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Replying to

@BillGates

and

@devisridhar

mRna vaccines still can't meet all the demand so figuring out who gets what is complicated.#

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There's been a lot of discussion on responsibility of pharma companies like Pfizer/Moderna for access. What is the role of these companies in ensuring pricing and availability esp in low and middle income contexts?

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When we have adequate supply then tiered pricing is used where the rich countries pay a lot more than middle income and low income pay the least which is funded by

@gavi

. When supply is limited rich countries have to not outbid the others so governments are key to this. #

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Looking back on 2020/21 (and given you warned of a respiratory pandemic for years before), what do you think is the biggest mistake most countries (with resources) made in responding?

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A few countries like Australia moved fast to diagnose cases at scale and isolate people who were infected. They were able to limit deaths dramatically. Once the numbers get large in a country it is too late. So the first few months made a lot of difference.

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Also some countries did a better job of reducing mobility, using masks and protecting the elderly. We weren't prepared - no practice in advance.#

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Do you think the world will come together to get ready for the next one? I hope so but I am not sure.#

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I'm optimistic about the '100 day challenge'- the idea of sequencing a new genome to developing diagnostics, therapeutics and effective vaccines- and getting them out to people. But requires leadership, planning & foresight. Now is the window to prepare.#

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One major problem has been online misinformation on Facebook & other platforms around vaccines, masks and other interventions- how do we deal with this challenge? When expertise is neglected and conspiracy theories are spread as if they are truth?

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Trusted authorities like

@WHO

and

@CDCgov

need more resources to see the pandemic early (surveillance) and to communicate better. Social media got behind on trying to get factual information out - there will be a lot of debate about how to do better on that...

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People like you and I and Tony Fauci have been subject to a lot of misinformation. I didn't expect that. Some of it like me putting chips in arms doesn't make sense to me - why would I want to do that?#

6:42 PM · Jan 11, 2022

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Replying to

I'd make a joke but would cause a storm😆. Turning to the Gates Foundation's mission, what do you see as the biggest challenges to development in poor countries now? Have we gone backwards on girls' education & the child survival revolution?

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From 2000 to the start of the pandemic we made strong progress on health and other goals. The pandemic is a huge setback - including rich countries not focusing on the needs of developing countries as much. I hope we can reverse that.

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