In the early days of the pandemic, President Trump made headlines when he reportedly tried to secure rights to a vaccine from German developer CureVac on behalf of the US government—a move that stirred questions about equity and justice. Should the United States get priority access to the Covid vaccine just because we are the world’s wealthiest nation? Shouldn’t the most vulnerable—no matter their nationality or salary—get vaccinated first?

“Capitalism has its limits,” one German lawmaker noted in a widely reported tweet.

Had Trump succeeded, the deal might also have sent another stark message about economic inequality—delivering a financial windfall to one of the most moneyed players in the pandemic response: the Gates Foundation.

The foundation recently reported a $40 million stake in CureVac—one of dozens of investments the foundation reports having in companies working on Covid vaccines, therapeutics, diagnostics or manufacturing, according to The Nation’s analysis of the foundation’s most recent tax return, web site, and various SEC filings. The foundation has also announced that it will “leverage a portion of its $2.5 billion Strategic Investment Fund” to advance its work on Covid.

These investments, amounting to more than $250 million, show that the world’s most visible charity, and one of the world’s most influential voices in the pandemic response, is in a position to potentially reap considerable financial gains from the Covid-19 pandemic.

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Gates’s reported investment in CureVac, alone, may have already delivered tens of millions of dollars in shareholder value for the nonprofit Gates Foundation. Even though Trump’s bid for CureVac failed, the company’s stock skyrocketed 400 percent just two days after going public in August.

Revelations of the Gates Foundation’s financial stake in Covid-19, which Bill Gates does not appear to have publicly disclosed in dozens of recent media appearances, speak to broader criticisms about the lack of transparency in the foundation’s increasingly central role in the pandemic.

“Who are they accountable to? They don’t even have a governance structure that’s clear,” notes Kate Elder, senior vaccines policy adviser to Doctors Without Borders. “Increasingly, I see less information coming from the Gates Foundation. They don’t answer most of our questions. They don’t make their technical staff available for discussions with us when we’re trying to learn more about their technical strategy [on Covid] and how they’re prioritizing certain things.”

And Gates’s priorities in developing and distributing a Covid vaccine, Elder says, are increasingly the world’s priorities, as multilateral institutions like the World Health Organization have ceded leadership to a group of public-private partnerships where Gates provides key funding. These organizations, the Coalition for Epidemic Preparedness Innovations and Gavi, the Vaccine Alliance, are working with the WHO to develop “the largest and most diverse Covid-19 vaccine portfolio in the world,” which they hope can deliver billions of vaccine doses in the year ahead, including to many poor countries.

James Love, director of the NGO Knowledge Ecology International, says the foundation’s decades of work on vaccines, along with its sprawling financial ties, allowed it to assert influence early in the pandemic.

“He had enough money and enough presence in the area for a long enough period of time to be positioned as the first mover and the most influential mover. So people just relied upon his people and his institutions,” says Love, “In a pandemic, when there is a vacuum of leadership, people that move fast and seem to know what they’re doing, they just acquire a lot of power. And he did that in this case.”

Gates’s leadership in the pandemic has been widely, almost universally, praised, with The New York Times calling him a “vocal counterweight to President Trump,” and Madonna making a million-dollar donation to support the foundation’s work. But because Gates is not an elected representative or public official, the details of his far-reaching influence—and finances—have largely eluded public scrutiny.

“You have an enormous amount of power that affects everyone around the globe, and there should be some accountability, some transparency,” says Love. “People are not asking unreasonable things. It’s a charity.… [We’re asking], ‘Can you explain what you’re doing, for example? Can you show us what these contracts look like?’ Particularly since they’re using their money to influence policies that involve our money.”

The Gates Foundation declined requests for interviews and did not respond to detailed questions sent by e-mail, including about its investments in pharmaceutical companies working on Covid.

Love and other critics say a key role Gates has played in the pandemic has been elevating the pharmaceutical industry—for example, pushing the University of Oxford to deliver its leading Covid-19 vaccine platform into the hands of Big Pharma. The resulting partnership with AstraZeneca had another effect, as Bloomberg and Kaiser Health News recently reported, changing the university’s distribution model from an open-license platform, designed to make its vaccine freely available for any manufacturer, to an exclusive license controlled by AstraZeneca.

Gates had the leverage to push the university, Bloomberg reports, because the foundation is one of the founders and largest funders of the Coalition for Epidemic Preparedness Innovations, which in turn funds the University of Oxford’s vaccine development (to the tune of some $384 million). The Gates Foundation has also directly given hundreds of millions of dollars to the university through charitable grants for a variety of projects—including previous funding to the university’s Jenner Institute, which is developing Oxford’s Covid vaccine.

Oxford and AstraZeneca have made public promises about forgoing profits and providing equitable access to their vaccine, if it is successful, but neither organization would provide details or documentation about this plan. Other companies have made similar humanitarian pledges even as they have pursued a traditional business model—based on exclusive licenses—that critics say is designed to generate profits, not promote equitable access.

Jörg Schaaber, executive director of the German advocacy group BUKO Pharma-Kampagne, sees the Gates Foundation as having an ideological investment in this business model, pointing to many of the foundation’s senior staff who come from the pharmaceutical industry, including the president of Gates’s global health program. Other critics note how the Gates Foundation’s endowment could benefit from the foundation pushing Covid vaccine development toward exclusive licenses.

“If we change the way in which you regulate the industry, or the ways in which you want medicines or vaccines to be produced and delivered,” says K.M. Gopakumar, legal adviser to the Third World Network, who is based in India, “it’s definitely going to affect these companies’ business model—and also the investments of Gates Foundation. So they are using their money to reinforce the status quo.”

Gates himself describes his foundation as intimately involved in the partnership between AstraZeneca and the University of Oxford.

“Every week we’re talking with AstraZeneca about, okay, what’s going on in India, what’s going on in China, and so that we can get, assuming that the Phase Two data and eventually the Phase Three data is promising, that we’re ready to go with that,” Gates noted in a press briefing in June—one of many interactions with the media where he seems to describe his foundation as, essentially, leading the global pandemic response.

“Our foundation has a lot of vaccine expertise and deep relationships with the manufacturers, and so, we’ve taken our staff and now are looking at each of these [potential vaccine] constructs and the data and making sure that for the ones that are the most promising, there is a plan to have multiple factories in Asia, multiple factories in the Americas, multiple factories in Europe…. We understand which of these vaccines we can scale up the production, and I’m hopeful that it will be at that large number, because the cooperation from the pharma companies, of saying, ‘yes, you can use my factory to make someone else’s vaccine,’ we’re getting a very good response to that, and that’s really unprecedented.”

During Gates’s remarks, he made no mention of his foundation’s investment in any pharmaceutical companies working on Covid. Similarly, in an August interview with Wired, the former head of Microsoft said that if he were infected with Covid, he would want to be prescribed the therapeutic drug Remdesivir—failing to mention his foundation’s stock position in the drug’s owner, Gilead, according to the charity’s most recent tax return, from 2018. (The foundation refused to provide details about its current investment portfolio.)

Journalistic norms require disclosure of conflicts of interest. So do the prevailing rules in science, but even when Gates enters the scientific discourse—for example in the commentary he penned in the New England Journal of Medicine, prescribing what he thought government leaders should be doing to tackle Covid—he does not disclose the details of his financial ties. Gates filled out the journal’s required conflict-of-interest form, but simply listed his conflicts as “numerous”—giving readers no sense of the size, scope, or type of his financial stake in the pandemic.

Lisa Bero, professor of medicine and public health at the University of Colorado, says authors have to provide details of their financial conflicts of interest, even if it means listing dozens of companies—which is not unheard of among authors in the New England Journal of Medicine. The journal did not respond to multiple inquiries about Gates’s disclosure.

Sheldon Krimsky, a professor of humanities and social sciences at Tufts University (with whom I co-authored an academic journal article in 2017), says disclosures are critical because they notify readers about potential bias.

“The last person I would want to tell me if a vaccine was ready to go is a person who has an investment in the vaccine,” Krimsky said.

Gates didn’t mention specific vaccines in his journal article, but elsewhere he seems to be picking winners and losers. In a longform interview on The Daily Show in April, Bill Gates seemed to say his foundation would spend billions of dollars to support manufacturing for seven of its favored vaccine constructs. (The foundation would not confirm this spending or provide any details).

If Gates followed disclosure rules, we would have transparency not just around the Gates Foundation’s $47 billion endowment but also about where Bill and Melinda Gates’s personal fortune is held.

According to Forbes’s estimates, Bill Gates’s private wealth, estimated at around $115 billion, has increased by more than $10 billion during the pandemic. It is unknown if the Gateses have personal investments in companies working on Covid.