“Too Late” to Vaccinate 70% of the World: What If an Equity Sequence® Mindset Had Prevailed?

by Suhlle Ahn

Like the reply that comes too late, it might seem like an exercise in futility to apply the Equity Sequence® to a missed opportunity—that is, a past inequitable decision that can’t be undone.

But because Equity Sequence® is intended as an ongoing practice—one that ideally helps you learn to catch yourself before instead of after the fact, the more you use it—every “wow, I could have had a V8!” moment has the potential to lead to an opportunity down the line, seized in time.

In that vein, I thought it worth doing another “what if” thought experiment, using the COVID global vaccine response as a case study. 

Sadly, it’s one with stark implications for what might have been, if only the blueprint for the response had been written with an Equity Sequence® mindset—that is, a more democratic, all-voices-at-the-table ethos—in the early days of the pandemic. 

It was not. 

Or, perhaps more accurately, there WAS such a blueprint. But it was scrapped, in favor of a business-as-usual conformity with an existing “global drug system based on proprietary science and market monopolies.” 

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Recently, at the Munich Security Conference in February, panel members including Bill Gates discussing the topic, “Get Well Soon: Finding a Way Out of the Pandemic,” were asked if it was still possible to reach the World Health Organization (WHO)’s goal of vaccinating 70% of the world’s population against COVID by July of 2022. 

With what seemed almost casual, “that ship has sailed” dismissal, Gates replied:

“No, it’s too late.”

But could things have been otherwise?

According to an October, 2021 Slate article titled, “How Did a Billionaire in Seattle Gain So Much Power Over Global Public Health?,” it really might have been.

Based on the picture elicited in this interview, the vaccine rollout might truly have taken a different course, had not a combination of money, influence, concentrated power, and biased assumptions created a situation whereby decision-making was ceded to the voice of one man (Gates), who effectively ended up calling the shots.

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Early in the pandemic response, one vaccine innovator ahead of the curve was Oxford University, and conversation among lab researchers there centered around the idea that the pandemic response should NOT be handled with a business-as-usual approach; that it should be public-health-driven, not profit-driven; that there should be a people’s vaccine.

Within this context, the World Health Organization was seen as the obvious entity to direct this strategy—especially on behalf of the global poor—because of its mandate, which includes:

“working worldwide to promote health, keeping the world safe, and serv[ing] the vulnerable…engagement with the monitoring of public health risks, coordinating responses to health emergencies, and promoting health and well-being.”

According to journalist Tim Schwab, who has been investigating the Gates Foundation for years, the message telegraphed by Oxford University at the time was:

“you could develop this vaccine and have it available as an open license, which would mean that any capable manufacturer anywhere around the world could get a hold of the vaccine technology and start producing it.”

Most notably, this would include sub-Saharan Africa and Southeast Asia.

But according to Schwab, this is what happened instead:

“Bill Gates and the Gates Foundation came to the University of Oxford—they’d been funding the University of Oxford and their work on vaccines for years. So Bill Gates and the Gates Foundation had a relationship. You could even say they had leverage there, and they talked to the university and they encouraged them. They pushed them, really. And they said, ‘You should really be partnering up with a major multinational pharmaceutical company, somebody who has the wherewithal, the resources, the experience to get this over the finish line and out into people’s arms.’ And not long after that they partnered with AstraZeneca. And the die was cast. Now it was an exclusive license with AstraZeneca, and so they ended up going down this business-as-usual route to patents, exclusive license, the way the pharmaceutical industry has always operated.”

An even more detailed sketch of how events unfolded is drawn in an April, 2021 article from The New Republic by journalist Alexander Zaitchik titled, “How Bill Gates Impeded Global Access to Covid Vaccines.”

In both articles, the crucial point that comes to light is that Gates dismissed out of hand any concerns that going the route of intellectual property protection would create barriers to more rapid and equitable development, production, and distribution of the vaccine globally. 

And according to Zaitchik, it wasn’t just Oxford voicing the need for a non-status quo, non-market approach:

“Not only were the obstacles posed by intellectual property easily predictable a year ago [i.e., in April, 2020], there was no lack of people making noise about the urgency of avoiding them. They included much of the global research community, major NGOs with long experience in medicines development and access, and dozens of current and former world leaders and public health experts. In a May 2020 open letter, more than 140 political and civil society leaders called upon governments and companies to begin pooling their intellectual property. ‘Now is not the time…to leave this massive and moral task to market forces,’ they wrote.”

To this day, however, Gates defends his position, even though facts and hindsight appear to have proven him wrong. 

According to Schwab: 

“One of the arguments that Bill Gates continues to make is that there simply are not available manufacturing facilities around the world that could scale up production. So, he wants to say there’s no reason that we should be having this conversation about waiving intellectual property and patents because it’s not like they’re all of these idle manufacturing facilities out there that could be producing these vaccines.”

The assumption behind this claim?

That, as Schwab puts it, “poor nations aren’t sophisticated enough or smart enough to produce this complicated vaccine.”

In other words, at best, Gates was operating (and continues to operate) with a biased assumption about the capabilities of poorer nations—an assumption many have criticized as neo-colonial or paternalistic.

 But most importantly, as Schwab explains, the assumption was inaccurate:

“[A]t the same time that Bill Gates is saying this, The New York Times is coming out with a big investigation, highlighting 10 vaccine manufacturers around the world, which could be producing these mRNA vaccines—that have the capacity, that have the professional expertise, that have all the ingredients in place to be producing these vaccines. And this is not a new story. Throughout the spring of [2021], you had all these vaccine companies who were waving their hands saying, ‘If these vaccine companies would waive the patents and share the technology, my facility could be producing this many doses this year.’”

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Whether you choose to ascribe motives to Gates beyond harboring biased and faulty assumptions, I’m not here to say.

But what I think we CAN distill from this case are some insights and lessons.

First, that the concentration of power within a single figure or single organization, and the absence of “the correct mix of voices” in the decision-making room, made it that much easier for Gates’s biased assumptions to carry the day. 

And it’s precisely this concentration of power that an Equity Sequence® mindset challenges you to call into question—whether that concentrated power is brought about by economic policies that increase wealth inequality; by racial or cultural dynamics that breed paternalistic attitudes; by status-worship social habits that foster deference to celebrity gurus as sources of authority; or by elite-educated, tech-bro networks that lead to insular thinking.

As Schwab points out:

“The Gates Foundation is a very top-down technocratic enterprise where Bill Gates sees himself as this really smart guy with these innovative ideas and technology, and he surrounds himself with this elite cadre of highly educated experts. And it’s his view that from this purse in Seattle, they can devise solutions to fix all the problems of the global poor. And that’s a very different approach than going out into a poor nation or a poor community and talking to people and asking them what they need and what they want.”

It’s a different approach from the Equity Sequence® approach—which entails doing your utmost to democratize decision-making. To consciously seek out voices that might otherwise have been kept out of the room by circumstance or by omission. And to challenge existing decision-making power imbalances.

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This brings us to what I think is a second important lesson—namely, learning to better see the system in “systemic.” 

In fact, if ever the meaning of the term “systemic” feels elusive to you when you hear discussions about “systemic inequality,” this case makes it easy to visualize exactly what a “system” can look like. It’s like a closed-loop network of interconnected nodes, with all roads leading to Gates and the Gates Foundation as a principal source of funding.

Once again, per Tim Schwab:

“[T]hey’re funding everyone. Nobody is more than one degree removed from the Gates Foundation. So it’s really difficult to avoid the foundation’s money…it’s really hard to overstate how much influence that gives [them].”

If, for example, we were to ask why DIDN’T the World Health Organization take the lead in directing the vaccine response?, it turns out there’s a backstory, and it places the WHO squarely within this same closed-loop system. 

Just as the Gates Foundation was already funding research at Oxford at the time the pandemic hit, it has also been funding the World Health Organization for decades. It is, in fact, the WHO’s second-largest funder, having gradually supplanted government funding (specifically, “assessed contributions” of member states) as its principal source of funding since the 1990s.

How did such a closed-loop system come to be?

If we step back and take a bird’s-eye view, we start to see how all were part of an interrelated historical arc: the rise of Gates to billionaire status; the forty-year concentration of wealth into the hands of “the 1%”; the gradual takeover of publicly-funded institutions by private enterprise and private philanthropy; and the growth of that “global drug system based on proprietary science and market monopolies,” which I referred to at the outset.

Within a closed-loop system of this kind, it’s easy to see how real decision-making becomes the prerogative of only a handful of people; and how this can lead to inequitable outcomes, even if that handful of people is making decisions with the best of intentions—which, if you want to give Gates the benefit of the doubt, we can assume he was doing.

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And a final lesson to draw? That we are ALL bound by this system.Whether we like it or not; whether or not we feel we have any control over it; whether we choose to hold individuals, groups, or ourselves accountable, we have little choice but to participate. None of us stands wholly outside the system.

The more, therefore, we pool our voices together and raise awareness in unison, the greater the chances of tipping the balance toward a shift; toward more inclusive decisions, based on wider and more democratic representation. And the greater the odds of being able to help re-shape that system from within.

So is Bill Gates a villain? 

You can be the judge. But whether you conclude yes, no, or something in between, it’s possible to see how consequential his outsized voice in decision-making turned out to be in our shared global COVID story, and how things might have turned out differently, had the chorus of alternative voices had more power to prevail.

Suhlle Ahn

VP, Content and Community Relations at Tidal Equality.