Toby Green:

Translation: taxpayers invest in developing products through government agencies, and private companies and their shareholders reap the profits. How does this work in practice? Gates does not give what we might call full disclosure. He offers the example of the antiviral Molnupiravir which “Merck and its partners developed”. It was authorised to great fanfare as a Covid treatment inNovember 2021.

Yet Merck did not develop this drug. It was initially developed as a veterinary drug for horses at Emory University, with a US$19 million grant from Fauci’s NIAID and funding from other sectors of the US government. Molnupiravir costs US$17.74 per dose to manufacture, according to an estimate from researchers at Harvard and King’s College London, but is being retailed to the US government for US$712 per course — a profit of 4,000%.

Another example of Gates’s eye for detail is his discussion of Remdesivir, which was approved as “Standard of Care” for Covid in the US by the Federal Drug Agency. Again, like Molnupiravir, much of the funding and institutional support for the drug originally came from the US government. Remdesivir was the baby of the drug company Gilead.

Gates describes how one study showed that “it may have a major impact in patients who aren’t yet sick enough to be in the hospital”. But other details are ignored. He doesn’t tell us that in an earlier, peer-reviewed study from China, published in the Lancet in May 2020, “Remdesivir was not associated with statistically significant clinical benefits”, and that the trial was “stopped early because of adverse events in 18 (12%) patients versus four (5%) patients who stopped placebo early”. All the same, the profits were good: while the drug cost Gilead just US$10per dose to manufacture, it was being retailed to US taxpayers at US$3,120.

Maybe Gates knows nothing about the Lancet study. Perhaps he doesn’t know that in both of these cases, public investment has funded enormous private profits — and that in the case of one of the drugs, there’s little evidence that this was to any benefit. He’s just a software engineer after all. 

For Gates, technology really does provide all the answers, as it certainly has in his own life. He believes humanity belongs online: “once people learn the digital approach, they generally stick to it”. Post-Covid, he envisages a world of flexible working, in which regular guys like him with large mansions and decent living space can languidly choose between going into the office on Wednesdays or Thursdays. The problem with Gates’s digital utopia — full of virtual spaces where 3D avatars attend business meetings — is that I suspect many of us will not want to live in it.