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Bill Gates’ Somewhat Vague Wish List on AIDS

Bill Gates

Thomas Hawk

Bill Gates

A week before he was to speak at the world’s largest AIDS conference, which began Sunday, July 18, in Vienna, Bill Gates shared his thoughts with a select group of journalists.  What needs to be accomplished next to reign in the pandemic? Mostly, he said, we need to be more “efficient.”

Gates said he intends to make four key points at the massive AIDS meet:

1. Keep advocating for AIDS funding because it is money well-spent.

2. Be innovative in how we spend the money.

3. Focus on the most effective prevention efforts (Gates cited male circumcision as one example).

4. Adopt best practices to reduce treatment costs and increase the number of people on treatment.

5. Continue to support research for an effective AIDS vaccine. (Wait a minute, that’s five … unless number four is actually really an example of number two.)

“I’m optimistic about an AIDS vaccine,” said Gates, citing recent scientific and clinical advances that have renewed hope for a vaccine. He said fighting AIDS remains a top commitment for his philanthropy’s global health program.

Pressed for specifics on these four or five aims, Gates cited a report called Treatment 2.0 issued July 13 by the Joint United Nations Program on AIDS (UNAIDS). But the report made similarly broad (and not always very grammatical) recommendations — such as “stop cost being an obstacle” and “create a better pill.”

Yeah, do that! One wonders why they didn’t also recommend an end to poverty.

Another of UNAIDS’ Treatment 2.0 statements: “Treatment is prevention.” The UN organization noted the growing body of evidence that indicates people getting anti-HIV drugs are unlikely to spread the virus to others.

Gates was asked if his philanthropy, which favors prevention strategies and research, would shift more of its funding to helping people get these drugs — given this claim that treatment is also an effective way to prevent the spread of HIV.

Gates said he didn’t think the evidence was that strong. And, he says, it’s impractical because it would only work if people are put on medication within days of being first infected (a position many AIDS experts might dispute).

There were questions to Gates asking what the foundation would next invest in, how to get the public to continue to pay attention and accurately comprehend the still-expanding pandemic, and if he could be more specific about how to accomplish his wish list for AIDS.

Gates didn’t really give very many specifics. Perhaps he’s saving his big news for the conference. Or perhaps we journalists just didn’t ask very many probing questions. This privileged chat with Gates eventually just died away, like one of those awkward conversations at a dinner party.

After the moderator decided to end the teleconference ahead of schedule (or got tired of me repeatedly pressing the question button … I can usually only get one question in!), Gates must have assumed the speakerphone had been disconnected. He could be heard expressing frustration that so few of the journalists who were on the line had questions for him.

Just as it looked like Gates was about to say something really good, about a friend and fellow journalist I consider one of the best AIDS reporters out there, the line went dead. Dang.


About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at] or follow him on Twitter @tompaulson.