The public health world is in a precarious position.
Robert F. Kennedy Jr, the Trump administration's pick for HHS secretary, has a history of vaccine skepticism. USAID, the government agency responsible for a number of health initiatives around the world, has been all but shuttered.
As these changes make their way through the highest levels of government, how are important figures in the global health world thinking about the future and what their role will be?
In a wide-ranging interview with NPR, Microsoft co-founder Bill Gates expressed concern about the new administration's recent steps to pull back from public health efforts and said he hoped USAID's work on diseases like HIV and polio "will be preserved."
The Gates Foundation supports disease fighting efforts, including the development of vaccines across the globe.
"The fact we stopped mothers from giving their babies HIV, that has been so magnificent, and it's so tragic if we stop that" Gates said. "The people in the field and the people at that headquarters are a necessary part of it."
Still, Gates expressed optimism the foundation can find "common ground" with the White House on why it's critical to support public health efforts.
"In talking to the people in the government, including President Trump himself, and saying, no, even if we make it somewhat more efficient, this fits your value system. This fits morality, geopolitics. And if we innovate, you know, we eventually can cure AIDS. So let's stay the course."
Gates is also still bullish on the future of vaccine development, even with the appointment of Robert F. Kennedy Jr. all but sewn up.
Although Kennedy has attacked him personally – he's spread conspiracy theories about Gates profiting from vaccines and controlling the global food supply – Gates is hopeful he will be able to work closely with him. He plans to meet with Kennedy, if he is confirmed, along with Rubio and other officials at the end of the month.
"You know, I don't think he's (Robert F. Kennedy Jr) going to do anything precipitous against vaccines. I think the data on vaccine safety is very, very clear. I'll be very interested in what he goes after because the immune system and the research around it turns out to be important not just for HIV, but, you know, we now have cancer vaccines coming that the U.S. want to lead on" Gates said.
Gates says that his foundation's work to lower the cost of creating vaccines for poorer countries will likely be attractive to government officials.
"My goal is to engage because the idea of, you know, saving other humans, helping other humans along with many other benefits, I don't think it should be out of fashion."
The Gates Foundation is a funder of NPR.
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