus into their own country. They'll put in as much as 20 or 22 percent of GDP. But a low-income country can only put in about 3 percent of GDP to help with economic stimulus. So, people are really suffering around the world. It does mean people in places and countries in Africa going hungry. That is one of the hardest things to deal with when you're a family.

MS. SELLERS: And tell me about particularly the impact on women and families. You've written about how women often have an unfair burden in issues like this. What are you seeing now globally and nationally?

MS. GATES: Yeah, so I think COVID has laid bare the problems that we've had, these gaps we've had in society, these systemic issues. And so, while COVID is killing more men, it's the women that are dealing with the impact. It's the women who are taking care of the children. We see women are 70 percent of our health care workers. They're taking care of the young; they're taking care of the elderly. Women are losing their jobs at twice the rate of a man. So, we have to look at these issues. And it's right here in our faces. It's in our homes right now. It's in our essential workers in society.

And as we build back, we need to say we need to look at that unpaid labor. We can do something about it, and we can have a faster recovery if we address that unpaid labor with things like sick days and paid leave. We see some countries doing that. And the road to recovery will be faster if we address this particular gender issue as well as several others.

MS. SELLERS: So, do you think that women could play a unique role in this recovery? Is there a way to turn things around for women's fortunes as we turn around these other problems?

MS. GATES: Absolutely. Because what we know about women is they invest not just in themselves, but they invest in everybody around them. So the governments, for instance, India, who is doing cash transfer payments to the poor in their country, what are they doing? They're looking at their data infrastructure, and they actually have statistics on women. They're making sure the money goes into women's mobile wallets because they know the women will invest it in other women-led businesses; they will invest it in food for their children; they'll invest it in their own children's health.

So, if we look at these areas--investing in women-led business or investing in women's lives--it will absolutely stimulate the economy in ways that we haven't seen before. And so, this is the chance, instead of saying gender is a side issue, to say, no, this is the main issue; this is the infrastructure that will build back the economy that we all are desiring.

MS. SELLERS: So, another huge issue that this pandemic has exacerbated is racial disparities. Tell me what the foundation is doing to try to overcome some of those disparities as it supports health care around the world.

MS. GATES: Well, we're trying to look at, you know, where is--where are health systems unequal for people. In the United States, we have a higher maternal mortality than many, many other countries around the world. That's because of many racial issues related to our health care system.

The foundation is also looking at, particularly in the United States, our biggest investment in the U.S. is the U.S. education system because Bill and I believe that if a child is well-educated, they go on to great opportunities in life. And, yet, we're looking at--you know. We've known for a long time the education system does not treat everybody in our country equally, but we're looking back at our education investments and saying, how do we take an even deeper racial lens, to make sure that all kids are lifted up but particularly Black and Latinx kids in a way that maybe we hadn't looked at before.

MS. SELLERS: So, you've made an enormous commitment to this pandemic. Are there programs you've had to put aside in order to devote so many resources to fighting the coronavirus pandemic?

MS. GATES: Well, fortunately, you know, we have enough resources that Bill and I said to ourselves, three weeks into this pandemic, we will be investing more than we had budgeted for this year in the foundation. And so that's meant several hundred million dollars more. We're willing to do more if needed on COVID. We're always looking at different opportunities that--as they come forward with our teams.

But we've also said to ourselves, we need to keep up the work we're doing as a foundation because it's important to keep vaccinating kids against the diseases that already kill them. It's important to make sure that people still have agriculture for life and livelihood for most farmers in Africa or financial services. So, the foundation's continuing its work. Some of that is going a bit more slowly just because it's hard to get grants out. Our partners are stretched thin. Our employees are stretched thin. Many of our employees--

MS. SELLERS: Yeah, I'm sure they are.

MS. GATES: --have families [audio distortion]. And--but we're doing the best we can.

MS. SELLERS: Well--so let's talk a little bit about vaccines. You mentioned the notion of having to keep vaccinations going, but right now we're in this great race to produce a coronavirus vaccine. We saw one trial, a prominent trial, from Oxford and AstraZeneca put on pause because of a potential side effect. Are you concerned about safety and efficacy of these vaccines since they're being moved ahead so quickly?

MS. GATES: Well, what I know about the pharmaceutical companies is they want us to all have a safe and efficacious vaccine. Their reputations are staked on that. So, you saw the pharmaceutical companies come out as a whole in the last week and say, we are going to make sure this vaccine is not rushed out the door.

And so, this adverse event that happened in the AstraZeneca trial, that's exactly the thing that needs to be caught in trials. That happens in vaccine trials. Now what's great is there's transparency. There will be a monitoring board that looks at that adverse event and decides: Is this vaccine candidate safe enough to move forward, or is it one that we should stop? That's how it works, but that's how we're going to know at the end of the day that the vaccine that we--the vaccine, or vaccines, that we use are safe as a global community, and that's really important because we're putting them in our bodies and we should expect them to be safe and efficacious.

MS. SELLERS: Right. Now your husband has said that it will take more than one vaccine in order to combat this virus. What are the potential problem spots with equity if we have more than one vaccine being distributed in different parts of the world?

MS. GATES: Well, we need to have a safe and efficacious vaccine for the entire world. Now some of these vaccines will require much more difficult logistics, that is, cold chain. Minus 94 Celsius--minus 4 degrees Celsius, that is very hard to deliver in--everywhere in the world, but particularly in a low or middle-income country. It's not impossible, but it's why we are particularly interested in the vaccines that don't have those cold chain requirements because if we can get one that doesn't require this very, very difficult minus 94 degrees, keep it cool, we could actually get it out to the far reaches of the Earth much more quickly than we could otherwise. So, we have to look at all of these vaccines and figure out how do we get the right ones out first to the most vulnerable population.

MS. SELLERS: So I think the CDC has made pretty clear that the health care workers should be the first to receive the vaccine, but I think you've also spoken about the need to get the vaccine to underserved populations, particularly given the way we've seen disparities in how people are affected and Black and Latinx communities certainly suffering more. But how do we make sure that people feel confident about those vaccines, that they're not being seen--they don't feel like guinea pigs given the history of extraordinary racial inequity in public health in the past?

MS. GATES: Absolutely. And they're concerned for good reason. They've seen things in the past happen. And so, I think what we're going to have to do is, first of all, get it out to all the health care workers around the world, no matter what the cold chain requirements are, all health care workers. Then you start looking at most vulnerable populations. And I think you're going to have to prove to them that it's safe, and that does mean having some role-model people taking it, that they say: Okay, if that person takes it, I believe he or she are still safe after a few weeks or a month, okay, now I'm going to take it. I trust this system.

We have to systematically build back trust, but we also have to make sure that the vaccine is readily available for those who want it, who are in those vulnerable populations because, quite frankly, they deserve to get it first. They are the ones most at risk.

MS. SELLERS: What do you say to vaccine skeptics? It's not only about this vaccine, but measles and others, you know. And we now seen recent polling saying this vaccine is creating a lot of mistrust around Americans.

MS. GATES: I say, go ask your health care provider. Ask your pediatrician. Ask your doctor. Does he or she recommend you and your family take this particular vaccine? They are the people with the right knowledge to help you make a well-informed decision for your own health and for your family's health.

MS. SELLERS: And let's take this globally. We've seen rich countries like the U.S. and the U.K. order up millions of doses for their own populations. How can we make sure, how can you as a foundation make sure, that other countries get their fair share?

MS. GATES: Well, there is this facility. Under this ACT Accelerator, there is a whole arm of it called COVAX that is related to making sure that wealthy countries put in money so that they have reservations for their own countries but that at the same time they're putting in money to make sure there's reservations for low and middle-income countries. If we can get everybody to cooperate under that COVAX facility, there can be enough vaccine for everybody and to address vulnerable populations first. But it's going to take global cooperation, and it's deeply concerning when you see individual countries making these reservations just for themselves.

MS. SELLERS: Right. And even within those countries, the distribution problems are going to be enormous, right?

MS. GATES: That's right. There's a study that just came out from Northeastern University that says, if the first two billion doses of vaccines go just to the rich world, we're going to have double the death rate around the world. Double.

MS. SELLERS: Wow. Wow. Yeah, the vaccine--I mean, the virus knows no borders.

But you look back to Germany biotech company CureVac and a vaccine, why did you pick that one? Or, rather, the foundation.

MS. GATES: Well, we'd been--yeah, the foundation had been investing in CureVac. We knew them well. We're actually invested in quite a few of these vaccine companies. We do it through a mechanism, though, a global mechanism that we're involved in, called CEPI, the Center for Epidemic Preparedness. They and we look together at all the vaccine candidates and decide which ones do we want to invest in because, in particular, they might help the low and middle-income countries. And, we want to make sure that when that vaccine is available that we are also investing ahead of time in manufacturing so the manufacturing facilities are sitting there, ready to take the vaccine as soon as it's ready, so we can then get it out to the world.

MS. SELLERS: So just trying to think ahead, how long do you think it's going to take for the world to feel safe from this disease again?

MS. GATES: Well, I think that remains to be seen. If you can assume that we--if we're lucky and we have a vaccine in the first quarter of 2021 that's available, it still is going to take us at least a year, if not two years, to get enough vaccine to cover the world. And, as it becomes available, we're going to have to see how quickly do people take it up.

But I do think you'll have this rolling momentum, that as people see others taking it, they see that they're safe, they see that they're returning to their job, they're seeing that other people take the vaccine and send their kids to school, I think you'll have more people that want it. And it will be a rolling kind of flywheel.

But I think it could take, you know, two, two and a half, three years till we fully feel like we're back functioning, and then the economic recovery is going to take quite some time.

MS. SELLERS: Right. The early HIV drugs were mediocre, and we never got a vaccine. What's the measure of success that you will--you will understand with this coronavirus vaccine? What are you looking for?

MS. GATES: We're looking for a strong efficacy result and lots of uptake. Quite honestly, we can have an efficacious vaccine at the 90 percent level and if the uptake is only 10 percent, only 10 percent of the population will take it, we will never get through this disease. So, it's this balancing; we need an efficacious vaccine, and we need people to take it.

But I'm optimistic. You know. We've never seen the world come together with this many pharmaceutical companies, at once, all looking at this problem and scientists looking at it from all different angles, and we've never seen this much transparency, even in the vaccine trialing process. So that makes me optimistic.

MS. SELLERS: So, Facebook CEO Mark Zuckerberg said he would not remove posts that were about vaccine disinformation, anti-vaccine posts. Does that trouble you?

MS. GATES: I think anytime there's disinformation spread it's troubling. People do best when they have the facts and when they have the information, and that's why I tell them, you know, don't go read something on the internet. Go talk to your doctor when you're concerned about your health. That's where I go.

MS. SELLERS: Right. I mean, this battle over the coronavirus has been politicized probably like no other public health battle in the history of the world. You've been involved in public health before, internationally very much. What is the politicization done for the Gates Foundation, for you personally, for your employees? It must be a very different atmosphere to work in.

MS. GATES: It's difficult. It's very difficult because you're kind of constantly walking this fine line, but at some point, you stand up for what you know you believe in. And we felt like the Administration crossed a line with WHO because we know that partner deeply, and we know Tedros well and have for many, many years, that--the Director-General of WHO.

So, at some point you speak out with the facts you know, the science you know, and the work and your values and what you believe in. And that's what we do. And so, we've been calling many global leaders, working with scientists. We work with lots of representatives on the Hill, on both side of the aisle. And you just put your head down, and you keep doing the work even during the difficult times.

MS. SELLERS: So, we've talked about a vaccine. How about a curative treatment? We could have a vaccine that works more like a flu vaccine and needs to be renewed every year, and some people won't do that. How hopeful are you for a curative treatment or some sort of drug that will really address this virus?

MS. GATES: Yeah, so the drugs are being looked at. On the global front, honestly, I wish that there was more money going behind the therapeutics, that is, the drugs, because again if we had more money going behind that, systematically, we could have a database where we're tracking all of that. Some of that is happening. I do think there are some chances that an antibody will be found that can be manufactured and given to people. So that is the one probably that looks the most promising at this point.

But, again, we need to have good data. Even on the plasma in the United States, you know, we haven't seen good randomized controlled data, whereas you do see that data coming out of the U.K. It's data that helps us, and transparency, know where to pivot and what tools might or might not work because you're going to hit dead ends with drugs or vaccines and cancel those candidates and then move forward with new products. But it's that transparency that we need, and the openness.

MS. SELLERS: Well, then tell me what role technology, sorry, technology could play with--in combatting the virus and rebuilding economies around the world.

MS. GATES: Well, technology can play a huge role. I mean, we're already seeing it. The mobile phone gives us the opportunity to reach people when the vaccine is available, to tell them where they go, even if they live in a remote, rural area. It gives us the chance to reach people with digital cash transfer payments.

People are using even old--what you would consider old technology, radio announcements. A hundred percent of the population of Kenya knew about COVID-19 very, very quickly because the government knew to put messages on the radio. Now they've switched to broadcast, and they're saying, okay, on our broadcast TV stations, let's do real education as if kids were in school because our schools aren't open.

The digital technology in the United States and in Europe--kids with laptops, yeah, they're not learning the same amount that they would learn in person, but they are learning some. But, again, you've got to get the technology and the broadband distributed equitably so that kids can learn online.

But those are all opportunities that are being accelerated, and we're starting to learn how to do some of that with finesse.

MS. SELLERS: So, you talk in the report about three things the world should collaborate on to move ahead. Can you talk to us about those three elements and what they mean?

MS. GATES: Well, it means that when we talk about global collaboration we talk about working on a vaccine together, working on diagnostics, working on a therapeutic, and then getting those lessons learned, those tools out to the entire world in an equitable way, and learning lessons from one another across the world as we move forward. If we do those things, we're going to get through this pandemic and we're going to get on the road to recovery much, much sooner.

MS. SELLERS: You also talk about it being our own responsibility, about the decisions we make in the next weeks and months really holding the key to success or not. How is the world going to collaborate its way out of this problem?

MS. GATES: Well, we're going to share information, and we're going to share knowledge. And you're seeing it happen with the pharmaceutical companies, with the vaccines. You're seeing data come out of Vietnam. You're seeing data come out of Germany, out of the U.K. The U.S. is a bit of mess, quite honestly, on the data. But it's the sharing of knowledge and sharing our humanity, sharing our experiences.

This is hard. This is hard for all families. Whether you can work at home and be online but you've got little kids running around, whether you're an essential worker getting on a bus to go to your job, whether you're working in a food stall in Indonesia, this is just hard. And we need to have compassion for one another, and we need to do what's right, which today means wearing your mask, washing your hands and social distancing.

MS. SELLERS: I'd love to have you talk a little bit about what gives you hope now. You're dealing with these crushing problems across the world, not just here. Life is not easy for anybody at the moment. But, do you think we can come out of this better placed, more equitable, and better able to help people and build a better future?

MS. GATES: I do because I think COVID is laying bare some of these societal issues, these systemic issues we've had, that we don't want to look at, that we just kind of bury. Whether it's racial inequity, whether it's issues related to women and unpaid work, it's laying that all bare. It's right here in our face. Climate change in the U.S. is right in our face. We're dealing with fires, forest fires, all over the West Coast. And so, it gives us a chance to face what we need to face and say, how is it that we want to build back as a society?

And I keep hope when I see these small acts of kindness, but they reverberate. Somebody helping an older person, who's isolated, get their medicine. Somebody helping another family who's struggling with child care. You know.

When we go around our dinner table at night, we all name one thing that we're grateful for that happened that day. And I think even when things are hard, if you can find one thing to be grateful for, it keeps you lifted up and getting up the next morning, to say, I'm going to keep at the work that I'm doing.

MS. SELLERS: That's right. Let's all hope we can, and you can and the Gates Foundation can, keep up the work that you're doing.

Melinda Gates, thank you very much for joining us today.

MS. GATES: Thank you for having me, Frances.

MS. SELLERS: Well, it was a pleasure, and we learned a lot from it.

Thank you for joining us, everybody. If you’d like to see excerpts from the interview or see the whole thing, please tune in to WashingtonPostLive.com.

I’m Frances Stead Sellers. Thank you very much for joining us.