Speaking this week at the Lowy Institute, a think tank based in Sydney, the Microsoft cofounder gave his perspective on China’s transformation from a developing economy to a major world player. 

“China has gone from in 1980 being incredibly impoverished—poorer than India, I mean literally, with starvation, malnutrition—to being the most wealthy middle-income country in the world,” said Gates. “It’s incredible, and it’s great for the world.”

The Microsoft billionaire, who currently ranks as the fourth richest person in the world, also warned about the negative attitudes toward China in the United States today, and vice versa.

“I do think the current mentality of the U.S. to China, and which is reciprocated, is kind of a lose-lose mentality,” he said. “If you ask U.S. politicians, ‘Hey, would you like the Chinese economy to shrink by 20% or grow by 20%,’ I’m afraid they would vote that, ‘Yeah, let’s immiserate those people’—not understanding that for the global economy, the invention of cancer drugs, the solution of climate change, you know, we’re all in this together.”

The current hawkishness toward China in the U.S. could become “self-fulfilling in a very negative way,” he cautioned. He didn’t give an example. U.S. lawmakers voted overwhelmingly this month to establish a House select committee specifically to address the various threats that China poses to the U.S. GOP Wisconsin Rep. Mike Gallagher described a “coordinated whole-of-society strategy to undermine American leadership and American sovereignty” by the Chinese Communist Party.

Gates also noted China’s economic importance, saying it holds 20% of the world’s people.

“Their portion of the global economy and their portion of the global population match exactly. Countries like Australia, U.S., we have per capita GDPs five times what the Chinese have, so we have a disproportionate share of the world’s economy.”

But it wasn’t all rosy. Gates also leveled criticism at China. The country is “not a democracy,” he acknowledged, and is an “outlier today in terms of that level of wealth and still being as autocratic as they are.” 

He also knocked China for not acting quickly enough to get its population properly vaccinated early during the COVID pandemic. 

China “should have jumped on vaccines, particularly for the elderly, much faster, and that would have allowed them to open up somewhat sooner than they did,” he said. 

China recently loosened its strict COVID restrictions and is reporting an uptick in COVID deaths as people circulate more freely, but the official numbers are likely far below reality. “We’ll never know the true death numbers,” Gates said.

Still, Gates said nations like China needed to step up on the world stage. 

“The U.S. is politically weaker today, I would say, than it’s been, and, you know, that’s scary for the world,” he said. “The current world system is designed around U.S. leadership. As other countries have gotten richer, these middle-income countries including China and India need to play a stronger role in world governance.”