1 00:00:11,440 --> 00:00:13,640 Welcome to the Clinical Center Grand Rounds, 2 00:00:13,640 --> 00:00:17,440 a weekly series of educational lectures for physicians and 3 00:00:17,440 --> 00:00:20,080 health care professionals broadcast from the Clinical 4 00:00:20,080 --> 00:00:23,040 Center at the National Institutes of Health in 5 00:00:23,040 --> 00:00:24,840 Bethesda, MD. 6 00:00:24,840 --> 00:00:28,400 The NIH Clinical Center is the world's largest hospital totally 7 00:00:28,400 --> 00:00:32,080 dedicated to investigational research and leads the global 8 00:00:32,080 --> 00:00:35,040 effort in training today's investigators and discovering 9 00:00:35,040 --> 00:00:37,200 tomorrow's cures. 10 00:00:37,200 --> 00:00:47,400 Learn more by visiting us online at http://clinicalcenter.nih.gov 11 00:00:47,400 --> 00:00:50,360 WELCOME TO TODAY'S ETHICS GRAND 12 00:00:50,360 --> 00:00:51,000 ROUNDS. 13 00:00:51,000 --> 00:00:53,760 I'M FROM THE DEPARTMENT OF 14 00:00:53,760 --> 00:00:55,560 BIOETHICS AT THE NIH CLINICAL 15 00:00:55,560 --> 00:00:56,000 CENTER. 16 00:00:56,000 --> 00:00:58,200 WE DO ETHICS GRAND ROUNDS FOUR 17 00:00:58,200 --> 00:00:59,360 TIMES A YEAR FOR ANYBODY 18 00:00:59,360 --> 00:01:00,760 PLANNING AHEAD THE NEXT AND LAST 19 00:01:00,760 --> 00:01:02,640 SESSION FOR THE SPRING WILL BE 20 00:01:02,640 --> 00:01:05,440 THE FIRST WEDNESDAY IN APRIL. 21 00:01:05,440 --> 00:01:08,720 THAT'S THE FIRST WEDNESDAY IN 22 00:01:08,720 --> 00:01:08,920 APRIL. 23 00:01:08,920 --> 00:01:11,000 THAT ALSO WILL BE EXCLUSIVELY ON 24 00:01:11,000 --> 00:01:11,920 VIDEOCAST. 25 00:01:11,920 --> 00:01:12,880 HOPEFULLY IN THE FALL WE'LL GET 26 00:01:12,880 --> 00:01:13,600 BACK TO IN PERSON. 27 00:01:13,600 --> 00:01:14,880 WE'LL SEE ABOUT THAT. 28 00:01:14,880 --> 00:01:16,160 THE GOAL FOR ETHICS GRAND ROUNDS 29 00:01:16,160 --> 00:01:20,040 IS TO PROVIDE AN OPPORTUNITY FOR 30 00:01:20,040 --> 00:01:21,480 THE NIH COMMUNITY AND THE 31 00:01:21,480 --> 00:01:23,240 BROADER COMMUNITY TO DISCUSS 32 00:01:23,240 --> 00:01:25,600 WHAT WE THINK ARE INTERESTING 33 00:01:25,600 --> 00:01:27,240 AND IMPORTANT ETHICAL ISSUES. 34 00:01:27,240 --> 00:01:29,360 AND IN THAT REGARD, IT'S 35 00:01:29,360 --> 00:01:31,400 IMPORTANT TO NOTE THAT WE'RE NOT 36 00:01:31,400 --> 00:01:32,200 SPOKES PEOPLE. 37 00:01:32,200 --> 00:01:33,520 I'M CERTAINLY NOT A SPOKESPERSON 38 00:01:33,520 --> 00:01:36,720 FOR THE NIH. 39 00:01:36,720 --> 00:01:38,080 WE'RE NOT POLICY MAKERS. 40 00:01:38,080 --> 00:01:39,840 THE GOAL IS FOR EVERYBODY WHO 41 00:01:39,840 --> 00:01:41,040 SPEAKS TO GIVE THEIR VIEWS SO 42 00:01:41,040 --> 00:01:43,120 UNLESS THEY TELL YOU OTHERWISE, 43 00:01:43,120 --> 00:01:45,160 NOBODY'S SPEAKING FOR THE 44 00:01:45,160 --> 00:01:46,880 INSTITUTIONS TO WHICH THEY'RE 45 00:01:46,880 --> 00:01:47,160 AFFILIATED. 46 00:01:47,160 --> 00:01:48,520 THEY'RE JUST SPEAKING FOR 47 00:01:48,520 --> 00:01:48,840 THEMSELVES. 48 00:01:48,840 --> 00:01:50,320 WE WELCOME ANYBODY'S QUESTIONS. 49 00:01:50,320 --> 00:01:52,840 WE ALWAYS GET SOME REALLY GOOD 50 00:01:52,840 --> 00:01:54,360 QUESTIONS FROM THE AUDIENCE. 51 00:01:54,360 --> 00:01:56,000 TO DO THAT FIND THE LIVE 52 00:01:56,000 --> 00:01:59,680 FEEDBACK BUTTON ON THE VIDEOCAST 53 00:01:59,680 --> 00:02:00,160 WEBS 54 00:02:00,160 --> 00:02:04,400 WEBSITE, CLICK THAT AND ASK YOUR 55 00:02:04,400 --> 00:02:05,720 QUESTION AND THAT WILL GET SENT 56 00:02:05,720 --> 00:02:06,960 TO ME AND I'LL TRY TO ASK 57 00:02:06,960 --> 00:02:08,120 QUESTIONS AS WE HAVE TIME. 58 00:02:08,120 --> 00:02:09,400 WE TYPICALLY HAVE MORE QUESTIONS 59 00:02:09,400 --> 00:02:11,080 THAN WE'RE ABLE TO GET TO. 60 00:02:11,080 --> 00:02:12,600 IT'S ONE OF THE COST OF HAVING A 61 00:02:12,600 --> 00:02:16,160 WONDERFUL AND ENGAGED AUDIENCE 62 00:02:16,160 --> 00:02:18,080 BUT I'LL TRY TO FORWARD THEM TO 63 00:02:18,080 --> 00:02:19,760 THE APPROPRIATE PERSON FOR THE 64 00:02:19,760 --> 00:02:21,320 ONES WE DON'T GET TO AND 65 00:02:21,320 --> 00:02:23,360 HOPEFULLY GET YOU ANSWERS TO 66 00:02:23,360 --> 00:02:23,720 THOSE. 67 00:02:23,720 --> 00:02:25,880 WE ALSO GET CME CREDIT THROUGH 68 00:02:25,880 --> 00:02:28,160 JOHNS HOPKINS FOR THESE 69 00:02:28,160 --> 00:02:28,680 SESSIONS. 70 00:02:28,680 --> 00:02:29,760 AND IN ORDER TO CLAIM THAT 71 00:02:29,760 --> 00:02:32,440 CREDIT WHAT YOU NEED TO DO IS 72 00:02:32,440 --> 00:02:34,040 YOU NEED TO TEXT THE CODE TO THE 73 00:02:34,040 --> 00:02:35,120 PHONE NUMBER YOU'LL SEE THAT 74 00:02:35,120 --> 00:02:36,320 COMES UP ON THE SLIDES HERE. 75 00:02:36,320 --> 00:02:40,440 AND THE CODE FOR TODAY'S SESSION 76 00:02:40,440 --> 00:02:44,840 IS 44542. 77 00:02:44,840 --> 00:02:47,360 THAT'S 44542 AND AGAIN YOU TEXT 78 00:02:47,360 --> 00:02:50,440 THAT CODE TO THE HOPKINS CME 79 00:02:50,440 --> 00:02:53,080 CREDIT NUMBER YOU'LL SEE. 80 00:02:53,080 --> 00:02:56,360 THERE'S ALSO EVALUATION PDFs ON 81 00:02:56,360 --> 00:02:56,800 THE WEBSITE. 82 00:02:56,800 --> 00:02:59,920 WE'RE VERY INTERESTED IN 83 00:02:59,920 --> 00:03:00,160 FEEDBACK. 84 00:03:00,160 --> 00:03:01,840 ANYBODY WHO HAS INTEREST THIS OR 85 00:03:01,840 --> 00:03:03,560 FUTURE SESSIONS WE WELCOME THEM. 86 00:03:03,560 --> 00:03:04,960 FOR PEOPLE JOINING US FOR A LONG 87 00:03:04,960 --> 00:03:06,720 TIME THEY REALIZE MANY OF OUR 88 00:03:06,720 --> 00:03:08,440 SESSIONS ARE THE RESULT OF CASES 89 00:03:08,440 --> 00:03:10,200 WE GOT THROUGH OUR ETHICS 90 00:03:10,200 --> 00:03:11,200 CONSULTATION SERVICE. 91 00:03:11,200 --> 00:03:16,080 OUR DEPARTMENT HAS A 24/7 92 00:03:16,080 --> 00:03:16,840 BIOETHICS CONSULTATION SERVICE. 93 00:03:16,840 --> 00:03:18,960 THIS CAME THROUGH DIFFERENTLY. 94 00:03:18,960 --> 00:03:21,200 IT WAS A RECOMMENDATION FROM 95 00:03:21,200 --> 00:03:23,400 JANICE LEE THE CLINICAL DIRECTOR 96 00:03:23,400 --> 00:03:26,000 OF NIDCR AND THOUGHT IT WAS A 97 00:03:26,000 --> 00:03:27,280 GREAT IDEA AND DECIDED TO DO THE 98 00:03:27,280 --> 00:03:27,560 SESSION. 99 00:03:27,560 --> 00:03:29,880 AGAIN, WE WELCOME SESSIONS FOR 100 00:03:29,880 --> 00:03:31,120 FURTHER ONES. 101 00:03:31,120 --> 00:03:32,880 JANICE IS A CLINICAL DIRECTOR 102 00:03:32,880 --> 00:03:35,360 AND HER OFFICE IS CO-SPONSORING 103 00:03:35,360 --> 00:03:35,920 THIS EVENT. 104 00:03:35,920 --> 00:03:38,040 SO TODAY'S SESSION STARTS WITH 105 00:03:38,040 --> 00:03:40,000 THE FACT THAT DEVELOPING NEW 106 00:03:40,000 --> 00:03:41,880 MEDICAL INTERVENTIONS IS REALLY, 107 00:03:41,880 --> 00:03:42,600 REALLY EXPENSIVE. 108 00:03:42,600 --> 00:03:46,000 IT COSTS HUNDREDS OF MILLIONS TO 109 00:03:46,000 --> 00:03:49,080 BILLIONS OF DOLLARS TO DEVELOP 110 00:03:49,080 --> 00:03:51,440 JUST ONE NEW MEDICAL 111 00:03:51,440 --> 00:03:51,840 INTERVENTION. 112 00:03:51,840 --> 00:03:53,520 THE WAY THE SYSTEM CURRENTLY 113 00:03:53,520 --> 00:03:56,920 WORKS, MOST OF THAT COST IS BORN 114 00:03:56,920 --> 00:03:58,080 BY PHARMACEUTICAL COMPANIES, 115 00:03:58,080 --> 00:03:59,680 PRIVATE, FOR-PROFIT ENTITIES 116 00:03:59,680 --> 00:04:03,200 THAT PAY FOR THE DEVELOPMENT OF 117 00:04:03,200 --> 00:04:05,320 THOSE DRUGS AND IN RETURN THEY 118 00:04:05,320 --> 00:04:07,360 KEEP THE INFORMATION ON HOW TO 119 00:04:07,360 --> 00:04:09,160 DEVELOP THEM PROPRIETARY AND 120 00:04:09,160 --> 00:04:11,360 THAT ALLOWS THEM TO RECOUP THE 121 00:04:11,360 --> 00:04:12,880 COST OF DEVELOPING THE DRUGS AND 122 00:04:12,880 --> 00:04:14,480 ALSO TO MAKE A PROFIT. 123 00:04:14,480 --> 00:04:17,360 AT THE SAME TIME, WHAT THAT DOES 124 00:04:17,360 --> 00:04:20,160 IS IT MAKES IT DIFFICULT AND 125 00:04:20,160 --> 00:04:22,240 THERE'S A LITTLE INCENTIVE TO 126 00:04:22,240 --> 00:04:24,240 DEVELOP DRUGS AS YOU'LL HEAR FOR 127 00:04:24,240 --> 00:04:26,720 DISEASES THAT PRIMARILY AFFECT 128 00:04:26,720 --> 00:04:28,240 PEOPLE IN LOWER INCOME 129 00:04:28,240 --> 00:04:29,040 COUNTRIES. 130 00:04:29,040 --> 00:04:30,480 IT CAN MAKE IT DIFFICULT EVEN 131 00:04:30,480 --> 00:04:32,400 FOR DISEASES WORLDWIDE TO GET 132 00:04:32,400 --> 00:04:35,000 ACCESS TO PEOPLE IN LOWER INCOME 133 00:04:35,000 --> 00:04:35,280 COUNTRIES. 134 00:04:35,280 --> 00:04:42,880 AND ONE WAY TO EXEMPLIFY THAT 135 00:04:42,880 --> 00:04:44,440 DILEMMA WE THINK OF THE 136 00:04:44,440 --> 00:04:46,560 INCREDIBLE MIRACLE AND TRAGEDY 137 00:04:46,560 --> 00:04:47,360 OF COVID-19 VACCINES. 138 00:04:47,360 --> 00:04:51,080 TO GIVE A QUOTE FROM AN ARTICLE 139 00:04:51,080 --> 00:04:54,200 FROM INFECTIOUS DISEASES, I'LL 140 00:04:54,200 --> 00:04:56,440 READ THIS, COVID-19 VACCINATION 141 00:04:56,440 --> 00:04:58,040 ALTER THE COURSE OF THE PANDEMIC 142 00:04:58,040 --> 00:05:02,720 SAVING TENS OF MILLIONS OF LIVES 143 00:05:02,720 --> 00:05:03,000 GLOBALLY. 144 00:05:03,000 --> 00:05:05,360 HOWEVER, INADEQUATE ACCESS TO 145 00:05:05,360 --> 00:05:10,600 VACCINES IN LOW-IMPACT COUNTRIES 146 00:05:10,600 --> 00:05:14,080 REINFORCED THE IDEA FOR EQUITY 147 00:05:14,080 --> 00:05:16,440 AND COVERING AND LIMITING THE 148 00:05:16,440 --> 00:05:18,680 IMPACT MEANING BECAUSE OF THE 149 00:05:18,680 --> 00:05:21,640 COST PEOPLE IN LOWER INCOME 150 00:05:21,640 --> 00:05:22,600 COUNTRIES WEREN'T ABLE TO ACCESS 151 00:05:22,600 --> 00:05:24,760 THE VACCINES AND SOME PEOPLE 152 00:05:24,760 --> 00:05:26,200 DIED SO THIS IS SERIOUS IMPACT. 153 00:05:26,200 --> 00:05:27,680 THE QUESTION IS WHAT IF ANYTHING 154 00:05:27,680 --> 00:05:29,720 WE CAN DO ABOUT THAT. 155 00:05:29,720 --> 00:05:32,440 WHAT WE'LL DISCUSS TODAY IS AN 156 00:05:32,440 --> 00:05:37,360 AMAZING EFFORT AS YOU'LL HEAR 157 00:05:37,360 --> 00:05:39,080 AND HOW TO MAKE THE INFORMATION 158 00:05:39,080 --> 00:05:41,000 TO MAKE VACCINES GLOBALLY 159 00:05:41,000 --> 00:05:42,480 ACCESSIBLE SO THOSE VACCINES CAN 160 00:05:42,480 --> 00:05:43,760 BE DEVELOPED IN DEVELOPING 161 00:05:43,760 --> 00:05:45,360 COUNTRIES AND HOPEFULLY MADE 162 00:05:45,360 --> 00:05:48,000 MORE ACCESSIBLE TO PEOPLE WHO 163 00:05:48,000 --> 00:05:49,920 NEED THEM IN LOWER INCOME 164 00:05:49,920 --> 00:05:50,160 COUNTRIES. 165 00:05:50,160 --> 00:05:52,880 SO THE QUESTION FOR TODAY IS, IS 166 00:05:52,880 --> 00:05:54,480 THIS OR SHOULD THIS TO SOME 167 00:05:54,480 --> 00:05:56,120 EXTENT OR MORE BE THE WAY WE DO 168 00:05:56,120 --> 00:05:56,920 THIS IN THE FUTURE? 169 00:05:56,920 --> 00:05:58,840 THE WAY WE DEVELOP AND MAKE 170 00:05:58,840 --> 00:06:01,640 DRUGS IN MEDICAL INTERVENTIONS 171 00:06:01,640 --> 00:06:01,920 ACCESSIBLE? 172 00:06:01,920 --> 00:06:05,920 TO EXPLAIN THAT POSSIBILITY TO 173 00:06:05,920 --> 00:06:08,480 US WE HAVE WITH US THE SENIOR 174 00:06:08,480 --> 00:06:11,680 ASSOCIATE DEAN AND DISTINGUISHED 175 00:06:11,680 --> 00:06:16,440 PROFESSOR OF BIOLOGY AT BAYLOR 176 00:06:16,440 --> 00:06:21,720 AND SHE'S THE CO-DIRECTOR OF 177 00:06:21,720 --> 00:06:22,760 CHILDREN'S CENTER VACCINE 178 00:06:22,760 --> 00:06:23,560 DEVELOPMENT AND SHE'LL TALK 179 00:06:23,560 --> 00:06:24,920 ABOUT WHAT THEY'VE DONE IN TERMS 180 00:06:24,920 --> 00:06:26,440 OF DEVELOPING VACCINES AND 181 00:06:26,440 --> 00:06:29,200 MAKING THEM ACCESSIBLE AND AFTER 182 00:06:29,200 --> 00:06:31,200 MARIA GOES THEN FOR THE 183 00:06:31,200 --> 00:06:33,040 DISCUSSANT TO HELP US WORK 184 00:06:33,040 --> 00:06:34,160 THROUGH THE ETHICAL ISSUES 185 00:06:34,160 --> 00:06:39,000 RAISED BY THIS CASE, WE HAVE THE 186 00:06:39,000 --> 00:06:42,520 VICE PROVOST FOR GLOBAL 187 00:06:42,520 --> 00:06:43,800 INITIATIVES IN THE UNIVERSITY 188 00:06:43,800 --> 00:06:48,920 PROFESSOR AT THE UNIVERSITY OF 189 00:06:48,920 --> 00:06:49,480 PENNSYLVANIA. 190 00:06:49,480 --> 00:06:52,440 HE'S REGARDED AS AN EXPERT ON 191 00:06:52,440 --> 00:06:54,560 HEALTH POLICY AND BIOETHICS IN 192 00:06:54,560 --> 00:06:58,440 THE WORLD AND HAPPY TO HAVE HIM 193 00:06:58,440 --> 00:07:01,200 HERE TODAY AND SOME PEOPLE MAY 194 00:07:01,200 --> 00:07:02,880 REMEMBER HE WAS ESSENTIALLY THE 195 00:07:02,880 --> 00:07:03,880 FOUNDER OF THE BIOETHICS 196 00:07:03,880 --> 00:07:05,880 DEPARTMENT AND THE PERSON WHO 197 00:07:05,880 --> 00:07:08,400 SET UP THE ETHICS GRAND ROUND 198 00:07:08,400 --> 00:07:08,640 SESSIONS. 199 00:07:08,640 --> 00:07:10,040 WELCOME BACK, ZEKE, IT'S GREAT 200 00:07:10,040 --> 00:07:10,480 TO HAVE YOU. 201 00:07:10,480 --> 00:07:14,440 TO GET US STARTED, MARIA. 202 00:07:14,440 --> 00:07:16,040 >>THANK YOU, DR. WENDLER. 203 00:07:16,040 --> 00:07:17,480 IT'S A PLEASURE TO BE WITH YOU 204 00:07:17,480 --> 00:07:20,480 AND OF COURSE I ALSO SEND MY 205 00:07:20,480 --> 00:07:25,720 REGARDS TO DR. LEE WHO IS MY 206 00:07:25,720 --> 00:07:26,640 PARTNER IN CRIME A TRAINING 207 00:07:26,640 --> 00:07:26,880 PROGRAM. 208 00:07:26,880 --> 00:07:29,120 SO WE HAVE A FEW YEARS WE KNOW 209 00:07:29,120 --> 00:07:30,080 EACH OTHER. 210 00:07:30,080 --> 00:07:34,600 IT'S JUST A PLEASURE AND 211 00:07:34,600 --> 00:07:36,960 DR. EMANUEL FOR GIVING HIS 212 00:07:36,960 --> 00:07:38,760 INSIGHTFUL REMARKS AFTER A 213 00:07:38,760 --> 00:07:39,440 PRESENTATION. 214 00:07:39,440 --> 00:07:42,360 >>I'LL START MY PRESENTATION 215 00:07:42,360 --> 00:07:46,960 WITH OF COURSE WITH MY 216 00:07:46,960 --> 00:07:48,760 DISCLOSURES WITH THE COVID-19 217 00:07:48,760 --> 00:07:50,360 TECHNOLOGY AND THAT I'M WITH A 218 00:07:50,360 --> 00:07:58,400 TEAM A CO-INVENTOR OF A FEW 219 00:07:58,400 --> 00:08:02,360 PATENTS IN SEVERAL VACCINE 220 00:08:02,360 --> 00:08:02,680 TECHNOLOGIES. 221 00:08:02,680 --> 00:08:04,240 I WANT TO BRING YOU BACK TO THE 222 00:08:04,240 --> 00:08:05,640 TURN OF THE CENTURY. 223 00:08:05,640 --> 00:08:07,440 THE REASON I WANT TO START THERE 224 00:08:07,440 --> 00:08:09,040 IS A FEW THINGS THAT WERE VERY 225 00:08:09,040 --> 00:08:13,960 IMPORTANT ESPECIALLY IN THE AREA 226 00:08:13,960 --> 00:08:16,040 OF GLOBAL HEALTH HAPPENED. 227 00:08:16,040 --> 00:08:18,880 THE LAUNCH OF THE MILLENNIUM 228 00:08:18,880 --> 00:08:21,880 DEVELOPMENT GOALS WERE PUT FORTH 229 00:08:21,880 --> 00:08:22,480 BY THE UNITED NATIONS WITH 230 00:08:22,480 --> 00:08:23,680 AUDACIOUS GOALS. 231 00:08:23,680 --> 00:08:25,960 ALL VERY IMPORTANT, ALL OF THEM 232 00:08:25,960 --> 00:08:28,280 VERY WELL INTERCONNECTED WITH 233 00:08:28,280 --> 00:08:30,760 EACH OTHER. 234 00:08:30,760 --> 00:08:35,240 BUT AS WE AND WE AND MYSELF AND 235 00:08:35,240 --> 00:08:38,400 DR. PETER HOTIS AND OUR TEAM 236 00:08:38,400 --> 00:08:41,880 NOTICED A FEW MDGs THAT WERE 237 00:08:41,880 --> 00:08:44,840 IMPORTANT FOR US AS WE WERE 238 00:08:44,840 --> 00:08:46,560 CRAFTING OUR SCIENTIFIC 239 00:08:46,560 --> 00:08:47,600 PROGRAMS. 240 00:08:47,600 --> 00:08:49,960 ONE OF THEM WAS MDG NUMBER 6 241 00:08:49,960 --> 00:08:51,560 THAT SPECIFICALLY CALLED AT THE 242 00:08:51,560 --> 00:08:55,760 TIME TO COMBAT INFECTIOUS 243 00:08:55,760 --> 00:09:01,880 DISEASES LIKE HIV/AIDS, MALL 244 00:09:01,880 --> 00:09:03,200 MALARIA AND THERE WERE ANOTHER 245 00:09:03,200 --> 00:09:05,600 CATEGORY OF DISEASES WITH THE 246 00:09:05,600 --> 00:09:07,640 YEARS BRANDED AND LAUDED THEY 247 00:09:07,640 --> 00:09:13,400 COULD BE A COMPENDIUM OF MANY 248 00:09:13,400 --> 00:09:13,960 DISEASES. 249 00:09:13,960 --> 00:09:18,280 MANY CONSIDER NEGLECT EDOF DISE 250 00:09:18,280 --> 00:09:19,280 BRANDED AND LAUDED THEY COULD BE 251 00:09:19,280 --> 00:09:19,880 A COMPENDIUM OF MANY DISEASES. 252 00:09:19,880 --> 00:09:22,920 MANY CONSIDER NEGLECT ED AND 253 00:09:22,920 --> 00:09:24,320 AFFLICT MANY RESOURCE POOR 254 00:09:24,320 --> 00:09:24,520 AREAS. 255 00:09:24,520 --> 00:09:27,040 AND WHAT WAS INTERESTING WAS 256 00:09:27,040 --> 00:09:29,360 NUMBER EIGHT WHICH CALLS WITH 257 00:09:29,360 --> 00:09:31,960 TRYING TO DO THIS TYPE OF 258 00:09:31,960 --> 00:09:33,360 DEVELOPMENT USING PARTNERSHIPS. 259 00:09:33,360 --> 00:09:36,160 I HIGHLIGHT THAT AT THE SAME 260 00:09:36,160 --> 00:09:37,680 TIME. 261 00:09:37,680 --> 00:09:40,640 FOUNDATIONS, MANY, NOT ONLY BUT 262 00:09:40,640 --> 00:09:42,280 FOUNDATIONS SUCH AS THE BILL AND 263 00:09:42,280 --> 00:09:44,240 MELINDA GATES FOUNDATION WERE 264 00:09:44,240 --> 00:09:46,120 CREATED WITH THIS ASPIRATION TO 265 00:09:46,120 --> 00:09:47,800 TRY TO USE THE PARTNERSHIP 266 00:09:47,800 --> 00:09:52,880 APPROACH AND THE MODEL OF 267 00:09:52,880 --> 00:09:55,240 BRINGING TOGETHER TO SAVE 268 00:09:55,240 --> 00:09:58,480 EFFICIENCIES AND FOR THE ADVENT 269 00:09:58,480 --> 00:09:59,440 OF TECHNOLOGIES TOWARDS GLOBAL 270 00:09:59,440 --> 00:10:00,920 HEALTH AND WE ALSO STARTED 271 00:10:00,920 --> 00:10:04,560 SEEING THE PUSH FOR THAT CONCEPT 272 00:10:04,560 --> 00:10:07,120 OF TRYING TO MAKE SCIENCE OPEN 273 00:10:07,120 --> 00:10:10,440 BY BEING MORE SHAREABLE, BY 274 00:10:10,440 --> 00:10:11,440 PROVIDING NOT ONLY THE 275 00:10:11,440 --> 00:10:15,400 EDUCATIONAL RESOURCES BUT ALSO 276 00:10:15,400 --> 00:10:17,680 RE-AGENTS AND DATA. 277 00:10:17,680 --> 00:10:19,600 THAT'S WHY IN THE CREATING OF 278 00:10:19,600 --> 00:10:20,680 OUR GUIDING PRINCIPLES OF THE 279 00:10:20,680 --> 00:10:23,240 WORK WE WANTED TO ACHIEVE, OUR 280 00:10:23,240 --> 00:10:26,840 GROUP DECIDED THAT WE WOULD TRY 281 00:10:26,840 --> 00:10:28,440 TO FOCUS ON TRYING TO ATTEMPT TO 282 00:10:28,440 --> 00:10:34,760 ADDRESS SOME OF THESE MDGs. 283 00:10:34,760 --> 00:10:36,880 WE CREATED AN INFRASTRUCTURE 284 00:10:36,880 --> 00:10:37,960 PREDICATED ON THE STRUCTURE OF 285 00:10:37,960 --> 00:10:42,680 PARTNERSHIPS. 286 00:10:42,680 --> 00:10:45,200 THERE'S THE PRODUCT DEVELOPMENT 287 00:10:45,200 --> 00:10:49,040 PARTNERSHIP MODEL SOME EXAMPLE 288 00:10:49,040 --> 00:10:51,720 THE MALARIA VACCINE INITIATIVE 289 00:10:51,720 --> 00:10:55,440 AND ONE FOR AIDS AND THERE'S 290 00:10:55,440 --> 00:10:56,080 ORGANIZATIONS THAT USE THIS TYPE 291 00:10:56,080 --> 00:11:06,240 OF MODEL. 292 00:11:11,720 --> 00:11:13,560 OUR MODEL WAS FOR NEGLECTED S 293 00:11:13,560 --> 00:11:16,800 AND WE WANTED TO FOCUS ON 294 00:11:16,800 --> 00:11:18,160 CONVENTIONAL PLATFORMS IN OUR 295 00:11:18,160 --> 00:11:19,840 CASE RECOMBINANT PROTEIN 296 00:11:19,840 --> 00:11:24,400 TECHNOLOGIES THOUGH WITH THE 297 00:11:24,400 --> 00:11:34,920 YEARS IT MORPHED TECHNOLOGIES. 298 00:11:37,760 --> 00:11:43,840 THE DECISION START WITH US AT 299 00:11:43,840 --> 00:11:44,760 THE GEORGE WASHINGTON UNIVERSITY 300 00:11:44,760 --> 00:11:49,920 FOR 11 YEARS AND FOR 11 MORE 301 00:11:49,920 --> 00:11:55,560 WE'VE BEEN AT TEXAS AT THE 302 00:11:55,560 --> 00:11:57,040 BAYLOR CHILDREN'S HOSPITAL AND 303 00:11:57,040 --> 00:11:59,960 WE HAD TO SELECT WHICH OF THE 304 00:11:59,960 --> 00:12:01,680 GLOBAL MORBIDITY DISEASES WE 305 00:12:01,680 --> 00:12:03,640 WOULD WANT TO FOCUS. 306 00:12:03,640 --> 00:12:07,960 JUST TO GIVE YOU VERY BRIEF 307 00:12:07,960 --> 00:12:09,040 MOSTLY DISEASES THAT AFFLICT 308 00:12:09,040 --> 00:12:12,840 MANY PEOPLE AROUND THE WORLD IN 309 00:12:12,840 --> 00:12:15,560 FACT MANY CALL THEM THE DISEASE 310 00:12:15,560 --> 00:12:18,000 AFFECT PEOPLE THAT MOSTLY LIVE 311 00:12:18,000 --> 00:12:19,000 BELOW THE POVERTY LINE. 312 00:12:19,000 --> 00:12:21,000 THEY CAN BE PARASITES. 313 00:12:21,000 --> 00:12:22,840 THEY CAN BE VIRUSES. 314 00:12:22,840 --> 00:12:27,440 THEY CAN BE FUNGI. 315 00:12:27,440 --> 00:12:29,920 THEY CAN BE BACTERIA THEY HAD 316 00:12:29,920 --> 00:12:36,760 SOCIAL FACTORS THAT AFFECT THEIR 317 00:12:36,760 --> 00:12:40,000 TRANSMISSION AND EVEN CLINICAL 318 00:12:40,000 --> 00:12:40,800 DISEASE CAPABILITIES. 319 00:12:40,800 --> 00:12:44,600 OF COURSE, EXAMPLES NOT ONLY 320 00:12:44,600 --> 00:12:46,400 CLIMATE CHANGE AND POLITICAL 321 00:12:46,400 --> 00:12:48,240 INSTABILITY, ETCETERA. 322 00:12:48,240 --> 00:12:50,800 AND WE NOW USE METRICS WHICH 323 00:12:50,800 --> 00:12:54,600 SOMETIMES YOU HAVE TO QUANTIFY 324 00:12:54,600 --> 00:12:56,000 WHAT MORBIDITY THEY CAUSE AND 325 00:12:56,000 --> 00:13:00,280 YOU KNOW MORBIDITY METRIC IS THE 326 00:13:00,280 --> 00:13:03,720 DISABILITY ADJUSTED AND IN 327 00:13:03,720 --> 00:13:06,960 AGGREGATE THESE GLOBAL MORBIDITY 328 00:13:06,960 --> 00:13:09,040 DISEASES CAN CAUSE MANY MANY 329 00:13:09,040 --> 00:13:11,880 YEARS LOSS BECAUSE PEOPLE LIVE 330 00:13:11,880 --> 00:13:14,800 WITH A LOW CAPABILITY WITH A LOT 331 00:13:14,800 --> 00:13:17,680 OF DISABILITY AND THEREFORE THEY 332 00:13:17,680 --> 00:13:22,200 PROMOTE AND CAUSE POVERTY. 333 00:13:22,200 --> 00:13:24,880 WITH HEALTH ECONOMISTS WE CAN 334 00:13:24,880 --> 00:13:27,200 QUANTIFY HOW THE MORBIDITY CAN 335 00:13:27,200 --> 00:13:29,240 IMPACT THE ECONOMIC POTENTIAL OF 336 00:13:29,240 --> 00:13:30,800 A SOCIETY. 337 00:13:30,800 --> 00:13:34,320 WE KNOW FOR EXAMPLE WITH 338 00:13:34,320 --> 00:13:36,960 DISEASES WE CAN QUANTIFY A LOT 339 00:13:36,960 --> 00:13:39,920 OF ECONOMIC LOSSES NOT ONLY IN 340 00:13:39,920 --> 00:13:42,240 HEALTH CARE LOSSES BUT ALSO 341 00:13:42,240 --> 00:13:47,400 PRODUCTIVITY LOSSES BECAUSE 342 00:13:47,400 --> 00:13:48,120 INDIVIDUALS DON'T CONTRIBUTE TO 343 00:13:48,120 --> 00:13:48,640 SOCIETY. 344 00:13:48,640 --> 00:13:51,160 OF COURSE, AS YOU KNOW, DISEASES 345 00:13:51,160 --> 00:13:53,240 NEVER TRAVEL ALONE. 346 00:13:53,240 --> 00:13:56,840 THERE'S MAJOR COFACTORS AND 347 00:13:56,840 --> 00:14:00,560 MOSTLY THE PARASITIC OR 348 00:14:00,560 --> 00:14:01,640 MORBIDITY DISEASES GO WITH MANY 349 00:14:01,640 --> 00:14:05,880 OTHER DISEASES LIKE MALARIA OR 350 00:14:05,880 --> 00:14:06,360 HIV. 351 00:14:06,360 --> 00:14:10,440 SO RAPIDLY HOW DID WE EMBARK IN 352 00:14:10,440 --> 00:14:11,560 DEVELOPING A STRATEGY TO DEVELOP 353 00:14:11,560 --> 00:14:14,720 THESE TYPES OF VACCINES KNOWING 354 00:14:14,720 --> 00:14:17,040 THEY WERE NEGLECTED AND DIDN'T 355 00:14:17,040 --> 00:14:18,680 HAVE THAT COMMERCIALIZATION 356 00:14:18,680 --> 00:14:20,840 POTENTIAL THAT WE PROBABLY WOULD 357 00:14:20,840 --> 00:14:23,960 NOT GET THE INCENTIVES OF THE 358 00:14:23,960 --> 00:14:24,920 MULTI-NATIONAL COMPANIES. 359 00:14:24,920 --> 00:14:27,560 THE INTENT WAS TO TRY TO NOT 360 00:14:27,560 --> 00:14:29,040 ONLY DEVELOP THEM BUT PRODUCE 361 00:14:29,040 --> 00:14:34,000 THEM AND HAND THEM OFF TO THE 362 00:14:34,000 --> 00:14:35,960 LOW AND MIDDLE-INCOME COUNTRIES 363 00:14:35,960 --> 00:14:37,600 BUT FOR PEOPLE WHO LIVE IN THE 364 00:14:37,600 --> 00:14:38,440 POOR RESOURCE AREAS. 365 00:14:38,440 --> 00:14:40,520 WE USED A SIX-PRONGED STRATEGY 366 00:14:40,520 --> 00:14:44,440 THAT OF COURSE HAS MORE THAN TWO 367 00:14:44,440 --> 00:14:47,200 DECADES OF TRYING TO SHOW IT 368 00:14:47,200 --> 00:14:48,080 WORKS AND FUNCTIONS. 369 00:14:48,080 --> 00:14:51,080 ONE, AS YOU KNOW, LEVERAGING OUR 370 00:14:51,080 --> 00:14:52,920 ACADEMIC POTENTIAL AND 371 00:14:52,920 --> 00:14:55,120 CREATIVITY AND RESOURCES AND 372 00:14:55,120 --> 00:14:57,640 KNOWLEDGE WITHIN THE ACADEMIC 373 00:14:57,640 --> 00:15:01,960 FRAMEWORK WHICH ALSO ENABLES US 374 00:15:01,960 --> 00:15:03,040 TO BUILD CAPACITY AND TRAIN THE 375 00:15:03,040 --> 00:15:04,760 NEXT GENERATION OF SCIENTISTS. 376 00:15:04,760 --> 00:15:07,880 USE ALL THE COMPLIANCES AND 377 00:15:07,880 --> 00:15:09,040 ETHICS AND EVEN THE GRAND 378 00:15:09,040 --> 00:15:09,960 FINANCIAL MANAGEMENT OF THE 379 00:15:09,960 --> 00:15:12,200 ORGANIZATIONS AND OF COURSE THE 380 00:15:12,200 --> 00:15:12,560 LABORATORIES. 381 00:15:12,560 --> 00:15:14,480 WE THEN HAVE TO LEARN HOW TO 382 00:15:14,480 --> 00:15:16,800 SPEAK THE BUSINESS LANGUAGE, 383 00:15:16,800 --> 00:15:19,880 RIGHT, BECAUSE WE HAVE TO COME 384 00:15:19,880 --> 00:15:21,760 FROM THE BENCH INTO THE CLINIC 385 00:15:21,760 --> 00:15:22,480 AND BEYOND AND THEREFORE WE HAVE 386 00:15:22,480 --> 00:15:28,400 TO LEARN HOW TO SPEAK IN VALUE 387 00:15:28,400 --> 00:15:29,720 PROPOSITIONS AND BRANDING AND 388 00:15:29,720 --> 00:15:30,760 VALUE PRODUCT CHAINS. 389 00:15:30,760 --> 00:15:35,080 AS MENTIONED EARLIER, ALSO 390 00:15:35,080 --> 00:15:36,160 UNDERSTANDING THAT CRITICAL PATH 391 00:15:36,160 --> 00:15:39,560 OF WHEN A PRODUCT STARTS TO BE 392 00:15:39,560 --> 00:15:42,640 REGULATORY, ENABLING AND HAVE 393 00:15:42,640 --> 00:15:44,080 QUALITY AND REGULATORY SCIENCE. 394 00:15:44,080 --> 00:15:45,880 I THINK THAT'S A BIG LESSON 395 00:15:45,880 --> 00:15:50,240 LEARNED WE HAVE TO WRAP UP THIS 396 00:15:50,240 --> 00:15:52,600 KNOWLEDGE IN REGULATORY SCIENCE 397 00:15:52,600 --> 00:15:54,160 AND DOCUMENTATION AND QUALITY 398 00:15:54,160 --> 00:15:55,840 MANAGEMENT SYSTEMS ENABLING ALL 399 00:15:55,840 --> 00:15:59,440 THE MATERIALS AND REAGENTS AND 400 00:15:59,440 --> 00:16:00,120 DOCUMENTATION TO BE SUITABLE FOR 401 00:16:00,120 --> 00:16:03,880 THE REGULATORY AGENCIES. 402 00:16:03,880 --> 00:16:05,440 SINCE WE PREDICATE ON 403 00:16:05,440 --> 00:16:07,840 PARTNERSHIPS WE HAVE TO FIND 404 00:16:07,840 --> 00:16:09,440 PARTNERS, FORGE THE 405 00:16:09,440 --> 00:16:11,000 PARTNERSHIPS, TRUST THE 406 00:16:11,000 --> 00:16:12,280 PARTNERSHIPS, UNDERSTAND WHAT 407 00:16:12,280 --> 00:16:16,600 THEY DO, WHAT WOULD DO, HOW WE 408 00:16:16,600 --> 00:16:18,600 WOULD MANAGE THE ACCOUNTABILITY 409 00:16:18,600 --> 00:16:20,840 AND THEREFORE AT THE END OF THE 410 00:16:20,840 --> 00:16:22,640 DAY THEN DISSEMINATE OUR 411 00:16:22,640 --> 00:16:24,000 INFORMATION IF WE WERE 412 00:16:24,000 --> 00:16:25,200 PREDICATING ON OPEN SCIENCE HOW 413 00:16:25,200 --> 00:16:30,680 WE WOULD ENGAGE NOT ONLY THE 414 00:16:30,680 --> 00:16:32,680 FUNDERS, THE SOCIETY, OUR PEERS 415 00:16:32,680 --> 00:16:35,920 AND FOR THAT OF COURSE IT'S 416 00:16:35,920 --> 00:16:37,040 REQUIRED TO BE A LITTLE BIT OUT 417 00:16:37,040 --> 00:16:40,160 OF THE FUNDING STRATEGY. 418 00:16:40,160 --> 00:16:42,120 WE OF COURSE LEVERAGED A LOT OF 419 00:16:42,120 --> 00:16:43,960 THE FEDERAL FUNDING CONVENTIONAL 420 00:16:43,960 --> 00:16:49,680 STRATEGIES OF GRANTS BUT WE ALSO 421 00:16:49,680 --> 00:16:52,280 SEEK PHILANTHROPIC FUNDING OR 422 00:16:52,280 --> 00:16:55,280 SHARED GOVERNMENT FUNDING 423 00:16:55,280 --> 00:16:56,640 CONTRIBUTIONS OR EVEN PRIVATE 424 00:16:56,640 --> 00:17:00,120 INDIVIDUALS. 425 00:17:00,120 --> 00:17:05,280 SO WE WERE ACTUALLY PRETTY 426 00:17:05,280 --> 00:17:07,960 EFFICIENT IN 15, 20 YEARS WE 427 00:17:07,960 --> 00:17:11,720 HAVE ADVANCED SOME IMPORTANT AND 428 00:17:11,720 --> 00:17:12,120 UNIQUE VACCINES. 429 00:17:12,120 --> 00:17:16,000 OUR HUMAN VACCINE IS NOW IN 430 00:17:16,000 --> 00:17:18,280 PHASE 2 CLINICAL TRIALS AFTER 20 431 00:17:18,280 --> 00:17:21,400 YEARS BUT IT'S MOVING AND WE'RE 432 00:17:21,400 --> 00:17:22,200 SLOWLY ADVANCING IT. 433 00:17:22,200 --> 00:17:24,800 WE HAVE A VACCINE ALSO ENTERING 434 00:17:24,800 --> 00:17:25,640 PHASE 2 CLINICAL TRIALS. 435 00:17:25,640 --> 00:17:31,720 WE ARE NOW ADVANCING A CHILDHOOD 436 00:17:31,720 --> 00:17:33,440 VACCINE WE JUST MANUFACTURED IN 437 00:17:33,440 --> 00:17:34,680 MEXICO AND WILL START A CLINICAL 438 00:17:34,680 --> 00:17:37,000 TRIAL THIS YEAR IN MEXICO. 439 00:17:37,000 --> 00:17:40,520 AS YOU KNOW, THE MDGs CAME AND 440 00:17:40,520 --> 00:17:42,320 WENT, 2015 GAME. 441 00:17:42,320 --> 00:17:44,800 THE WORLD CONTINUED CHANGING. 442 00:17:44,800 --> 00:17:46,960 NOW WE KNOW WE HAVE A 443 00:17:46,960 --> 00:17:48,840 SUSTAINABLE DEVELOPMENT GOAL AND 444 00:17:48,840 --> 00:17:49,960 GLOBAL GOAL AND THERE WAS 445 00:17:49,960 --> 00:17:52,280 SOMETHING WE STARTED PAYING 446 00:17:52,280 --> 00:17:54,400 ATTENTION ON THE FACT THAT IN 447 00:17:54,400 --> 00:17:58,320 THE MIDST OF THESE 20 YEARS, A 448 00:17:58,320 --> 00:18:00,120 FEW CORONAVIRUS OUTBREAKS POPPED 449 00:18:00,120 --> 00:18:00,360 UP. 450 00:18:00,360 --> 00:18:10,800 THE SARS, THE MERS, BUT WE 451 00:18:10,800 --> 00:18:13,960 NOTICED WITH A CRISIS AND IT 452 00:18:13,960 --> 00:18:15,800 BECAME CLEAR THE CORONAVIRUSES 453 00:18:15,800 --> 00:18:16,840 WERE ENTERING INTO THE 454 00:18:16,840 --> 00:18:18,560 DEFINITION OF NEGLECTED. 455 00:18:18,560 --> 00:18:19,800 WE KNEW A BUNCH OF OUR 456 00:18:19,800 --> 00:18:21,160 COLLABORATORS THAT WERE NOT ONLY 457 00:18:21,160 --> 00:18:24,480 WORKING WITH US IN SOME OF OUR 458 00:18:24,480 --> 00:18:25,960 VACCINES BUT ALSO EXPERTS IN 459 00:18:25,960 --> 00:18:28,800 CORONAVIRUS VIROLOGY AND WE 460 00:18:28,800 --> 00:18:30,360 FORMED A PRODUCT DEVELOPMENT 461 00:18:30,360 --> 00:18:30,680 PARTNERSHIP. 462 00:18:30,680 --> 00:18:36,920 WE WERE VERY LUCKY WE GOT AN NIH 463 00:18:36,920 --> 00:18:40,400 GRANT TO INDEED MOVE A 464 00:18:40,400 --> 00:18:43,120 TECHNOLOGY FROM BENCH TO CLINIC 465 00:18:43,120 --> 00:18:44,080 SPECIFICALLY FOR SARS. 466 00:18:44,080 --> 00:18:50,000 WE FOCUSSED ON LOW-COST 467 00:18:50,000 --> 00:18:50,320 TECHNOLOGY. 468 00:18:50,320 --> 00:18:53,600 WE KNEW THE SPIKE PROTEIN OF 469 00:18:53,600 --> 00:18:58,160 CORONAVIRUS WAS A CANDIDATE AND 470 00:18:58,160 --> 00:19:00,200 LOOKED AT SARS AND MERS AND 471 00:19:00,200 --> 00:19:01,800 LOOKED AT THE PROFESSION 472 00:19:01,800 --> 00:19:03,400 DEVELOPMENT AND SCALABILITY OF 473 00:19:03,400 --> 00:19:03,960 THE TECHNOLOGIES. 474 00:19:03,960 --> 00:19:05,680 WE TRANSFERRED THE TECHNOLOGY TO 475 00:19:05,680 --> 00:19:07,280 THE ARMY. 476 00:19:07,280 --> 00:19:08,800 WALTER REED HAS A BIO 477 00:19:08,800 --> 00:19:10,120 MANUFACTURING FACILITY THAT MADE 478 00:19:10,120 --> 00:19:15,720 A PILOT PRODUCT FOR US BUT THEN 479 00:19:15,720 --> 00:19:17,080 OF COURSE AS IT BECAME NEGLECTED 480 00:19:17,080 --> 00:19:20,440 IT BECAME MORE NEGLECTED AND THE 481 00:19:20,440 --> 00:19:22,360 SURPRISE CAME WE HAVE A THIRD 482 00:19:22,360 --> 00:19:24,440 OUTBREAK THAT LED TO THE GLOBAL 483 00:19:24,440 --> 00:19:26,400 PANDEMIC WHICH WAS THE SARS 484 00:19:26,400 --> 00:19:26,600 COV2. 485 00:19:26,600 --> 00:19:30,840 SO WE WERE READY. 486 00:19:30,840 --> 00:19:32,960 WE WERE READY IN 2010 WE START 487 00:19:32,960 --> 00:19:36,440 THE PROGRAM AND BY 2020 WE KNEW 488 00:19:36,440 --> 00:19:38,160 HOW TO ENGINEER WHAT WE CALLED 489 00:19:38,160 --> 00:19:38,800 STARTER KITS. 490 00:19:38,800 --> 00:19:42,760 WE HAD TO READAPT THEM TO MAKE 491 00:19:42,760 --> 00:19:45,800 SPECIFICALLY THE RBD FOR THE 492 00:19:45,800 --> 00:19:46,560 SARS COV2. 493 00:19:46,560 --> 00:19:49,000 WE ALSO KNEW HOW TO CREATE THE 494 00:19:49,000 --> 00:19:51,480 PRAX IS FOR THE PRODUCTION AND 495 00:19:51,480 --> 00:19:56,320 FORMULATION AND WE HAD 496 00:19:56,320 --> 00:19:57,800 PRE-CLINICAL EVIDENCE WE 497 00:19:57,800 --> 00:19:58,720 REPRODUCED FOR SARS COV2 AND 498 00:19:58,720 --> 00:20:00,760 THOSE WERE THE RECIPES AND 499 00:20:00,760 --> 00:20:03,320 DEVELOPED A TOOLBOX OF THE 500 00:20:03,320 --> 00:20:06,280 REGULATORY ENABLING ASSAYS TO 501 00:20:06,280 --> 00:20:07,600 TEST THEIR QUALITY AND 502 00:20:07,600 --> 00:20:07,840 STABILITY. 503 00:20:07,840 --> 00:20:12,840 AND THEN WE EMBARKED INTO WHAT 504 00:20:12,840 --> 00:20:16,240 WILL WE DO WITH THE TECHNOLOGY. 505 00:20:16,240 --> 00:20:18,400 OUR HOPE WAS A MULTI-NATIONAL 506 00:20:18,400 --> 00:20:23,480 LIKE MERCK THAT KNOWS HOW TO 507 00:20:23,480 --> 00:20:26,800 MAKE RECOMBINANT PROTEIN 508 00:20:26,800 --> 00:20:27,520 VACCINES WOULD COLLABORATE WITH 509 00:20:27,520 --> 00:20:30,520 US BUT WITH NO AVAIL WE STARTED 510 00:20:30,520 --> 00:20:38,000 LOOKING FOR THE NTDs INTO 511 00:20:38,000 --> 00:20:40,200 ANOTHER GROUP OF PRODUCERS THE 512 00:20:40,200 --> 00:20:41,720 DEVELOPING COUNTRIES VACCINE 513 00:20:41,720 --> 00:20:42,200 MANUFACTURERS. 514 00:20:42,200 --> 00:20:44,400 WHEN WE LOOKED AT HOW THE 515 00:20:44,400 --> 00:20:45,720 COVID-19s WERE BEING CONTRIBUTED 516 00:20:45,720 --> 00:20:48,720 AROUND THE WORLD, MOST THE 517 00:20:48,720 --> 00:20:51,000 MULTI-NATIONALS WERE FOCUSSING 518 00:20:51,000 --> 00:20:53,320 ON WHAT WE NICELY CALL THE SHINY 519 00:20:53,320 --> 00:20:55,120 NEW TOYS, THE RNA TECHNOLOGIES 520 00:20:55,120 --> 00:21:03,840 WHICH ARE AMAZING BUT RELATIVELY 521 00:21:03,840 --> 00:21:06,520 NEW, MAYBE NOT SCIENTIFICALLY 522 00:21:06,520 --> 00:21:08,640 NEW BUT NEEDED TO SHOW THEY WERE 523 00:21:08,640 --> 00:21:13,880 IN LARGE WORLD EXERCISES AND 524 00:21:13,880 --> 00:21:19,200 EVEN TODAY WE SEE THE DIFFERENT 525 00:21:19,200 --> 00:21:20,560 COUNTRIES AND WHERE YOU SEE RED 526 00:21:20,560 --> 00:21:22,240 AND ORANGE ARE ALL THE COUNTRIES 527 00:21:22,240 --> 00:21:25,040 PRIMARILY LOW-INCOME COUNTRIES 528 00:21:25,040 --> 00:21:27,080 AND LOW-MIDDLE INCOME COUNTRIES 529 00:21:27,080 --> 00:21:29,120 AND SOME IN UPPER MIDDLE INCOME 530 00:21:29,120 --> 00:21:32,000 COUNTRIES THEY'VE HAD NO ACCESS 531 00:21:32,000 --> 00:21:38,520 TO THE COVID-19 VACCINE. 532 00:21:38,520 --> 00:21:39,640 I THINK THE REASON THE 533 00:21:39,640 --> 00:21:43,360 TRADITIONAL METHODOLOGY AND 534 00:21:43,360 --> 00:21:45,040 MODEL FOR VACCINE DEVELOPMENT 535 00:21:45,040 --> 00:21:47,480 REALIZE ON AN R&D LAB LIKE OURS 536 00:21:47,480 --> 00:21:50,000 TO GIVE THE TECHNOLOGY TO A BIG 537 00:21:50,000 --> 00:21:51,600 MULTI-NATIONAL WHERE THEY ABSORB 538 00:21:51,600 --> 00:21:52,400 THE I.T. 539 00:21:52,400 --> 00:21:54,040 WE DON'T KNOW HOW THEY DEVELOP 540 00:21:54,040 --> 00:21:58,840 IT OR HOW THEY MATURE IT, MAYBE 541 00:21:58,840 --> 00:22:01,040 THEY UTILIZE SOME OF THE 542 00:22:01,040 --> 00:22:04,040 DEVELOPING COUNTRY PRODUCERS AS 543 00:22:04,040 --> 00:22:08,000 FOL 544 00:22:08,000 --> 00:22:09,440 FOLLOW-ONES SAYING THIS WHAT WE 545 00:22:09,440 --> 00:22:15,480 WANT YOU TO MAKE AND RATHER THAN 546 00:22:15,480 --> 00:22:21,040 A DIRECT TRANSFER LIKE WE DO AND 547 00:22:21,040 --> 00:22:22,720 HAVE THEM DEVELOP AS A 548 00:22:22,720 --> 00:22:27,120 FIRST-RATE INNOVATION AND 549 00:22:27,120 --> 00:22:29,640 EMPOWER THEM BY REMOVING IP 550 00:22:29,640 --> 00:22:31,160 BARRIERS TO OWN THE TECHNOLOGY 551 00:22:31,160 --> 00:22:37,040 AND CALL IT AND USE IT AS THEIR 552 00:22:37,040 --> 00:22:47,400 OWN AND WE DID THAT WITH OTHER 553 00:22:47,400 --> 00:22:50,440 COUNTRIES AND INDONESIA WAS VERY 554 00:22:50,440 --> 00:22:54,200 ADVANCED AND TWO COMPANIES KNEW 555 00:22:54,200 --> 00:22:57,040 HOW TO MAKE YEAST RECOMBINANT 556 00:22:57,040 --> 00:23:01,040 PROTEINS AND KNEW HOW TO MATURE 557 00:23:01,040 --> 00:23:11,600 THE PROCESS AND SCALE IT AND A 558 00:23:16,760 --> 00:23:19,360 SMALLER COMPANY WORKED ON SCALE 559 00:23:19,360 --> 00:23:25,040 AND IN BOTSWANA WE BUILT AND 560 00:23:25,040 --> 00:23:25,960 CREATED NEW INFRASTRUCTURE. 561 00:23:25,960 --> 00:23:36,480 THE RESULT FROM THE PROCESS TO 562 00:23:36,840 --> 00:23:37,600 GETTING AUTHORIZATION AND THE 563 00:23:37,600 --> 00:23:39,880 COMMUNITIES WHERE WE HAVE 564 00:23:39,880 --> 00:23:44,000 VACCINATED NOW MORE THAN 100 565 00:23:44,000 --> 00:23:48,240 MILLION VACCINATIONS IS BIO-E 566 00:23:48,240 --> 00:23:49,480 WHO DEVELOPED A VACCINE THEY 567 00:23:49,480 --> 00:23:58,720 CALL CORBEVAX AND ANOTHER CALLED 568 00:23:58,720 --> 00:24:03,160 INDOVAC AND THEY WENT ONE STEP 569 00:24:03,160 --> 00:24:05,080 AHEAD BECAUSE THEY WERE ABLE TO 570 00:24:05,080 --> 00:24:09,440 SUBMIT A REQUEST TO THEIR 571 00:24:09,440 --> 00:24:11,040 REGULATORY AUTHORITIES TO 572 00:24:11,040 --> 00:24:12,080 RECEIVE CERTIFICATION. 573 00:24:12,080 --> 00:24:13,160 ALSO VERY CULTURALLY IMPORTANT 574 00:24:13,160 --> 00:24:20,000 TO KNOW WHEN YOU DEVELOP A 575 00:24:20,000 --> 00:24:21,760 TECHNOLOGY WHO WILL BE YOUR 576 00:24:21,760 --> 00:24:24,120 HANDOFF TO AND IN OUR CASE IT 577 00:24:24,120 --> 00:24:26,120 WAS A YEAST VEGAN TECHNOLOGY WE 578 00:24:26,120 --> 00:24:28,480 KNEW HAD NO CONCERNS ABOUT 579 00:24:28,480 --> 00:24:30,760 ANIMAL-DERIVED PRODUCTS OR HUMAN 580 00:24:30,760 --> 00:24:33,360 CELL LINES SO WE WERE ABLE TO 581 00:24:33,360 --> 00:24:37,880 GIVE THEM ALL THAT DOCUMENT IN 582 00:24:37,880 --> 00:24:40,440 SUPPORT TO THEIR REGULATORY 583 00:24:40,440 --> 00:24:40,840 REQUIREMENTS. 584 00:24:40,840 --> 00:24:42,720 IN SUMMARY, I JUST WANT TO 585 00:24:42,720 --> 00:24:44,200 HIGHLIGHT AGAIN THAT FROM THE 586 00:24:44,200 --> 00:24:45,920 BEGINNING BECAUSE WE KNEW WE 587 00:24:45,920 --> 00:24:49,920 WERE WORKING ON NEGLECTED 588 00:24:49,920 --> 00:24:51,680 DISEASES, WE EMBRACED THE 589 00:24:51,680 --> 00:24:53,360 CONCEPT OF OPEN SCIENCE WHERE WE 590 00:24:53,360 --> 00:24:55,960 SHARED KNOWLEDGE DATA AND 591 00:24:55,960 --> 00:24:57,520 PUBLISHED WIDELY AND ALSO WANTED 592 00:24:57,520 --> 00:24:59,840 TO MAKE SURE WHEN WE CREATED OUR 593 00:24:59,840 --> 00:25:01,680 PARTNERSHIPS THAT OUR TEAM-BASED 594 00:25:01,680 --> 00:25:03,560 APPROACHES WERE VERY HOLISTIC. 595 00:25:03,560 --> 00:25:06,680 AS I MENTIONED WE NOT ONLY 596 00:25:06,680 --> 00:25:09,040 WORKED SCIENTIFICALLY WITH 597 00:25:09,040 --> 00:25:11,960 HARD-CORE SCIENCE, ALSO WITH 598 00:25:11,960 --> 00:25:12,800 ENGINEERS AND LAWYERS AND 599 00:25:12,800 --> 00:25:13,200 ECONOMISTS. 600 00:25:13,200 --> 00:25:16,920 ANYTHING WE NEEDED TO ENSURE WE 601 00:25:16,920 --> 00:25:21,040 FOLLOW THE PROCESSES LOOKING AT 602 00:25:21,040 --> 00:25:23,200 WHOLISTIC WAY WHERE OUR PRODUCT 603 00:25:23,200 --> 00:25:24,560 WILL EVENTUALLY END UP. 604 00:25:24,560 --> 00:25:25,680 APPROPRIATE BASED ON WHAT IS 605 00:25:25,680 --> 00:25:26,480 NEEDED. 606 00:25:26,480 --> 00:25:29,080 WE KNEW TECHNOLOGIES LIKE 607 00:25:29,080 --> 00:25:31,200 RECOMBINANT PROTEINS WOULD BE 608 00:25:31,200 --> 00:25:34,640 VERY -- A LITTLE EASIER TO ADOPT 609 00:25:34,640 --> 00:25:35,280 AND ADAPT. 610 00:25:35,280 --> 00:25:36,800 THEY'RE CHEAPER AND ALREADY HAVE 611 00:25:36,800 --> 00:25:38,600 AN INFRASTRUCTURE AND FOR 612 00:25:38,600 --> 00:25:40,400 COVID-19 WE WENT EVEN ONE MORE 613 00:25:40,400 --> 00:25:40,960 STEP. 614 00:25:40,960 --> 00:25:45,600 WE REMOVED COMPLETELY THE 615 00:25:45,600 --> 00:25:46,400 BARRIER OF INTELLECTUAL PROPERTY 616 00:25:46,400 --> 00:25:48,560 AND DECIDED NOT TO PATENT OUR 617 00:25:48,560 --> 00:25:50,080 GENETIC ENGINEERING. 618 00:25:50,080 --> 00:25:53,120 THIS CONCEPT ENABLED US TO DO 619 00:25:53,120 --> 00:25:55,040 REVERSE INNOVATION WHERE WE HAND 620 00:25:55,040 --> 00:25:57,080 OVER TECHNOLOGY WHICH WAS CRUDE 621 00:25:57,080 --> 00:26:00,280 AND HAD A STARTING POINT OF A 622 00:26:00,280 --> 00:26:02,280 BASE OF INFORMATION BUT THEN 623 00:26:02,280 --> 00:26:06,600 DLMIC PRODUCER INNOVATED AND 624 00:26:06,600 --> 00:26:07,960 CREATED THEIR OWN PRODUCT AS WE 625 00:26:07,960 --> 00:26:14,000 VALUE THE ENGAGEMENT TO ENSURE 626 00:26:14,000 --> 00:26:17,040 WE SHARE OUR INFORMATION TO 627 00:26:17,040 --> 00:26:20,000 EDUCATE WITH POLICY MAKERS TO 628 00:26:20,000 --> 00:26:22,240 MAKE GOOD DECISIONS FOR THE 629 00:26:22,240 --> 00:26:24,960 GOVERNMENT AND TO ENABLE TRUST 630 00:26:24,960 --> 00:26:25,840 WITHIN SOCIETY. 631 00:26:25,840 --> 00:26:29,080 AND WE WERE SUPPORTED MOSTLY 632 00:26:29,080 --> 00:26:30,800 AGAIN BY COMBINING TRADITIONAL 633 00:26:30,800 --> 00:26:33,560 AND ALTERNATIVE TYPE OF FUNDING. 634 00:26:33,560 --> 00:26:36,880 AND THIS IS OUR TEAM JUST TO 635 00:26:36,880 --> 00:26:39,320 GIVE YOU A FEW FACES BEHIND THE 636 00:26:39,320 --> 00:26:39,720 SCENES. 637 00:26:39,720 --> 00:26:42,400 AND AS YOU CAN SEE EVEN FROM THE 638 00:26:42,400 --> 00:26:45,200 LIST OF OUR SPONSORS, WE DID GET 639 00:26:45,200 --> 00:26:47,120 SOME NIH TRADITIONAL FEDERAL 640 00:26:47,120 --> 00:26:49,040 FUNDING BUT AS YOU CAN SEE MOST 641 00:26:49,040 --> 00:26:52,200 THE FUNDING CAME FROM VERY 642 00:26:52,200 --> 00:26:53,040 INTERESTING ORGANIZATIONS 643 00:26:53,040 --> 00:26:55,600 INCLUDING ORGANIZATIONS SUCH AS 644 00:26:55,600 --> 00:27:00,040 FIFTH GENERATION WHICH IS THE 645 00:27:00,040 --> 00:27:04,880 COMPANY THAT OWNS TITO'S 646 00:27:04,880 --> 00:27:06,720 HANDMADE VODKA IN TEXAS AND 647 00:27:06,720 --> 00:27:07,040 INDIVIDUALS. 648 00:27:07,040 --> 00:27:10,920 I'LL STOP SHARING AND GIVE THE 649 00:27:10,920 --> 00:27:21,400 MICROPHONE TO DR. EMMANUEL. 650 00:27:22,640 --> 00:27:24,000 >>THANK YOU FOR ALL MY FRIENDS 651 00:27:24,000 --> 00:27:28,040 AT THE NIH FOR INVITING ME TO 652 00:27:28,040 --> 00:27:28,960 PRESENT AND ADDRESS THIS VERY 653 00:27:28,960 --> 00:27:30,800 IMPORTANT ISSUE. 654 00:27:30,800 --> 00:27:33,640 SO LET ME MAKE TWO PRELIMINARY 655 00:27:33,640 --> 00:27:33,960 OBSERVATIONS. 656 00:27:33,960 --> 00:27:35,640 THE FIRST IS ABOUT MY CONFLICT 657 00:27:35,640 --> 00:27:36,600 OF INTEREST. 658 00:27:36,600 --> 00:27:38,000 YOU HAVE THEM. 659 00:27:38,000 --> 00:27:39,440 LET ME SUMMARIZE THEM IN THE 660 00:27:39,440 --> 00:27:42,040 FOLLOWING WAY, I DO NO WORK -- I 661 00:27:42,040 --> 00:27:47,000 HAVE NO PHARMA STOCK, NO 662 00:27:47,000 --> 00:27:48,960 INVESTMENT IN ANY PHARMA 663 00:27:48,960 --> 00:27:49,680 COMPANY. 664 00:27:49,680 --> 00:27:57,440 I DO WORK WITH J&J TRYING TO 665 00:27:57,440 --> 00:27:59,400 IMPROVE INFORMED CONSENT 666 00:27:59,400 --> 00:28:00,120 DOCUMENTS FOR CLINICAL RESEARCH 667 00:28:00,120 --> 00:28:01,040 TRIALS AND THEY PAY FOR THE 668 00:28:01,040 --> 00:28:03,280 AMOUNT OF TIME I WORK ON IT BUT 669 00:28:03,280 --> 00:28:04,160 NOTHING ABOVE THAT. 670 00:28:04,160 --> 00:28:07,760 I'M ON THE ADVISORY BOARD OF 671 00:28:07,760 --> 00:28:13,400 SOLARUS IT'S A COMPANY TRYING TO 672 00:28:13,400 --> 00:28:17,600 AUTOMATE CELL PRODUCTION FOR CAR 673 00:28:17,600 --> 00:28:20,400 T THERAPY AND DO THOSE KINDS OF 674 00:28:20,400 --> 00:28:21,040 THINGS. 675 00:28:21,040 --> 00:28:22,360 I DON'T THINK THAT'S 676 00:28:22,360 --> 00:28:24,480 PARTICULARLY RELEVANT TO TODAY'S 677 00:28:24,480 --> 00:28:25,680 DISCUSSION BUT YOU CAN TAKE IT 678 00:28:25,680 --> 00:28:26,160 AS YOU WILL. 679 00:28:26,160 --> 00:28:28,840 THE SECOND OBSERVATION I WANT TO 680 00:28:28,840 --> 00:28:31,240 MAKE IS ABOUT MY COMMITMENT TO 681 00:28:31,240 --> 00:28:34,240 NTDs. 682 00:28:34,240 --> 00:28:35,720 BETWEEN 2009 AND 2011 AT THE 683 00:28:35,720 --> 00:28:38,240 OFFICE OF MANAGEMENT AND BUDGET, 684 00:28:38,240 --> 00:28:42,040 I HAD SOME OVERSIGHT AND 685 00:28:42,040 --> 00:28:43,480 DEVELOPMENT WITH OUR GLOBAL 686 00:28:43,480 --> 00:28:44,040 HEALTH ASSISTANCE BUDGET. 687 00:28:44,040 --> 00:28:47,280 ONE OF THE THINGS I NOTED WAS 688 00:28:47,280 --> 00:28:53,040 THE ABSOLUTE TOTAL PITIFUL 689 00:28:53,040 --> 00:28:57,040 CONTRIBUTIONS WE WERE MAKING TO 690 00:28:57,040 --> 00:28:58,560 TROPICAL DISEASES I BELIEVE IN 691 00:28:58,560 --> 00:29:00,360 THE $30 MILLION RANGE AT THAT 692 00:29:00,360 --> 00:29:00,640 TIME. 693 00:29:00,640 --> 00:29:02,920 I THINK OUR CONTRIBUTION AT THAT 694 00:29:02,920 --> 00:29:06,680 TIME TO MALARIA WAS SOMETHING IN 695 00:29:06,680 --> 00:29:11,240 THE HALF A BILLION DOLLAR RANGE. 696 00:29:11,240 --> 00:29:14,000 IN BOTH THOSE CASES, I 697 00:29:14,000 --> 00:29:16,080 DRAMATICALLY IMPROVED AND 698 00:29:16,080 --> 00:29:17,040 SUBSTANTIALLY INCREASED THE 699 00:29:17,040 --> 00:29:19,400 U.S. GOVERNMENT CONTRIBUTIONS TO 700 00:29:19,400 --> 00:29:21,120 THOSE PROGRAMS. 701 00:29:21,120 --> 00:29:24,760 I NEGLECTED TROPICAL DISEASES, 702 00:29:24,760 --> 00:29:26,760 EXACTLY WHAT MARIA SAID SEVERELY 703 00:29:26,760 --> 00:29:31,400 UNDER FINANCED AND VERY 704 00:29:31,400 --> 00:29:32,560 SIGNIFICANTLY UNATTENDED TO. 705 00:29:32,560 --> 00:29:36,280 THAT'S WHY WE CALL THEM 706 00:29:36,280 --> 00:29:36,960 NEGLECTED. 707 00:29:36,960 --> 00:29:37,960 BUT THEY ARE SUBSTANTIALLY 708 00:29:37,960 --> 00:29:38,640 IMPORTANT. 709 00:29:38,640 --> 00:29:42,600 NOW, I WANT TO MAKE JUST SIX 710 00:29:42,600 --> 00:29:43,840 SIMPLE POINTS TO START OUR 711 00:29:43,840 --> 00:29:46,720 DISCUSSION AND START OUR 712 00:29:46,720 --> 00:29:47,000 ANALYSIS. 713 00:29:47,000 --> 00:29:49,040 THE FIRST ONE IS I'M HERE 714 00:29:49,040 --> 00:29:55,240 BECAUSE I'M A BIOETHICISTS. 715 00:29:55,240 --> 00:29:56,640 THE ONE THING WE OUGHT TO BE 716 00:29:56,640 --> 00:30:00,440 DOING IS DELINEATE THE ETHICAL 717 00:30:00,440 --> 00:30:02,440 PRINCIPLES RELEVANT TO THE 718 00:30:02,440 --> 00:30:03,760 CONSIDERATION HERE TODAY. 719 00:30:03,760 --> 00:30:07,640 I'M GOING TO FOCUS NOT ON THE 720 00:30:07,640 --> 00:30:09,040 PROCEDURAL PRINCIPLES LIKE 721 00:30:09,040 --> 00:30:10,320 ACCOUNTABILITY OR TRANSPARENCY 722 00:30:10,320 --> 00:30:13,040 OR THAT BUT THREE SUBSTANTIVE 723 00:30:13,040 --> 00:30:15,840 PRINCIPLES WHICH WE PUBLISHED IN 724 00:30:15,840 --> 00:30:18,560 THE LANCET, I THINK SEPTEMBER 725 00:30:18,560 --> 00:30:20,680 2021, WHEN WE WERE DISCUSSING 726 00:30:20,680 --> 00:30:22,440 THE PHARMACEUTICAL COMPANY 727 00:30:22,440 --> 00:30:23,080 OBLIGATIONS DURING A HEALTH CARE 728 00:30:23,080 --> 00:30:27,760 EMERGENCY BUT I THINK THEY'RE 729 00:30:27,760 --> 00:30:29,520 QUITE IMPORTANT GENERAL AND 730 00:30:29,520 --> 00:30:30,560 MARIA, STAY TUNED BECAUSE I'LL 731 00:30:30,560 --> 00:30:32,520 ASK YOU TO BRING UP THE SLIDE 732 00:30:32,520 --> 00:30:35,560 WHEN I DISCUSS THE SECOND 733 00:30:35,560 --> 00:30:36,520 PRINCIPLE, YOUR CIRCLE SLIDE 734 00:30:36,520 --> 00:30:37,760 WITH HOW MANY UNVACCINATED 735 00:30:37,760 --> 00:30:39,840 PEOPLE IN THE POPULATION ARE. 736 00:30:39,840 --> 00:30:41,600 SO THE FIRST PRINCIPLE IS WE 737 00:30:41,600 --> 00:30:43,800 WANT TO OPTIMIZE VACCINE 738 00:30:43,800 --> 00:30:45,600 PRODUCTION FOR THE DISEASES 739 00:30:45,600 --> 00:30:47,360 WE'RE CONSIDERING WHATEVER 740 00:30:47,360 --> 00:30:49,400 DISEASES THEY ARE. 741 00:30:49,400 --> 00:30:51,320 THIS IS EXTREMELY IMPORTANT AS 742 00:30:51,320 --> 00:30:52,800 MARIA'S MADE CLEAR. 743 00:30:52,800 --> 00:30:54,040 IF YOU HAVE A TECHNOLOGY BUT 744 00:30:54,040 --> 00:30:57,080 YOU'RE NOT ACTUALLY ABLE TO 745 00:30:57,080 --> 00:31:01,200 PRODUCE IT, THAT IS A SERIOUS 746 00:31:01,200 --> 00:31:02,280 PROBLEM. 747 00:31:02,280 --> 00:31:04,240 IT MEANS PEOPLE WILL DIE OR AT 748 00:31:04,240 --> 00:31:06,840 THE WORSE WILL NOT BE PROTECTED. 749 00:31:06,840 --> 00:31:09,040 SO RESOURCES HAVE TO BE 750 00:31:09,040 --> 00:31:10,560 MOBILIZED AS QUICKLY AS POSSIBLE 751 00:31:10,560 --> 00:31:13,960 TO REDUCE THE HEALTH AND 752 00:31:13,960 --> 00:31:16,040 ECONOMIC BURDENS OF ANY HEALTH 753 00:31:16,040 --> 00:31:19,640 CARE CONDITION AND ESPECIALLY IN 754 00:31:19,640 --> 00:31:20,160 AN EMERGENCY. 755 00:31:20,160 --> 00:31:24,800 AND THE RESEARCH AND DEVELOPMENT 756 00:31:24,800 --> 00:31:26,000 PROCESS ESPECIALLY IN AN 757 00:31:26,000 --> 00:31:29,080 EMERGENCY WITH A SEVERE ILLNESS 758 00:31:29,080 --> 00:31:32,000 CAN PUSH THE BOUNDS OF RISK 759 00:31:32,000 --> 00:31:32,280 TOLERANCE. 760 00:31:32,280 --> 00:31:34,520 THE SEVERITY OF DISEASE AFFECTS 761 00:31:34,520 --> 00:31:37,240 OUR PERCEPTION OF A RISK BENEFIT 762 00:31:37,240 --> 00:31:37,520 RATIO. 763 00:31:37,520 --> 00:31:38,880 HOW MUCH RISK WITH A PRODUCT 764 00:31:38,880 --> 00:31:39,760 WE'RE WILLING TO TOLERATE. 765 00:31:39,760 --> 00:31:42,240 THAT'S THE FIRST PRINCIPLE. 766 00:31:42,240 --> 00:31:43,160 SO OPTIMIZE VACCINE PRODUCTION 767 00:31:43,160 --> 00:31:45,560 AND AVAILABILITY. 768 00:31:45,560 --> 00:31:49,000 THE SECOND PRINCIPLE IS FAIR 769 00:31:49,000 --> 00:31:50,000 DISTRIBUTION. 770 00:31:50,000 --> 00:31:52,920 ONCE YOU HAVE A VACCINE, 771 00:31:52,920 --> 00:31:54,720 FAIRNESS IS GOING TO REQUIRE 772 00:31:54,720 --> 00:31:57,040 THAT THE VACCINE ALLOCATION 773 00:31:57,040 --> 00:32:00,000 SHOULD BE APPROPRIATELY 774 00:32:00,000 --> 00:32:01,040 PRIORITIZED COUNTRIES IN THE 775 00:32:01,040 --> 00:32:02,480 GREATEST NEED NOT THOSE WITH THE 776 00:32:02,480 --> 00:32:05,760 GREATEST WEALTH OR THE GREATEST 777 00:32:05,760 --> 00:32:06,160 POPULATION. 778 00:32:06,160 --> 00:32:08,360 FAIRNESS REQUIRES NOT LEAVING 779 00:32:08,360 --> 00:32:10,520 PEOPLE WHO ARE IN NEED AT THE 780 00:32:10,520 --> 00:32:12,960 BACK OF THE QUEUE BUT INSTEAD 781 00:32:12,960 --> 00:32:13,960 ENSURING THAT THE VACCINE 782 00:32:13,960 --> 00:32:17,520 ARRIVED TO THEM IN A TIMELY 783 00:32:17,520 --> 00:32:18,120 MANNER. 784 00:32:18,120 --> 00:32:19,280 SO THIS PRINCIPLE OF 785 00:32:19,280 --> 00:32:21,040 DISTRIBUTING IT ON THE BASIS OF 786 00:32:21,040 --> 00:32:22,360 THE GREATEST NEED IS VERY 787 00:32:22,360 --> 00:32:22,760 IMPORTANT. 788 00:32:22,760 --> 00:32:25,760 I'M GOING TO COME BACK TO THIS 789 00:32:25,760 --> 00:32:27,800 WHEN WE TALK ABOUT COVID BUT 790 00:32:27,800 --> 00:32:29,760 MAYBE MARIA, YOU CAN BRING UP 791 00:32:29,760 --> 00:32:32,880 THE FAN SLIDE I WAS SUGGESTING. 792 00:32:32,880 --> 00:32:36,880 THIS FAN SLIDE IS TOTALLY WRONG, 793 00:32:36,880 --> 00:32:38,280 NOT ETHICAL. 794 00:32:38,280 --> 00:32:41,760 WHAT THIS SHOWS IS THE SHARE OF 795 00:32:41,760 --> 00:32:43,040 UNVACCINATED IN A POPULATION. 796 00:32:43,040 --> 00:32:45,040 WE DON'T KNOW WHETHER THOSE 797 00:32:45,040 --> 00:32:46,880 PEOPLE ARE IN NEED. 798 00:32:46,880 --> 00:32:48,840 THIS IS NOT A VACCINE -- A 799 00:32:48,840 --> 00:32:50,360 VACCINE SHOULD NOT BE 800 00:32:50,360 --> 00:32:53,040 DISTRIBUTED BY THE POPULATION 801 00:32:53,040 --> 00:32:58,960 ESPECIALLY FOR A 802 00:32:58,960 --> 00:32:59,600 LIFE-THREATENING SITUATION LIKE 803 00:32:59,600 --> 00:33:02,000 COVID BUT DISTRIBUTED ON THE 804 00:33:02,000 --> 00:33:04,160 BASIS OF HEALTH NEED. 805 00:33:04,160 --> 00:33:08,680 SO HOW MUCH IS THAT CONDITION 806 00:33:08,680 --> 00:33:09,080 AFFLICTING PEOPLE? 807 00:33:09,080 --> 00:33:11,680 NOT EVERYONE IN THE WORLD WAS IN 808 00:33:11,680 --> 00:33:14,240 THE SAME CONDITION TO BE EXPOSED 809 00:33:14,240 --> 00:33:16,720 TO COVID FOR EXAMPLE. 810 00:33:16,720 --> 00:33:18,320 SO LOOKING AT COUNTRIES IN TERMS 811 00:33:18,320 --> 00:33:18,840 OF POPULATION. 812 00:33:18,840 --> 00:33:24,480 YOU SEE THIS ALL THE TIME, 813 00:33:24,480 --> 00:33:25,840 VACCINE BY POPULATION AND WHEN 814 00:33:25,840 --> 00:33:27,560 YOU HAVE A LARGE POPULATION 815 00:33:27,560 --> 00:33:29,040 WITHOUT A VACCINE, PEOPLE SAY 816 00:33:29,040 --> 00:33:31,640 OH, IT'S UNETHICAL. 817 00:33:31,640 --> 00:33:32,000 WRONG QUESTION. 818 00:33:32,000 --> 00:33:36,560 THE DISTRIBUTION YOU NEED TO 819 00:33:36,560 --> 00:33:38,480 LOOK AT IS VACCINE BY COVID 820 00:33:38,480 --> 00:33:40,320 DEATHS OR EXCESS DEATHS. 821 00:33:40,320 --> 00:33:42,400 THANK YOU, MARIA FOR 822 00:33:42,400 --> 00:33:43,040 DISTRIBUTING THAT. 823 00:33:43,040 --> 00:33:45,040 THAT'S NOT THE RIGHT SLIDE FROM 824 00:33:45,040 --> 00:33:49,040 AN ETHICAL STANDPOINT. 825 00:33:49,040 --> 00:33:50,600 THE THIRD IS AN ETHICAL 826 00:33:50,600 --> 00:33:53,480 PRINCIPLE WHICH I THINK RECEIVES 827 00:33:53,480 --> 00:33:55,760 TOO LITTLE ATTENTION IN THE 828 00:33:55,760 --> 00:33:58,360 PHARMACEUTICAL SPACE THAT IS 829 00:33:58,360 --> 00:34:01,040 EXTREMELY IMPORTANT THIS IS THE 830 00:34:01,040 --> 00:34:04,680 PRINCIPLE OF SUSTAINABILITY. 831 00:34:04,680 --> 00:34:07,080 WE NEED GROUPS LIKE MARIA'S. 832 00:34:07,080 --> 00:34:11,360 WE NEED COMPANIES LIKE THE 833 00:34:11,360 --> 00:34:12,040 PHARMACEUTICAL COMPANIES TO BE 834 00:34:12,040 --> 00:34:14,920 IN THE GAME FOR A LONG TIME. 835 00:34:14,920 --> 00:34:18,480 NOT JUST THE CRISIS NOW OR JUST 836 00:34:18,480 --> 00:34:22,120 THE PRODUCT NOW BUT OVER TIME. 837 00:34:22,120 --> 00:34:24,880 WE NEED A LONG-TERM PERSPECTIVE 838 00:34:24,880 --> 00:34:26,600 FOR NOT JUST ADDRESSING THE 839 00:34:26,600 --> 00:34:27,760 CURRENT SITUATION BUT ENSURE WE 840 00:34:27,760 --> 00:34:31,200 HAVE THE INCENTIVES THAT ARE 841 00:34:31,200 --> 00:34:34,280 GOING TO KEEP GROUPS AND PEOPLE 842 00:34:34,280 --> 00:34:35,320 INVOLVED FOR THE NEXT CRISIS. 843 00:34:35,320 --> 00:34:38,800 IF YOU THINK THAT OVER THE NEXT 844 00:34:38,800 --> 00:34:41,720 20 YEARS THERE'S A 50/50 CHANCE 845 00:34:41,720 --> 00:34:42,840 WE'LL HAVE ANOTHER HEALTH 846 00:34:42,840 --> 00:34:45,040 EMERGENCY WITH THE SAME KIND OF 847 00:34:45,040 --> 00:34:47,960 GLOBAL IMPACT AS COVID, WHICH 848 00:34:47,960 --> 00:34:51,920 RECENT STUDIES SUGGEST, WE 849 00:34:51,920 --> 00:34:52,600 DEFINITELY NEED PHARMACEUTICAL 850 00:34:52,600 --> 00:34:55,320 COMPANIES, ACADEMICS, ALL SORTS 851 00:34:55,320 --> 00:35:00,440 OF PEOPLE TO BE ENGAGED IN THE 852 00:35:00,440 --> 00:35:02,200 NEXT CRISIS WITH THE CAPACITY TO 853 00:35:02,200 --> 00:35:05,320 ADDRESS THE PROBLEMS. 854 00:35:05,320 --> 00:35:07,520 SO WHEN WE THINK ABOUT -- WE 855 00:35:07,520 --> 00:35:09,480 SHOULD GET RID OF IP WE HAVE TO 856 00:35:09,480 --> 00:35:10,400 ASK THE QUESTION NOT ONLY IS 857 00:35:10,400 --> 00:35:12,880 THAT GOOD FOR THE MOMENT BUT FOR 858 00:35:12,880 --> 00:35:14,680 THE LONG-TERM HEALTH OF 859 00:35:14,680 --> 00:35:15,080 PRODUCTION? 860 00:35:15,080 --> 00:35:16,480 SO THAT'S THE FIRST THING. 861 00:35:16,480 --> 00:35:18,040 THREE ETHICAL PRINCIPLES. 862 00:35:18,040 --> 00:35:20,000 OPTIMIZE VACCINE PRODUCTION, A 863 00:35:20,000 --> 00:35:21,840 FAIR DISTRIBUTION OF VACCINE 864 00:35:21,840 --> 00:35:23,360 THAT TAKES INTO ACCOUNT 865 00:35:23,360 --> 00:35:24,880 DISTRIBUTING IT BY HEALTH NEED 866 00:35:24,880 --> 00:35:27,200 NOT BY POPULATION, NOT BY 867 00:35:27,200 --> 00:35:29,520 WEALTH, NOT BY EXTRANEOUS 868 00:35:29,520 --> 00:35:32,000 FACTORS BUT BY THE NEED OF THE 869 00:35:32,000 --> 00:35:34,080 POPULATION FOR THE INTERVENTION. 870 00:35:34,080 --> 00:35:36,480 AND THIRD, IS THE ARRANGEMENT 871 00:35:36,480 --> 00:35:38,160 WE'RE CREATING IN TERMS OF 872 00:35:38,160 --> 00:35:39,920 OPTIMIZING PRODUCTION, FAIR 873 00:35:39,920 --> 00:35:43,640 DISTRIBUTION, GOT THE RIGHT 874 00:35:43,640 --> 00:35:46,520 INCENTIVES FOR SUSTAINABLE 875 00:35:46,520 --> 00:35:47,680 ABILITY TO ADDRESS HEALTH 876 00:35:47,680 --> 00:35:47,960 PROBLEMS. 877 00:35:47,960 --> 00:35:51,200 FIRST POINT, THREE ETHICAL 878 00:35:51,200 --> 00:35:51,480 PRINCIPLES. 879 00:35:51,480 --> 00:35:56,280 SECOND POINT, I WOULD POSIT THAT 880 00:35:56,280 --> 00:36:00,600 SPEED AND SCALABILITY IN 881 00:36:00,600 --> 00:36:05,920 PRODUCTION REQUIRES COMPANIES 882 00:36:05,920 --> 00:36:10,840 THAT WE ARE NOT LIKELY SPEED AND 883 00:36:10,840 --> 00:36:12,160 SCALE MUCH LESS SCALABILITY 884 00:36:12,160 --> 00:36:14,080 WITHOUT THE PHARMACEUTICAL 885 00:36:14,080 --> 00:36:15,600 COMPANIES. 886 00:36:15,600 --> 00:36:17,440 WHAT WE SEE IS ADVANCED PHASE 2 887 00:36:17,440 --> 00:36:20,320 AND PHASE 3 RESEARCH SURMOUNTING 888 00:36:20,320 --> 00:36:24,920 THE REGULATORY CHALLENGES FOR 889 00:36:24,920 --> 00:36:27,720 GETTING A VACCINE OR DRUG 890 00:36:27,720 --> 00:36:28,640 PRODUCED, MAKING SURE WE HAVE 891 00:36:28,640 --> 00:36:30,960 CAPACITY TO PRODUCE THEM IN 892 00:36:30,960 --> 00:36:33,920 LARGE ACCOUNTS QUICKLY 893 00:36:33,920 --> 00:36:37,040 ESPECIALLY IN AN EMERGENCY AND 894 00:36:37,040 --> 00:36:38,440 THE ABILITY FOR WORLDWIDE 895 00:36:38,440 --> 00:36:40,040 DISTRIBUTION ALL OF THOSE THINGS 896 00:36:40,040 --> 00:36:46,000 WHICH ARE NECESSARY TO ACTUALLY 897 00:36:46,000 --> 00:36:46,880 RESPOND REQUIRE PHARMACEUTICAL 898 00:36:46,880 --> 00:36:47,160 COMPANIES. 899 00:36:47,160 --> 00:36:50,640 WE ARE NOT GOING TO DO THOSE 900 00:36:50,640 --> 00:36:52,080 WITHOUT PHARMACEUTICAL 901 00:36:52,080 --> 00:36:52,360 COMPANIES. 902 00:36:52,360 --> 00:36:53,880 INTERESTINGLY WE HAVE A LOT OF 903 00:36:53,880 --> 00:36:56,000 COMPANIES, NOW THEY'RE NOT FOR 904 00:36:56,000 --> 00:36:58,480 PROFIT COMPANIES IN THE AMERICAN 905 00:36:58,480 --> 00:37:00,920 DRUG MARKET TRYING TO PRODUCE 906 00:37:00,920 --> 00:37:02,160 BASICALLY GENERIC DRUGS. 907 00:37:02,160 --> 00:37:05,680 THAT MIGHT BE TRUE. 908 00:37:05,680 --> 00:37:07,280 GENERIC DRUGS HAVE FEWER OF 909 00:37:07,280 --> 00:37:08,520 THESE ISSUES. 910 00:37:08,520 --> 00:37:13,240 THEY DON'T HAVE PHASE II, III 911 00:37:13,240 --> 00:37:14,840 RESEARCH AND AS MANY REGULATORY 912 00:37:14,840 --> 00:37:15,480 HURDLES AS OTHERS. 913 00:37:15,480 --> 00:37:18,960 THEY HAVE A PRODUCTION AND THE 914 00:37:18,960 --> 00:37:20,640 REGULATION AROUND GOOD 915 00:37:20,640 --> 00:37:22,960 MANUFACTURING PROCESSES. 916 00:37:22,960 --> 00:37:25,200 AND THE DISTRIBUTION BUT LESS OF 917 00:37:25,200 --> 00:37:25,640 THE OTHERS. 918 00:37:25,640 --> 00:37:28,040 LET ME JUST SAY YOU WOULD BE 919 00:37:28,040 --> 00:37:33,040 HARD PRESSED IN MOST THINGS TO 920 00:37:33,040 --> 00:37:37,120 FIND SCALE WHERE WE DON'T HAVE 921 00:37:37,120 --> 00:37:40,120 FOR PROFIT COMPANIES. 922 00:37:40,120 --> 00:37:42,360 I THINK THAT'S IMPORTANT AND WE 923 00:37:42,360 --> 00:37:44,920 SHOULD THINK THAT ALSO IN A CASE 924 00:37:44,920 --> 00:37:48,120 OF PUBLIC HEALTH EMERGENCY OR IN 925 00:37:48,120 --> 00:37:50,680 THE CASE OF CONDITIONS THAT 926 00:37:50,680 --> 00:37:54,760 MARIA'S OUTLINED LIKE NEGLECTED 927 00:37:54,760 --> 00:37:56,000 TROPICAL DISEASES, THE ALL THIS 928 00:37:56,000 --> 00:38:00,960 BECOMES MORE COMPLICATED BECAUSE 929 00:38:00,960 --> 00:38:08,000 WE HAVE A WORLDWIDE MARKET 930 00:38:08,000 --> 00:38:10,520 THEREFORE MULTIPLE HURDLES TO 931 00:38:10,520 --> 00:38:11,960 PASS AND PRODUCTION AND 932 00:38:11,960 --> 00:38:12,680 DISTRIBUTION THAT HAS OCCURRED 933 00:38:12,680 --> 00:38:22,960 ON A GLOBAL SCALE. 934 00:38:23,720 --> 00:38:25,360 THE ABILITY TO DO THAT REQUIRES 935 00:38:25,360 --> 00:38:25,880 LARGE COMPANIES. 936 00:38:25,880 --> 00:38:32,000 IF YOU THINK ABOUT ALL THE 937 00:38:32,000 --> 00:38:42,560 THINGS THAT NEED TO BE DONE YOU 938 00:38:44,480 --> 00:38:46,280 SEE SMALLER COMPANIES GETTING 939 00:38:46,280 --> 00:38:50,440 EATEN UP BY THE LARGER 940 00:38:50,440 --> 00:38:51,280 COMPANIES. 941 00:38:51,280 --> 00:38:56,320 AND SPEED AND SCALABILITY 942 00:38:56,320 --> 00:38:58,200 REQUIRING PHARMACEUTICAL 943 00:38:58,200 --> 00:39:00,240 COMPANIES THE BEST PROCESS IS 944 00:39:00,240 --> 00:39:01,800 NOT NECESSARILY AN OLD 945 00:39:01,800 --> 00:39:04,400 PRODUCTION PROCESS OR TRIED AND 946 00:39:04,400 --> 00:39:04,760 TRUE PROCESS. 947 00:39:04,760 --> 00:39:08,200 WE LEARNED THAT A LOT IN COVID. 948 00:39:08,200 --> 00:39:13,760 THE CHINESE TRIED AN OLD PROTEIN 949 00:39:13,760 --> 00:39:14,080 PROCESS. 950 00:39:14,080 --> 00:39:16,680 THE RUSSIANS TRIED A PROCESS 951 00:39:16,680 --> 00:39:17,480 THAT HAD BEEN ESTABLISHED. 952 00:39:17,480 --> 00:39:22,200 THE BIGGEST IMPACT ON DISEASE 953 00:39:22,200 --> 00:39:25,680 SUSTAINABILITY WITH NOVEL 954 00:39:25,680 --> 00:39:30,000 TECHNOLOGY, mRNA. 955 00:39:30,000 --> 00:39:40,520 I DON'T THINK WE HAVEN'T SEEN 956 00:39:51,960 --> 00:39:53,680 THAT AND THINKING OF NEW 957 00:39:53,680 --> 00:39:54,520 PROCESSES THOUGH THEY'RE MORE 958 00:39:54,520 --> 00:39:56,520 EXPENSIVE THAN TRIED AND TRUE 959 00:39:56,520 --> 00:40:00,560 PROCESSES, MAYBE THE BEST EVEN 960 00:40:00,560 --> 00:40:02,560 IN NEGLECTED TROPICAL DISEASES 961 00:40:02,560 --> 00:40:03,960 MARIA OUTLINED, GOING TO THE 962 00:40:03,960 --> 00:40:09,040 BOTTOM OF THE BARREL AND THE 963 00:40:09,040 --> 00:40:19,560 REASON IS GIVEN THE ECONOMIC 964 00:40:20,480 --> 00:40:29,080 DISEAS 965 00:40:29,080 --> 00:40:34,600 DISEASES AND AFFECTING PEOPLE 966 00:40:34,600 --> 00:40:36,600 WITH THESE DISEASES SHOULD BE 967 00:40:36,600 --> 00:40:37,920 INVOLVED WITH THE DISTRIBUTION 968 00:40:37,920 --> 00:40:43,000 OF THE NOVEL VACCINES. 969 00:40:43,000 --> 00:40:53,360 FOURTH POINT, IG AND 970 00:41:02,320 --> 00:41:02,760 INTELLECTUAL PROPERTY. 971 00:41:02,760 --> 00:41:04,520 THEY WERE TALKING ABOUT GETTING 972 00:41:04,520 --> 00:41:08,840 RID OF THE PATENTS AND IP 973 00:41:08,840 --> 00:41:09,960 PROTECTIONS SO COUNTRIES CAN 974 00:41:09,960 --> 00:41:10,400 PRODUCE THIS. 975 00:41:10,400 --> 00:41:20,920 AS WE ALL KNOW, IT WAS NOT IP 976 00:41:34,920 --> 00:41:36,800 THE REAL BARRIER WAS KNOW-HOW. 977 00:41:36,800 --> 00:41:43,920 THERE WERE OVER 200 DIFFERENT 978 00:41:43,920 --> 00:41:45,960 INPUTS NEEDED FOR THE RNA 979 00:41:45,960 --> 00:41:48,240 VACCINES AND MAKE THEM 980 00:41:48,240 --> 00:41:48,720 SUCCESSFUL. 981 00:41:48,720 --> 00:41:52,080 THAT KNOW-HOW WAS MORE VALUABLE 982 00:41:52,080 --> 00:41:53,360 THAN ANY IP IN THE PROCESS. 983 00:41:53,360 --> 00:41:56,040 IT WAS THE KNOW-HOW THAT WAS 984 00:41:56,040 --> 00:42:00,920 MAINLY THE BARRIER AND THE MAIN 985 00:42:00,920 --> 00:42:02,000 BARRIER IN THE CASE OF THE 986 00:42:02,000 --> 00:42:03,880 KNOW-HOW IS THE FACT THERE 987 00:42:03,880 --> 00:42:04,880 WEREN'T THAT MANY PEOPLE 988 00:42:04,880 --> 00:42:06,240 AVAILABLE TO BOTH KEEP 989 00:42:06,240 --> 00:42:08,720 PRODUCTION UP AND DISTRIBUTE AND 990 00:42:08,720 --> 00:42:13,040 LAUNCH PRODUCTION IN MULTIPLE 991 00:42:13,040 --> 00:42:15,600 SITES AT ONCE. 992 00:42:15,600 --> 00:42:23,040 WE NEED TO KEEP THINKING IP IS 993 00:42:23,040 --> 00:42:25,040 NOT THE ONLY LIMIT IN THE 994 00:42:25,040 --> 00:42:26,440 PRODUCTION OF NOVEL TECHNOLOGIES 995 00:42:26,440 --> 00:42:27,440 IT'S ALSO KNOW-HOW. 996 00:42:27,440 --> 00:42:31,800 FIFTH POINT, LET ME HIGHLIGHT 997 00:42:31,800 --> 00:42:36,960 SOMETHING -- TWO THINGS WHICH I 998 00:42:36,960 --> 00:42:38,720 DON'T THINK GET ENOUGH 999 00:42:38,720 --> 00:42:39,240 ATTENTION. 1000 00:42:39,240 --> 00:42:41,040 WE HAD AVAILABILITY OF VACCINE 1001 00:42:41,040 --> 00:42:46,680 IN DECEMBER 2020. 1002 00:42:46,680 --> 00:42:48,680 THEN WE TOOK 2021 TO DISTRIBUTE 1003 00:42:48,680 --> 00:42:48,840 IT. 1004 00:42:48,840 --> 00:42:50,200 WE DIDN'T HAVE A FAIR 1005 00:42:50,200 --> 00:42:50,640 DISTRIBUTION. 1006 00:42:50,640 --> 00:42:53,040 I CAN SAY THAT PRETTY 1007 00:42:53,040 --> 00:42:55,280 CONFIDENTLY IN THE FIRST SIX 1008 00:42:55,280 --> 00:42:57,400 MONTHS CERTAINLY. 1009 00:42:57,400 --> 00:42:58,480 HIGH-INCOME COUNTRIES MANY OF 1010 00:42:58,480 --> 00:43:01,160 WHOM LIKE THE UNITED STATES WERE 1011 00:43:01,160 --> 00:43:03,840 SUFFERING A SUBSTANTIAL COVID 1012 00:43:03,840 --> 00:43:09,440 BURDEN RECEIVED A 1013 00:43:09,440 --> 00:43:12,840 DISPROPORTIONATE AMOUNT OF 1014 00:43:12,840 --> 00:43:13,880 VACCINE. 1015 00:43:13,880 --> 00:43:15,640 LATTER 2021 THAT EQUALIZED BUT 1016 00:43:15,640 --> 00:43:17,920 IT'S NOT TRUE THE LOW-INCOME 1017 00:43:17,920 --> 00:43:19,720 COUNTRIES HAD A HIGH BURDEN. 1018 00:43:19,720 --> 00:43:23,360 THEY HAD A TINY BURDEN OF COVID 1019 00:43:23,360 --> 00:43:25,360 AND THE BIG BURDEN AND BIG 1020 00:43:25,360 --> 00:43:30,000 UNFAIRNESS AND DISTRIBUTION WAS 1021 00:43:30,000 --> 00:43:32,600 THE LOW MIDDLE-INCOME COUNTRIES 1022 00:43:32,600 --> 00:43:36,840 THAT DID NOT RECEIVE THEIR FAIR 1023 00:43:36,840 --> 00:43:40,760 SHARE GIVEN THEIR BURDEN. 1024 00:43:40,760 --> 00:43:45,200 COUNTRIES LIKE PERU HAD DEATHS 1025 00:43:45,200 --> 00:43:46,280 AND NOT SUFFICIENT SUPPLY. 1026 00:43:46,280 --> 00:43:48,800 BY THE SECOND HALF OF 2021 THE 1027 00:43:48,800 --> 00:43:50,120 PROBLEM WAS NOT SUPPLY, THE 1028 00:43:50,120 --> 00:44:00,440 PROBLEM WAS DEMAND. 1029 00:44:05,800 --> 00:44:07,600 AND GOVERNMENT OFFICIALS AND THE 1030 00:44:07,600 --> 00:44:11,280 EDUCATED AND BUSINESS LEADERS 1031 00:44:11,280 --> 00:44:13,040 TOOK UP A VACCINE THE REST OF 1032 00:44:13,040 --> 00:44:14,320 THE POPULATION DIDN'T SEE A NEED 1033 00:44:14,320 --> 00:44:15,080 FOR A VACCINE. 1034 00:44:15,080 --> 00:44:18,040 DIDN'T WANT TO TAKE A VACCINE 1035 00:44:18,040 --> 00:44:19,760 THOUGH IT WAS NO-COST AND THERE 1036 00:44:19,760 --> 00:44:20,360 WAS PLENTY OF VACCINE TO GO 1037 00:44:20,360 --> 00:44:27,640 AROUND. 1038 00:44:27,640 --> 00:44:29,680 I BIG PROBLEM WAS DEMAND AND 1039 00:44:29,680 --> 00:44:33,040 THERE'S NO SUGAR COATING THE 1040 00:44:33,040 --> 00:44:37,280 FACT BY Q3 OF 2021 AND Q4 OF 1041 00:44:37,280 --> 00:44:40,200 2021 THE BIG PROBLEM AND 1042 00:44:40,200 --> 00:44:44,000 CERTAINLY ALL THROUGH 2022 THE 1043 00:44:44,000 --> 00:44:44,560 BIG PROBLEM WAS DEMAND NOT 1044 00:44:44,560 --> 00:44:49,280 SUPPLY. 1045 00:44:49,280 --> 00:44:52,880 WE HAVE SEEN THIS IN 2022 BUT 1046 00:44:52,880 --> 00:44:54,120 SAW THIS IN MANY PARTS OF THE 1047 00:44:54,120 --> 00:44:54,680 WORLD. 1048 00:44:54,680 --> 00:44:57,040 SECOND PART IS WE SHOULD BE 1049 00:44:57,040 --> 00:45:01,960 CLEAR ABOUT VACCINE NATIONALISM. 1050 00:45:01,960 --> 00:45:03,800 ALL CREDIT TO MARIA AND HER 1051 00:45:03,800 --> 00:45:05,520 GROUP FOR PUTTING PRODUCTION IN 1052 00:45:05,520 --> 00:45:05,760 INDIA. 1053 00:45:05,760 --> 00:45:09,840 BUT LET'S BE CLEAR, INDIA 1054 00:45:09,840 --> 00:45:11,200 EXERCISED VACCINE NATIONALISM 1055 00:45:11,200 --> 00:45:11,480 VERY MUCH. 1056 00:45:11,480 --> 00:45:17,640 WHEN THEY HAD THE CRISIS WITH 1057 00:45:17,640 --> 00:45:20,640 DELTA WHAT DID THEY DO, NO MORE 1058 00:45:20,640 --> 00:45:21,600 EXPORTS TO VACCINES IN THE WORLD 1059 00:45:21,600 --> 00:45:31,960 IT'S STAYING IN INDIA. 1060 00:45:38,760 --> 00:45:44,000 AND MANY ARE GOING TO 1061 00:45:44,000 --> 00:45:49,040 NATIONALIZE VACCINES AND THAT 1062 00:45:49,040 --> 00:45:53,040 REQUIRES OUTLINE FROM PROBABLY 1063 00:45:53,040 --> 00:46:03,520 OTHER PLACES AROUND THE WORLD. 1064 00:46:14,000 --> 00:46:17,040 AND I THINK PEOPLE TALK ABOUT 1065 00:46:17,040 --> 00:46:25,040 VACCINE NATIONALISM IN AMERICA 1066 00:46:25,040 --> 00:46:35,520 AND JUST REMEMBER PEOPLE IN 1067 00:46:37,120 --> 00:46:42,560 INDIA AND IN THE ABSENCE OF 1068 00:46:42,560 --> 00:46:44,000 WORLD GOVERNMENT THE BEST WAY 1069 00:46:44,000 --> 00:46:45,520 FOR CITIZENS TO GET THEIR MEANS 1070 00:46:45,520 --> 00:46:47,160 MET IS GOING TO BE NATIONAL 1071 00:46:47,160 --> 00:46:48,120 GOVERNMENT AND THEREFORE THE 1072 00:46:48,120 --> 00:46:48,960 NATIONAL GOVERNMENT IS 1073 00:46:48,960 --> 00:46:52,840 ACCOUNTABLE TO THEIR CITIZENS 1074 00:46:52,840 --> 00:46:54,240 AND SO ALMOST INEVITABLY ANY 1075 00:46:54,240 --> 00:46:56,240 NATIONAL GOVERNMENT IS GOING TO 1076 00:46:56,240 --> 00:46:57,480 NATIONALIZE THEIR VACCINE 1077 00:46:57,480 --> 00:47:01,040 PRODUCTION AND THEREFORE WE NEED 1078 00:47:01,040 --> 00:47:02,360 MULTIPLE VACCINES. 1079 00:47:02,360 --> 00:47:04,280 BUT WE SHOULD BE -- AND THIS IS 1080 00:47:04,280 --> 00:47:09,040 MY FINAL POINT, VERY VERY AWARE 1081 00:47:09,040 --> 00:47:12,120 THAT PRODUCTION IN LOW AND 1082 00:47:12,120 --> 00:47:13,480 MIDDLE INCOME COUNTRY IS NOT A 1083 00:47:13,480 --> 00:47:14,920 GUARANTEE OF DISTRIBUTION. 1084 00:47:14,920 --> 00:47:18,160 AS I MENTIONED, VACCINE 1085 00:47:18,160 --> 00:47:19,440 NATIONALISM IS ONE PROBLEM WE 1086 00:47:19,440 --> 00:47:20,760 SAW WITH INDIA. 1087 00:47:20,760 --> 00:47:24,680 I WOULD ALSO MENTION WAY BACK 1088 00:47:24,680 --> 00:47:27,320 WHEN DURING INFLUENZA WE SAW 1089 00:47:27,320 --> 00:47:29,640 SOME NATIONALISM ON THE PART OF 1090 00:47:29,640 --> 00:47:32,280 INDONESIA BY HOLDING ON TO 1091 00:47:32,280 --> 00:47:36,480 SAMPLES OF THE FLU THAT WAS 1092 00:47:36,480 --> 00:47:39,840 CIRCULATING BECAUSE THEY WANT 1093 00:47:39,840 --> 00:47:41,040 CONSIDERATION FOR THEIR OWN 1094 00:47:41,040 --> 00:47:42,240 POPULATION. 1095 00:47:42,240 --> 00:47:44,040 THIS KIND OF NATIONAL INSTINCT 1096 00:47:44,040 --> 00:47:50,000 IS GOING TO BE INEVITABLE. 1097 00:47:50,000 --> 00:47:52,080 THE FINAL POINT I'D MAKE IN 1098 00:47:52,080 --> 00:47:56,040 THINKING ABOUT SUSTAINABILITY 1099 00:47:56,040 --> 00:47:58,240 AND GOING FORWARD IT STRIKES ME 1100 00:47:58,240 --> 00:47:59,400 WITH YOU SHOULD NOT DRIVE FIRST 1101 00:47:59,400 --> 00:48:01,000 TO THE MOST HIGH TECH PRODUCTION 1102 00:48:01,000 --> 00:48:02,400 IN ALL OF THESE COUNTRIES. 1103 00:48:02,400 --> 00:48:08,600 HERE I DO WANT TO COMMEND MARIA 1104 00:48:08,600 --> 00:48:14,280 AND HER COLLEAGUES THAT THINKING 1105 00:48:14,280 --> 00:48:20,040 ABOUT TRIED AND TRUE PRODUCING 1106 00:48:20,040 --> 00:48:24,080 VACCINE AND EMBARKING ON mRNA 1107 00:48:24,080 --> 00:48:26,480 VACCINES AND THE KNOW-HOW AND 1108 00:48:26,480 --> 00:48:30,760 EXPERTISE AND CHALLENGES AS THE 1109 00:48:30,760 --> 00:48:33,040 FIRST APPROACH IS NOT A GOOD 1110 00:48:33,040 --> 00:48:37,040 IDEA IN MY HUMBLE OPINION. 1111 00:48:37,040 --> 00:48:38,800 IT'S NOT. 1112 00:48:38,800 --> 00:48:41,360 UNTIL THAT'S MORE TREME LINED 1113 00:48:41,360 --> 00:48:43,080 AND HAVE MORE EXPERTISE THAT CAN 1114 00:48:43,080 --> 00:48:44,040 ADDRESS THIS IT'S NOT THE PLACE 1115 00:48:44,040 --> 00:48:46,480 I WOULD GO. 1116 00:48:46,480 --> 00:48:49,520 LET ME CONCLUDE WITH 1117 00:48:49,520 --> 00:48:50,720 REEMPHASIZING THE THREE 1118 00:48:50,720 --> 00:48:56,840 PRINCIPLES IN CASES LIKE THE ONE 1119 00:48:56,840 --> 00:48:58,400 MARIA RAISES ABOUT THE NEGLECTED 1120 00:48:58,400 --> 00:48:59,800 TROPICAL DISEASE AND FOR 1121 00:48:59,800 --> 00:49:04,160 DISEASES WHERE THE COST AND THE 1122 00:49:04,160 --> 00:49:06,520 BENEFITS MAY NOT BE AS HIGH. 1123 00:49:06,520 --> 00:49:07,920 WE WANT TO OMENT MISVACCINE 1124 00:49:07,920 --> 00:49:08,440 PRODUCTION. 1125 00:49:08,440 --> 00:49:10,600 WE WANT TO HAVE A FAIR 1126 00:49:10,600 --> 00:49:13,120 DISTRIBUTION WHERE IT'S NOT A 1127 00:49:13,120 --> 00:49:14,840 DISTRIBUTION BASED ON POLICY OR 1128 00:49:14,840 --> 00:49:19,120 POPULATION BUT A DISTRIBUTION 1129 00:49:19,120 --> 00:49:21,360 BASED ON HEALTH NEED AND WE WANT 1130 00:49:21,360 --> 00:49:24,000 A SUSTAINABLE PRODUCTION 1131 00:49:24,000 --> 00:49:25,640 ARRANGEMENT WITH THE RIGHT 1132 00:49:25,640 --> 00:49:27,320 INCENTIVES SO THE PEOPLE WITH 1133 00:49:27,320 --> 00:49:30,480 THE SKILLS WILL NOT JUST FOR THE 1134 00:49:30,480 --> 00:49:32,880 MOMENT OR FOR THE NEXT YEAR BUT 1135 00:49:32,880 --> 00:49:36,480 FOR THE NEXT 20, 30 YEARS WILL 1136 00:49:36,480 --> 00:49:38,960 BE ENGAGED IN DEVELOPING 1137 00:49:38,960 --> 00:49:41,040 PRODUCTS AND MAKING PRODUCTS AND 1138 00:49:41,040 --> 00:49:42,520 DISTRIBUTING PRODUCTS THAT ARE 1139 00:49:42,520 --> 00:49:44,040 GOING TO BRING UP THE HEALTH OF 1140 00:49:44,040 --> 00:49:45,760 THE WORLD. 1141 00:49:45,760 --> 00:49:46,360 THANK YOU VERY MUCH. 1142 00:49:46,360 --> 00:49:49,200 I LOOK FORWARD TO YOUR 1143 00:49:49,200 --> 00:49:56,200 QUESTIONS. 1144 00:49:56,200 --> 00:49:59,120 >>A QUICK REMINDER THERE'S CME 1145 00:49:59,120 --> 00:50:02,000 CREDIT. 1146 00:50:02,000 --> 00:50:05,760 TO GET IT TEXT THE LINE AND IT'S 1147 00:50:05,760 --> 00:50:09,880 44542 AND TO ASK QUESTIONS, LOOK 1148 00:50:09,880 --> 00:50:13,040 FOR THE LIVE FEEDBACK BUTTON ON 1149 00:50:13,040 --> 00:50:23,440 THE VIDEOCAST WEBSITE. 1150 00:50:34,360 --> 00:50:36,240 YOU'RE SAYING IF WE GET THE 1151 00:50:36,240 --> 00:50:38,040 FACILITIES IN FOUR OR FIVE 1152 00:50:38,040 --> 00:50:39,800 COUNTRIES TO THE EXTENT THERE'S 1153 00:50:39,800 --> 00:50:41,360 NATIONALISM GOING ON WE HAVE TO 1154 00:50:41,360 --> 00:50:44,000 HAVE THE FACTORIES I ASSUME IN 1155 00:50:44,000 --> 00:50:49,080 SOME COUNTRIES AND HAVE NO IDEA 1156 00:50:49,080 --> 00:50:49,760 WHERE THE NEXT PANDEMIC WILL BE 1157 00:50:49,760 --> 00:50:55,640 AND NOT BE. 1158 00:50:55,640 --> 00:51:05,760 >>YES. 1159 00:51:12,560 --> 00:51:13,480 THIS IS FOR THE PARTICULAR 1160 00:51:13,480 --> 00:51:15,720 DISEASE NOT BASED ON THE 1161 00:51:15,720 --> 00:51:16,200 POPULATION. 1162 00:51:16,200 --> 00:51:17,920 CONTINUING TO CIRCULATE GRAPHICS 1163 00:51:17,920 --> 00:51:22,280 LIKE MARIA SHOWED PUBLISHED IN 1164 00:51:22,280 --> 00:51:24,000 THE NEW ENGLAND JOURNAL I THINK 1165 00:51:24,000 --> 00:51:26,160 SEPTEMBER SHOWING POPULATION AND 1166 00:51:26,160 --> 00:51:31,400 VACCINE DISTRIBUTION DISTORTS 1167 00:51:31,400 --> 00:51:41,960 THE POINT IN THE END WE SHOWED 1168 00:51:50,360 --> 00:51:51,200 IT WAS NOT JUSTIFIABLE. 1169 00:51:51,200 --> 00:51:53,320 YOU HAVE TO HAVE A DISEASE 1170 00:51:53,320 --> 00:51:54,600 BURDEN BASED DISTRIBUTION 1171 00:51:54,600 --> 00:51:54,880 METHOD. 1172 00:51:54,880 --> 00:51:59,840 RECOGNIZING THAT PRINCIPLE IS 1173 00:51:59,840 --> 00:52:01,600 FIRST AND FOREMOST. 1174 00:52:01,600 --> 00:52:03,800 SO HE WE DON'T SEND VACCINES TO 1175 00:52:03,800 --> 00:52:04,920 COUNTRIES THAT DON'T HAVE A HIGH 1176 00:52:04,920 --> 00:52:06,680 DISEASE BURDEN LIKE GHANA DURING 1177 00:52:06,680 --> 00:52:08,520 THE PANDEMIC INSTEAD OF SENDING 1178 00:52:08,520 --> 00:52:09,320 ENOUGH VACCINE TO PERU. 1179 00:52:09,320 --> 00:52:11,920 THE SECOND THING WE HAVE TO DO 1180 00:52:11,920 --> 00:52:16,960 IS BEFORE THE NEXT PANDEMIC GET 1181 00:52:16,960 --> 00:52:18,520 A BETTER ORGANIZATION THAN WE 1182 00:52:18,520 --> 00:52:21,440 HAD IN COVAX WHICH HAD MULTIPLE 1183 00:52:21,440 --> 00:52:22,720 MISTAKES AND ESTABLISH SO WE 1184 00:52:22,720 --> 00:52:26,760 HAVE A DISTRIBUTION OF VACCINE 1185 00:52:26,760 --> 00:52:30,320 AROUND THE WORLD IN A FAIR 1186 00:52:30,320 --> 00:52:32,120 PROCESS AND MAKE IT FAIR. 1187 00:52:32,120 --> 00:52:35,480 THE THIRD POINT I WOULD SAY IS, 1188 00:52:35,480 --> 00:52:39,400 LOOK, IN THE NEXT FEW YEARS WE 1189 00:52:39,400 --> 00:52:41,760 HAVE TO ESTABLISH A PRODUCTION 1190 00:52:41,760 --> 00:52:42,880 FACILITY AROUND THE WORLD. 1191 00:52:42,880 --> 00:52:44,240 WE DON'T KNOW WHAT THE BEST 1192 00:52:44,240 --> 00:52:47,640 VACCINE IS GOING TO BE, RIGHT? 1193 00:52:47,640 --> 00:52:49,960 IF WE HAD BEEN PRESENT SAY 2017 1194 00:52:49,960 --> 00:52:51,760 PLANNING FOR A PANDEMIC AND 1195 00:52:51,760 --> 00:52:52,600 SAYING ALL RIGHT WE'RE GOING TO 1196 00:52:52,600 --> 00:52:53,680 PLAN FOR A PANDEMIC. 1197 00:52:53,680 --> 00:52:57,040 WE WOULD NOT HAVE PLANNED FOR 1198 00:52:57,040 --> 00:52:59,400 mRNA PRODUCTION FACILITIES 1199 00:52:59,400 --> 00:52:59,680 ANYWHERE. 1200 00:52:59,680 --> 00:53:02,200 IT JUST WASN'T ON THE MAP. 1201 00:53:02,200 --> 00:53:03,000 WE DON'T KNOW. 1202 00:53:03,000 --> 00:53:06,320 WE CAN DO OUR BEST JOB AND WE 1203 00:53:06,320 --> 00:53:08,040 SHOULD DO THAT VERY EFFICIENTLY 1204 00:53:08,040 --> 00:53:11,400 AND EFFECTIVELY. 1205 00:53:11,400 --> 00:53:17,640 IT MAY NOT BE THAT WE DISTRIBUTE 1206 00:53:17,640 --> 00:53:19,320 mRNA VACCINATION IN 30 1207 00:53:19,320 --> 00:53:19,600 COUNTRIES. 1208 00:53:19,600 --> 00:53:24,960 WE PROBABLY HAVE TO DO IT SO 1209 00:53:24,960 --> 00:53:26,040 EVERY FACTORY OPERATES AT ITS 1210 00:53:26,040 --> 00:53:29,880 PEAK EFFICIENCY AND WE NEED TO 1211 00:53:29,880 --> 00:53:31,280 ENSURE THAT THOSE FACILITIES 1212 00:53:31,280 --> 00:53:32,800 WILL CONTRIBUTE NOT JUST TO THE 1213 00:53:32,800 --> 00:53:34,800 COUNTRY THEY'RE IN BUT TO A 1214 00:53:34,800 --> 00:53:36,160 GLOBAL POOL. 1215 00:53:36,160 --> 00:53:37,760 I THINK GETTING THAT AGREEMENT, 1216 00:53:37,760 --> 00:53:40,640 YES, WE UNDERSTAND THE DRIVE FOR 1217 00:53:40,640 --> 00:53:42,200 NATIONALIZATION OF VACCINE BUT 1218 00:53:42,200 --> 00:53:43,680 THERE'S A LIMIT TO THAT AND SOME 1219 00:53:43,680 --> 00:53:46,320 OF MY WRITINGS WE'VE EXPRESSED 1220 00:53:46,320 --> 00:53:52,920 AND CLEARLY DEFINED THE LIMIT TO 1221 00:53:52,920 --> 00:53:53,440 THAT. 1222 00:53:53,440 --> 00:53:57,280 THEREFORE WE NEED TO MAKE SURE 1223 00:53:57,280 --> 00:53:58,800 ABOVE THAT LIMIT COUNTRIES 1224 00:53:58,800 --> 00:53:59,480 CONTRIBUTE TO THE COMMON POOL 1225 00:53:59,480 --> 00:54:00,840 THAT GETS REDISTRIBUTED AROUND 1226 00:54:00,840 --> 00:54:02,600 THE WORLD. 1227 00:54:02,600 --> 00:54:06,360 I THINK THAT'S THE KEY APPROACH 1228 00:54:06,360 --> 00:54:08,760 AND THAT BEGINS WITH HAVING THE 1229 00:54:08,760 --> 00:54:10,520 RIGHT ETHICAL PRINCIPLES BECAUSE 1230 00:54:10,520 --> 00:54:12,200 WE SAW IN COVID WE HAD THE WRONG 1231 00:54:12,200 --> 00:54:15,360 ETHICAL PRINCIPLES AND TO KEEP 1232 00:54:15,360 --> 00:54:17,040 EVALUATING THE COVID 1233 00:54:17,040 --> 00:54:17,920 DISTRIBUTION ON THE BASIS OF THE 1234 00:54:17,920 --> 00:54:22,360 WRONG ETHICAL PRINCIPLES 1235 00:54:22,360 --> 00:54:25,360 DISTORTS THE EVALUATION AND 1236 00:54:25,360 --> 00:54:27,000 DISTORTS OUR JUDGMENT ABOUT WHAT 1237 00:54:27,000 --> 00:54:27,320 WE NEED. 1238 00:54:27,320 --> 00:54:28,880 I HOPE I ANSWERED THE QUESTION. 1239 00:54:28,880 --> 00:54:32,360 >>CAN YOU SAY MORE ABOUT THE 1240 00:54:32,360 --> 00:54:35,560 GLOBAL POOL SOUNDS INTERESTING. 1241 00:54:35,560 --> 00:54:37,080 HOW'S THAT WORK. 1242 00:54:37,080 --> 00:54:40,400 DO SOMEONE OVERSEE IT OR DO 1243 00:54:40,400 --> 00:54:41,800 COUNTRIES OVERSEE IT? 1244 00:54:41,800 --> 00:54:43,400 >>OF COURSE SOMEONE HAS TO 1245 00:54:43,400 --> 00:54:48,040 OVERSEE IT. 1246 00:54:48,040 --> 00:54:51,640 ONE OF OR PROBLEMS IS I THINK 1247 00:54:51,640 --> 00:54:54,680 THE W.H.O. AND OTHERS IN 1248 00:54:54,680 --> 00:54:57,040 ESTABLISHING COVAX DID NOT DO A 1249 00:54:57,040 --> 00:54:57,800 GOOD PROCESS. 1250 00:54:57,800 --> 00:55:00,240 THE GOVERNANCE WAS NOT GOOD, 1251 00:55:00,240 --> 00:55:03,080 I'VE WRITTEN ABOUT AND THAT THE 1252 00:55:03,080 --> 00:55:05,040 ETHICAL PRINCIPLES UNDER THE 1253 00:55:05,040 --> 00:55:07,400 DISTRIBUTION WERE NOT FAIR. 1254 00:55:07,400 --> 00:55:10,800 I THINK WE HAVE TO BEGIN BY 1255 00:55:10,800 --> 00:55:12,240 ESTABLISHING NOW A FRAMEWORK -- 1256 00:55:12,240 --> 00:55:14,200 MAYBE IT HAS TO BE OUTSIDE OF 1257 00:55:14,200 --> 00:55:18,080 THE W.H.O. FRAMEWORK KIND OF 1258 00:55:18,080 --> 00:55:19,960 LIKE U.N. AIDS A NEW FRAMEWORK 1259 00:55:19,960 --> 00:55:25,040 TO DISTRIBUTE ACCORDING TO 1260 00:55:25,040 --> 00:55:26,800 ETHICS NOT POPULATION AND PUT IN 1261 00:55:26,800 --> 00:55:28,840 THAT FRAMEWORK CAN WE GUARANTEE 1262 00:55:28,840 --> 00:55:31,080 COUNTRIES WILL PARTICIPATE? 1263 00:55:31,080 --> 00:55:31,320 NO. 1264 00:55:31,320 --> 00:55:32,960 CAN WE BEGIN DOING IT NOW BEFORE 1265 00:55:32,960 --> 00:55:35,560 ANY COUNTRY IS AT THE BOTTOM END 1266 00:55:35,560 --> 00:55:37,760 LIKE UNDER A VEIL OF IGNORANCE, 1267 00:55:37,760 --> 00:55:38,560 BRING IN THE PHARMACEUTICAL 1268 00:55:38,560 --> 00:55:41,200 COMPANIES THAT ARE LIKELY TO 1269 00:55:41,200 --> 00:55:42,240 DRIVE PRODUCTION? 1270 00:55:42,240 --> 00:55:46,240 THAT I THINK WE HAVE TO START 1271 00:55:46,240 --> 00:55:47,600 NOW BEFORE WE'RE FACED WITH THE 1272 00:55:47,600 --> 00:55:49,040 NEXT CRISIS AND PUT IT IN PLACE 1273 00:55:49,040 --> 00:55:53,160 AND OVERCOME SOME OF THE MAJOR 1274 00:55:53,160 --> 00:55:55,520 GOVERNANCE AND ETHICAL BARRIERS 1275 00:55:55,520 --> 00:55:56,720 THAT CONFRONTED COVID. 1276 00:55:56,720 --> 00:55:57,040 >>GREAT. 1277 00:55:57,040 --> 00:56:01,080 >>CAN I MAKE A QUICK COMMENT? 1278 00:56:01,080 --> 00:56:04,720 >>ABSOLUTELY. 1279 00:56:04,720 --> 00:56:07,120 >>I REALLY AGREE WITH YOUR 1280 00:56:07,120 --> 00:56:09,120 ETHICAL PRINCIPLES AND MAY I 1281 00:56:09,120 --> 00:56:12,480 COMMENT ON THE FIRST ETHICAL 1282 00:56:12,480 --> 00:56:13,560 PRINCIPLE WHICH IS THE 1283 00:56:13,560 --> 00:56:15,040 PRODUCTION CONCEPT. 1284 00:56:15,040 --> 00:56:18,680 I THINK THAT MAYBE WE CAN USE 1285 00:56:18,680 --> 00:56:19,760 THE WORD DIVERSIFICATION. 1286 00:56:19,760 --> 00:56:23,040 I THINK WHAT MAYBE WOULD HELP IS 1287 00:56:23,040 --> 00:56:25,840 THAT THE CAPACITY, KNOW 1288 00:56:25,840 --> 00:56:28,120 KNOWLEDGE, THE WORKFORCE THE 1289 00:56:28,120 --> 00:56:29,720 INFRASTRUCTURE HAS TO HAVE A 1290 00:56:29,720 --> 00:56:30,880 GOOD DIVERSIFICATION OF 1291 00:56:30,880 --> 00:56:33,320 TECHNOLOGIES BECAUSE AS YOU 1292 00:56:33,320 --> 00:56:36,680 SAID, RIGHT, SOME FACTORIES WERE 1293 00:56:36,680 --> 00:56:44,400 GOOD FOR ENA VACCINES BUT DON'TW 1294 00:56:44,400 --> 00:56:47,560 HOW TO DO PROTEINS SO 1295 00:56:47,560 --> 00:56:48,200 DIVERSIFICATION OF TECHNOLOGIES 1296 00:56:48,200 --> 00:56:48,960 WILL BE IMPORTANT BECAUSE WE 1297 00:56:48,960 --> 00:56:51,600 DON'T KNOW WHICH ONE WILL WORK. 1298 00:56:51,600 --> 00:56:53,400 THAT ALSO THEN FEEDS INTO THE 1299 00:56:53,400 --> 00:56:56,040 SELECTION OF YOUR ETHICAL 1300 00:56:56,040 --> 00:56:57,880 PRINCIPLE 2 OF WHO ARE THE 1301 00:56:57,880 --> 00:56:58,640 PEOPLE IN NEED. 1302 00:56:58,640 --> 00:57:05,040 MAYBE SOME WORDS FROM YOU, 1303 00:57:05,040 --> 00:57:13,040 DRDR 1304 00:57:13,040 --> 00:57:23,320 DRDR. 1305 00:57:24,920 --> 00:57:28,800 POPULATION THAT IS IN NEED OF 1306 00:57:28,800 --> 00:57:30,840 VACCINE BUT CAN'T SAY WHO THE 1307 00:57:30,840 --> 00:57:33,040 POPULATION IN NEED IS AND ONLY 1308 00:57:33,040 --> 00:57:36,600 THING THEY CAN RELY ON IS PEOPLE 1309 00:57:36,600 --> 00:57:38,240 WHO ARE OLD AND SHOULD GET THE 1310 00:57:38,240 --> 00:57:38,520 PRIORITY. 1311 00:57:38,520 --> 00:57:40,280 I FEEL THAT MAY BE SOMETHING 1312 00:57:40,280 --> 00:57:42,640 THAT I WOULD LIKE TO LEARN MORE 1313 00:57:42,640 --> 00:57:44,920 BECAUSE I AGREE WITH YOU BUT I 1314 00:57:44,920 --> 00:57:48,240 DON'T KNOW THE COUNTRIES WOULD 1315 00:57:48,240 --> 00:57:51,360 BE ABLE TO COME UP WITH 1316 00:57:51,360 --> 00:57:52,400 INFORMATION AND THEN COME WITH 1317 00:57:52,400 --> 00:57:54,760 THE INFORMATION WOULD BE ABLE TO 1318 00:57:54,760 --> 00:57:56,920 THEN MEET THAT REQUIREMENT AND 1319 00:57:56,920 --> 00:58:00,400 RECEIVE THE BENEFIT OF IT AND WE 1320 00:58:00,400 --> 00:58:02,440 WOULD ALWAYS LEAVE PEOPLE 1321 00:58:02,440 --> 00:58:02,640 BEHIND. 1322 00:58:02,640 --> 00:58:05,040 IF YOU COMBINE BOTH OF THEM, I 1323 00:58:05,040 --> 00:58:08,040 TOTALLY AGREE. 1324 00:58:08,040 --> 00:58:10,680 THEN YOU CAN -- 1325 00:58:10,680 --> 00:58:11,880 >>THANK YOU FOR THAT 1326 00:58:11,880 --> 00:58:13,920 CLARIFICATION, MARIA. 1327 00:58:13,920 --> 00:58:15,520 WE NEED TO DISTINGUISH 1328 00:58:15,520 --> 00:58:16,320 DISTRIBUTION INSIDE A COUNTRY 1329 00:58:16,320 --> 00:58:17,040 FROM DISTRIBUTION AROUND THE 1330 00:58:17,040 --> 00:58:21,840 WORLD. 1331 00:58:21,840 --> 00:58:23,960 DISTRIBUTION AMONG COUNTRIES. 1332 00:58:23,960 --> 00:58:25,720 THE BEST ASSESSMENT IS WHAT IS 1333 00:58:25,720 --> 00:58:30,760 THEIR DISEASE BURDEN. 1334 00:58:30,760 --> 00:58:32,000 IN THE CASE OF COVID THE 1335 00:58:32,000 --> 00:58:33,400 ASSESSMENT IS WHAT IS THEIR 1336 00:58:33,400 --> 00:58:33,840 EXCESS STEPS. 1337 00:58:33,840 --> 00:58:37,040 THE W.H.O. COLLECTS DATA ON 1338 00:58:37,040 --> 00:58:39,240 EXCESS DEATHS IN THE COUNTRY 1339 00:58:39,240 --> 00:58:39,960 PRETTY REGULARLY. 1340 00:58:39,960 --> 00:58:41,960 WE CAN DEBATE HOW RELIABLE IT 1341 00:58:41,960 --> 00:58:42,400 IS. 1342 00:58:42,400 --> 00:58:46,800 IT'S A METRIC WE DO USE 1343 00:58:46,800 --> 00:58:47,080 GLOBALLY. 1344 00:58:47,080 --> 00:58:50,040 THAT WAS IN COVID OUR BEST 1345 00:58:50,040 --> 00:58:51,280 ASSESSMENT OF DISEASE BURDEN. 1346 00:58:51,280 --> 00:58:54,600 LOOKING AT COUNTRIES THAT DIDN'T 1347 00:58:54,600 --> 00:58:57,200 HAVE A HIGH EXCESS DEATHS VERSUS 1348 00:58:57,200 --> 00:58:58,720 COUNTRIES THAT HAVE -- THERE'S 1349 00:58:58,720 --> 00:59:00,200 SOME COUNTRIES THAT HAVE 1350 00:59:00,200 --> 00:59:01,800 NEGATIVE EXCESS DEATHS DURING 1351 00:59:01,800 --> 00:59:03,440 COVID THEY DID A LOCKDOWN AND 1352 00:59:03,440 --> 00:59:05,600 OTHER THINGS AND THEY'RE DEATH 1353 00:59:05,600 --> 00:59:06,000 RATE DECLINED. 1354 00:59:06,000 --> 00:59:07,920 YOU HAVE A NUMBER OF 1355 00:59:07,920 --> 00:59:10,000 COUNTRIES -- I CAN'T TELL YOU 1356 00:59:10,000 --> 00:59:11,560 THE EXACT NUMBER SOMETHING LIKE 1357 00:59:11,560 --> 00:59:14,360 3035 THAT ACTUALLY WERE NEGATIVE 1358 00:59:14,360 --> 00:59:15,120 EXCESS DEATHS. 1359 00:59:15,120 --> 00:59:17,320 SO THAT'S A METRIC YOU CAN USE. 1360 00:59:17,320 --> 00:59:19,160 IT'S A METRIC WE HAVE IN PLACE. 1361 00:59:19,160 --> 00:59:22,920 IT'S A METRIC I THINK WHILE NOT 1362 00:59:22,920 --> 00:59:26,040 PERFECT AND THERE'S GOING TO BE 1363 00:59:26,040 --> 00:59:28,440 SOME DELAY IN TIME IS USEFUL. 1364 00:59:28,440 --> 00:59:32,040 ONE OF THE THINGS YOU FIND OUT 1365 00:59:32,040 --> 00:59:36,200 IS EXCESS DEATHS IN A LOT OF 1366 00:59:36,200 --> 00:59:38,040 LOW-INCOME COUNTRIES WAS LOW OR 1367 00:59:38,040 --> 00:59:39,600 EVEN NEGATIVE. 1368 00:59:39,600 --> 00:59:40,760 THAT TELLS YOU THEY PROBABLY 1369 00:59:40,760 --> 00:59:43,320 AREN'T AT THE TOP OF YOUR LIST 1370 00:59:43,320 --> 00:59:44,040 WHEREAS COUNTRIES THAT ARE 1371 00:59:44,040 --> 00:59:46,880 HAVING AN ENORMOUS OUTBREAK AND 1372 00:59:46,880 --> 00:59:49,680 I USE PERU AS AN EXAMPLE, I 1373 00:59:49,680 --> 00:59:51,400 THINK PERU HAD THE SECOND 1374 00:59:51,400 --> 00:59:53,800 HIGHEST EXCESS DEATH RATE DURING 1375 00:59:53,800 --> 00:59:55,920 THE COVID PANDEMIC, I COULD BE 1376 00:59:55,920 --> 01:00:01,040 WRONG ABOUT THAT, IT CERTAINLY 1377 01:00:01,040 --> 01:00:05,720 WAS VERY HIGH UP IN TERMS OF 1378 01:00:05,720 --> 01:00:07,120 COVID BURDEN AND SHOULD HAVE 1379 01:00:07,120 --> 01:00:08,000 GOTTEN MORE VACCINE. 1380 01:00:08,000 --> 01:00:14,040 I CAN SEE NO JUSTIFICATION FOR 1381 01:00:14,040 --> 01:00:21,040 USING POPULATION. 1382 01:00:21,040 --> 01:00:28,440 >>AND SEEMS LIKE WITH PANDEMIC 1383 01:00:28,440 --> 01:00:31,120 THERE'S TWO GENERAL APPROACHES 1384 01:00:31,120 --> 01:00:32,880 AND THIS IS SIMPLISTIC BUT WE 1385 01:00:32,880 --> 01:00:34,320 HAVE TO GET AHEAD AND GET 1386 01:00:34,320 --> 01:00:35,360 MANUFACTURING FACILITIES SET. 1387 01:00:35,360 --> 01:00:37,280 WE HAVE TO BE READY. 1388 01:00:37,280 --> 01:00:39,640 THE SECOND ONE IS THE PANDEMICS 1389 01:00:39,640 --> 01:00:43,920 ARE UNPREDICTABLE DISASTERS. 1390 01:00:43,920 --> 01:00:45,200 AND WE HAVE TO RECOGNIZE THAT 1391 01:00:45,200 --> 01:00:47,080 AND REALIZE THE LIMITATIONS TO 1392 01:00:47,080 --> 01:00:49,040 WHICH WE CAN ANTICIPATE THEM. 1393 01:00:49,040 --> 01:00:51,280 SO WE SHOULDN'T EXPECT THE SAME 1394 01:00:51,280 --> 01:00:53,200 RULES WHICH APPLY IN GENERAL ARE 1395 01:00:53,200 --> 01:00:55,880 GOING TO APPLY IN TERMS OF 1396 01:00:55,880 --> 01:00:57,040 PANDEMICS. 1397 01:00:57,040 --> 01:01:00,080 AS YOU KNOW PHILOSOPHERS LIKE TO 1398 01:01:00,080 --> 01:01:01,480 TALK ABOUT DISASTER SCENARIOS. 1399 01:01:01,480 --> 01:01:03,320 WE HAVE PRINCIPLES THAT APPLY 1400 01:01:03,320 --> 01:01:05,040 AND IN A DISASTER THEY MAY NO 1401 01:01:05,040 --> 01:01:06,800 LONGER APPLY. 1402 01:01:06,800 --> 01:01:07,800 SOME PEOPLE ARE WONDERING 1403 01:01:07,800 --> 01:01:10,360 WHETHER PANDEMICS ARE LIKE THAT 1404 01:01:10,360 --> 01:01:11,560 WITH RESPECT TO THINGS LIKE 1405 01:01:11,560 --> 01:01:13,320 INTELLECTUAL PROPERTY AND HOW WE 1406 01:01:13,320 --> 01:01:15,000 DEVELOP AND DISTRIBUTE 1407 01:01:15,000 --> 01:01:16,080 INTERVENTIONS WHERE, YEAH, 1408 01:01:16,080 --> 01:01:17,680 DURING REGULAR TIMES IT'S A GOOD 1409 01:01:17,680 --> 01:01:21,600 WAY TO GO BUT IN A DISASTER, WE 1410 01:01:21,600 --> 01:01:22,600 SHOULDN'T FOLLOW THEM NECESSARY. 1411 01:01:22,600 --> 01:01:25,360 IS THAT A GOOD IDEA OR BAD? 1412 01:01:25,360 --> 01:01:27,840 >>I DON'T THINK SO. 1413 01:01:27,840 --> 01:01:29,680 PART OF WHAT WE DID IN THINKING 1414 01:01:29,680 --> 01:01:31,400 THROUGH WAS THINKING THROUGH 1415 01:01:31,400 --> 01:01:34,200 DURING A PANDEMIC WHICH IS WHY 1416 01:01:34,200 --> 01:01:36,680 YOU WANT TO OPTIMIZE PRODUCTION. 1417 01:01:36,680 --> 01:01:40,560 YOU WANT SPEED, YOU WANT SCALE 1418 01:01:40,560 --> 01:01:41,480 AND YOU WANT SUSTAINABILITY. 1419 01:01:41,480 --> 01:01:47,360 I THINK ALL OF THOSE ARE FOR AN 1420 01:01:47,360 --> 01:01:48,840 EMERGENCY ABSOLUTELY ESSENTIAL 1421 01:01:48,840 --> 01:01:50,560 AND YOU WANT TO PUSH THERE. 1422 01:01:50,560 --> 01:01:53,040 WE SHOULD NOT LET THE WORLD OFF 1423 01:01:53,040 --> 01:01:57,080 FROM PREPARING FOR A PANDEMIC. 1424 01:01:57,080 --> 01:01:59,960 THEY ARE NOT -- WE CANNOT 1425 01:01:59,960 --> 01:02:00,640 PREDICT THEM. 1426 01:02:00,640 --> 01:02:04,200 WE DO HAVE SOME WAY. 1427 01:02:04,200 --> 01:02:05,800 WE CAN'T PREDICT EXACTLY WHEN 1428 01:02:05,800 --> 01:02:06,720 THEY'LL HAPPEN OR THE SHAPE 1429 01:02:06,720 --> 01:02:08,520 THEY'LL HAPPEN BUT WE CAN 1430 01:02:08,520 --> 01:02:10,200 PREDICT THEY'RE GOING TO HAPPEN 1431 01:02:10,200 --> 01:02:11,840 AND THEREFORE DO NEED TO PREPARE 1432 01:02:11,840 --> 01:02:15,920 AND WE DO NEED TO PUT IN PLACE 1433 01:02:15,920 --> 01:02:17,040 INFRASTRUCTURE, THINK THROUGH 1434 01:02:17,040 --> 01:02:20,080 THE ETHICAL PRINCIPLES. 1435 01:02:20,080 --> 01:02:21,840 BY THE WAY, NOT EVERY PANDEMIC 1436 01:02:21,840 --> 01:02:25,680 IS GOING TO BE THE ELDERLY OR 1437 01:02:25,680 --> 01:02:27,400 PEOPLE WITH IMMUNOCOMPROMISED 1438 01:02:27,400 --> 01:02:30,280 DISEASES ARE LIKELY TO BE WORSE 1439 01:02:30,280 --> 01:02:30,720 HIT. 1440 01:02:30,720 --> 01:02:32,720 IN A FLU PANDEMIC IT VERY WELL 1441 01:02:32,720 --> 01:02:35,360 COULD BE LIKE IN 1918 YOUNG 1442 01:02:35,360 --> 01:02:36,720 PEOPLE WILL BE HIT HARDEST AND 1443 01:02:36,720 --> 01:02:41,040 THEY ARE THE ONES THAT SHOULD 1444 01:02:41,040 --> 01:02:42,920 RECEIVE PRIORITY. 1445 01:02:42,920 --> 01:02:44,720 SO WE NEED TO HAVE THE RIGHT 1446 01:02:44,720 --> 01:02:46,320 PRINCIPLES TO IDENTIFY THE RIGHT 1447 01:02:46,320 --> 01:02:47,920 GROUPS TO GO TO THE TOP OF THE 1448 01:02:47,920 --> 01:02:48,320 PRIORITY LIST. 1449 01:02:48,320 --> 01:02:53,040 BUT THE IDEA THAT WE CAN'T PLAN 1450 01:02:53,040 --> 01:02:56,800 IS A TERRIBLE IDEA AND LETS OUR 1451 01:02:56,800 --> 01:02:59,160 POLICY MAKERS OFF TOO EASILY. 1452 01:02:59,160 --> 01:03:01,040 NOW, THERE'S MANY THINGS WE 1453 01:03:01,040 --> 01:03:03,720 CAN'T PREDICT EXACTLY HOW BAD IT 1454 01:03:03,720 --> 01:03:05,040 WILL BE AND WHETHER IT WILL 1455 01:03:05,040 --> 01:03:07,800 FIZZLE OUT, ALL OF THINGS BUT 1456 01:03:07,800 --> 01:03:09,120 DOESN'T MEAN WE SHOULDN'T 1457 01:03:09,120 --> 01:03:09,960 ANTICIPATE THE PROBLEMS. 1458 01:03:09,960 --> 01:03:10,240 THANK YOU. 1459 01:03:10,240 --> 01:03:10,920 >>THANK YOU. 1460 01:03:10,920 --> 01:03:12,680 I WANT TO APOLOGIZE TO ALL THE 1461 01:03:12,680 --> 01:03:13,120 GOOD QUESTIONS. 1462 01:03:13,120 --> 01:03:15,000 I'LL TRY TO RESPOND TO SOME I 1463 01:03:15,000 --> 01:03:16,800 DIDN'T HAVE TIME TO GET TO. 1464 01:03:16,800 --> 01:03:19,280 AND I LOOK FORWARD TO SEEING 1465 01:03:19,280 --> 01:03:20,600 PEOPLE AGAIN THE FIRST WEDNESDAY 1466 01:03:20,600 --> 01:03:21,360 IN APRIL. 1467 01:03:21,360 --> 01:03:23,160 IN THE MEANTIME, THANKS VERY 1468 01:03:23,160 --> 01:03:25,560 MUCH TO MARIA AND ZEKE FOR A 1469 01:03:25,560 --> 01:03:25,960 FABULOUS SESSION. 1470 01:03:25,960 --> 01:03:28,080 WE REALLY APPRECIATE YOUR 1471 01:03:28,080 --> 01:03:28,400 PARTICIPATION. 1472 01:03:28,400 --> 00:00:00,000 THANKS, EVERYBODY.