In May 2021, President Biden threw his weight behind the movement, calling for a temporary suspension of patent protections for COVID19 vaccines to ensure coverage among poorer nations.145 “We believe that intellectual property rights constitute a very substantial barrier to ensure equitable access,” he said. “We believe that if we could have a limited, targeted waiver to ensure that we can ramp up production in various parts of the world, we would go a long way to ensure that we address not only the prevention but also the treatment of COVID19.” Biden’s equity initiative forced Gates into the open. Gates’s entire philanthrocapitalism business model rests on the sanctity of knowledge monopolies; and so, with the whole world watching, Gates revealed that patent integrity—the source of vaccine profits to his pharma partners— is the sine qua non of Gates’s global health initiatives. When push turns to shove, patent protection eclipses his professed concerns for public health.
His ironclad control of WHO made Gates’s opposition to C-Tap dispositive. The runaway train hit a granite mountain. Any pretense that democracy or equity should determine global health policy collapsed before the raw power and influence of Bill Gates. According to the New Republic, “Advocates for pooling and open science, who seemed ascendant and even unstoppable that winter, confronted the possibility that they’d been outmatched and outmaneuvered by the most powerful man in global public health.”146
Gates derailed the C-Tap pool, replacing it with his own WHO program, the “COVID19 Act-Accelerator,” which consecrated industry patent rights and relegated developing world vaccination programs to the charitable impulses of pharmaceutical companies and Western donor nations fighting for their own share of the vaccines. As the predictable result of Gates’s intervention, around 130 of the poorest of the world’s 190 nations, 2.5 billion people, have had zero access to vaccines as of February 2021. As Zaitchik pointed out, the supply crisis was easily foreseeable: “Not only were the obstacles posed by intellectual property easily predictable a year ago, there was no lack of people making noise about the urgency of avoiding them.” Gates had once again used his international reputation and money authority to shield corporate greed with a “halo effect.”147, 148 International health officials warned, for example, that despite all government expressions of concern about Africa, “Less than 2 percent of all doses administered globally have been in Africa. Just 1.5 percent of the continent’s population are fully vaccinated.” (Paradoxically, these nations happen to have lower COVID mortalities by orders of magnitude.)
“There has never been a point at which the Gates Foundation—before the pandemic, at the start of the pandemic, and now at the worst moment of the pandemic— is willing to surrender and look at IP as something that has to be managed differently to ensure that we’re doing as much as possible,” said Rohit Malpani, board member of the global health agency UNITAID.149
Gates opposed waiving some provisions of the World Trade Organization‘s Agreement on Trade-Related Aspects of Intellectual Property Rights, or TRIPS. A waiver would allow member nations to stop enforcing a set of COVID19-related patents for the duration of the pandemic. “Bill Gates asked everyone to block the TRIPS waiver and trust a handful of companies hoarding IP and know-how,” said James Love, director at Knowledge Ecology International.150
Gates’s commitment to patent rights is existential and unyielding. Gates has ruthlessly defended intellectual property monopolies since his early battles with open-source hobbyists in Microsoft’s natal days. Gates built both his fortune and his charitable model of philanthrocapitalism on the sanctity of intellectual property protections in software, food, and drugs.
Gates made his bones with his Big Pharma partners by triumphing over Nelson Mandela in hand-to-hand combat during the grim African AIDS crisis of the 1990s. South Africa was ground zero in the global AIDS epidemic, with HIV infection rates affecting one in every five adults. Mandela had made himself the paladin in a Third World crusade to allow generic drugmakers to give the global poor access to expensive AIDS drugs. Mandela’s reputation as a kind of saint stymied the pharmaceutical companies, reluctant to defend a venal business model that—by their own estimation— was a death sentence for 29 million African children and adults. Cloaking himself in the moral authority as the world’s largest charitable benefactor, Gates stepped forward as the industry champion, expounding the cause of intellectual property and knowledge monopolies over public health. That ghillie suit of selfless altruism successfully confused the press and public—especially the liberal establishment—about Gates’s solipsistic motives for over two decades.
In December 1997, Mandela’s administration pushed through a law allowing the health officials to import, produce, or purchase generic AIDS drugs that were out of reach for most Africans. Pharma was happy to test AIDS drugs on Africans but had priced the final product far out of their reach. Glaxo, for example, was still selling annual dosages of AZT for $10,000. Gates declared war on Mandela and his generic drug crusade by supporting a suit by thirty-nine pharma multinationals who sued South Africa to prevent poorer nations from accessing generic AIDS drugs for their people.151 Once again, Gates put the halo on greed.
The New Republic chronicled the fight: “In Geneva, the lawsuit was reflected in a battle at the WHO, which was divided along a north-south fault line: on one side, the home countries of the Western drug companies; on the other, a coalition of most from the global south and dozens of leading public health groups including Médecins Sans Frontières and Oxfam joined the battle on behalf of Mandela.”152
In the end, Gates and pharma won the legal case, and Gates helped push through enduring bullet-proof protection for pharmaceutical patents by his implacable support of the Trade-Related Aspects of Intellectual Property (TRIPS), an international agreement that outlawed the use of unsanctioned generics to combat AIDS and other diseases.
Today, leading public health officials agree that the primary drivers of the current artificial shortage of COVID19 vaccines is Gates’s defense of intellectual property rights to protect the profiteering by his pharma partners.
Zaitchik recounts how “battle-scarred” public health veterans saw clearly, for the first time, how Gates’s addiction to proprietary science and market monopolies easily overrode his professed concern about the impacts of the pandemic and poor nations and the structural inequality in access to medicines: “COVID19 reveals the deep structural inequality in access to medicines globally, and a root cause is IP that sustains and dominates industry’s interests at the cost of lives.”153