In their 2021 annual letter, Bill and Melinda Gates reflect on their foundation's response to COVID-19, the inequities highlighted by the pandemic, and the opportunity that exists to work toward "a healthier, more equal future for all" by prioritizing equity and pandemic preparedness.
To date, the Seattle-based foundation has committed $1.75 billion in support of COVID-19 response efforts, including the production and procurement of medical supplies and the development of treatments and vaccines. To address the disproportionate health, economic, and social impacts of COVID-19 on women and BIPOC communities, the foundation also partnered with historically black colleges and universities to expand diagnostic testing capacity on HBCU campuses; expanded partnerships with organizations that use digital tools to help students stay on track to a college degree; called on world leaders to put women at the center of their COVID-19 response; and supported efforts to design economic response plans targeting women and low-wage workers.
In addition to highlighting existing global health inequities exacerbated by COVID-19, Melinda Gates calls out a new one in the letter: "immunity inequality" between wealthy and low- and middle-income nations. "Demanding an inclusive response will save lives and livelihoods now,' she writes, "and create a foundation for a post-pandemic world that is stronger, more equal, and more resilient."
Preventing the next pandemic will require spending tens of billions of dollars a year, Bill Gates argues. To that end, Gates calls for doubling down on investments in research and development, supporting organizations that have proven to be invaluable in the current crisis, and building new capabilities. The governments of wealthy countries must lead that effort, he adds, and invest in science-based tools such as mega-diagnostic platforms and monoclonal antibodies, support the development of a global alert system based on diagnostic testing, create a corps of infectious disease first-responders, and fund simulations that help improve how the world responds to disease outbreaks.
"We hope the experience we've all lived through over the last year will lead to a long-term change in the way people think about global health — and help people in rich countries see that investments in global health benefit not only low-income countries but everyone," the Gateses write. The leadership not only of policy makers but healthcare workers, teachers, parents, caregivers, and scientists "will get us through this pandemic, and we owe it to them to recover in a way that leaves us stronger and more prepared for the next challenge....By next year, we hope an equitable, effective COVID-19 response will have reached the whole world, too."