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Bill Gates has been big on vaccines since before the start of the coronavirus pandemic, but in a new blog posting, the Microsoft co-founder and billionaire philanthropist says the only way to end the pandemic for good is to offer a vaccine to almost all of the planet’s 7 billion inhabitants.

That’s big.

“We’ve never delivered something to every corner of the world before,” Gates notes.

It’s especially big considering that a vaccine hasn’t yet been approved for widespread use, and that it may take as long as a year to 18 months to win approval and start distribution.

Some companies are aiming for a faster pace: Oxford University says its vaccine candidate has shown encouraging results in trials with rhesus macaque monkeys, and if it clears accelerated human trials, a few million doses could be available by September.

Like Fauci, Gates says the January time frame is conceivable — but he also says the vaccine development effort could take as long as two years.

Gates says there are more than 100 different COVID-19 vaccine candidates in the pipeline. “I think that eight to 10 of those look particularly promising,” he said, although he adds that the Bill & Melinda Gates Foundation will be keeping an eye on all the other just to make sure nothing is missed.

“Even if an RNA vaccine continues to show promise, we still must continue pursuing the other options.” Gates says. “We don’t know yet what the COVID-19 vaccine will look like. Until we do, we have to go full steam ahead on as many approaches as possible.”

Finding the right vaccines won’t end the challenge. Gates says it’ll be tricky to ramp up production, particularly since we don’t yet know which candidates will work.

“What we can do now is build different kinds of vaccine factories to prepare,” he says. “Each vaccine type requires a different kind of factory. This will cost billions of dollars. Governments need to quickly find a mechanism for making the funding for this available.”

Then there’s the question of prioritizing access to vaccines.

“Most people agree that health workers should get the vaccine first,” Gates says. “But who gets it next? Older people? Teachers? Workers in essential jobs?

Gates says the World Health Organization and national health authorities will have to develop a distribution plan. Which raises a question that Gates doesn’t address in today’s posting.

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