Transcripts For CSPAN2 Council On Foreign Relations Discussi

Theres efforts to wrap it up. It will not get there when we first have first doses of vaccines. So the real issue is if that is locked up in advance which currently it is being still locked up by wealthy nations, the multilateral initiated by the time it gets the resources to compete will not have so the challenge we have is most of the vaccine manufacturing in these advanced purchasing agreement are in these large and merrily wealthy nations but not exclusively you if they are willing to play ball in sharon early doses the rest of the world will wake potentially months or a year or longer to receive the vaccine they need to protect their Health Workers and most vulnerable populations and that will leave a legacy that isnt just about thishad. It will undermine Global Cooperation on a host of other issues. If we cant cooperate in this situation on it sharing a vaccine, what hope do we have to cooperate on climate change, what hope do we have on otherproblems and with that ill stop and let sylvia talk about the other aspect. I think that the transition to the rule about philanthropy and how do we make sure we get the most of that in terms of the private sector entities in philanthropy and now the bill and Melinda Gates foundation is engaged in ensuring that Vaccine Access can occur in the developingworld , but its a part of what theyre doing things when one things about philanthropic organizations is spread across a number of different elements of fighting a pandemic. When one talks about the conditions of the previous questioner in terms of Global Health , when the people up, when we found there were cases ofevil law in nigeria it was one of the darkest days for me. Knowing the density and the challenges that one would face in a country as populous as nigeria, also with an economic anchoring it does in west africa and however, what happened was they were able to control it and they control it on the back of the polio work that had been done to cause basic Public Health, things have been put in place that what they used to do the context raising, to do the other things that what happened was they control those things were investments. The Gates Foundation had io invested in polio in nigeria in terms of trying to wipe out polio for many years and so everything from the vaccines and the scientific, the Gates Foundation and others have invested in this reduction of those vaccines and their therapeutics and parts of the science that were using, philanthropy does that. Places like the nih does that and i think your question of how you bring it all together is an important one. One of the things that asthe who moves forward as he said , there were things that were challenging and things that they did right. One of the places the who needs to continue to improve his the willingness to think about partners that are broader than governments that are those that mainly fund them although philanthropy also contributes, the bill and Melinda Gates foundation has historically also supported the World Health Organization and making sure it does have capacity to do things so i think what we need is we need places where those conversations can occur with the private sector, with philanthropy and with governments at the table important issues from vaccine. We seem to have lostsylvia for a moment. Lets while we wait to get her back lets go to the next question. Our next question will be from brad. Thank you and i should maybe note that im with the Gates Foundation but my question was about financing and i was curious to hear your perspective on Public Financing and while i havent had a chance to read the full report i appreciate knowing that covid19 has highlighted this is more than a Health Crisis and requires more than Traditional Health sources particularly globally looking at how we can move pandemics possibly to an overseas Development Issue and how we can mobilize those resources globally and domestically. To be able to support what is truly Holistic Society and i would just want to hear about how you think we can do that more effectively. Who wants to take this one . Im happy to. In terms of a number of different places in ways that we think about the public pfinancing of the effort in the preparedness, i think what fran has said earlier and others have said is it is the importance part of taking this to the level of it is a National Securityissue. Its a National Economic security issue and the resources we put against those things on a regular basis, we need to as a federal government but those resources against those. The same thing needs to occur at the state and local level. We know the spending on Public Health and gone down to a place where most of the funding all comes from the federal government and even that money has been reduced over period of time in terms of the priority one of the things we need to do is we need to have a system that is funded at the federal eelevel but also state and local communities need to because whats different in terms of one of the things that difference is we compare these things to defense and National Security in this way. A pandemic is fought at the government level, at the state level, at the local level and we all know as citizens in the middle of this we all need to do our part and i would recommend everyone get their flu shot sas a part of that. But we all have to do our part so as you think about the funding think about it at all those levels and think about the base and the core of whats happening in Public Health and that the health of different communities and that brings us back to some of those disparity issues we were talking about or the issues in an International Scene that the gentleman marks raised the question about the broader Global Health. We had a strong platform of Health Across countries whether its the us or in the developing world. That is the part of the funding when you describe it because you have that ace to build off. Go ahead, i was just going to add some numbers illustrate sylvias already great points. We have never since 1995 and more than one percent of global assistance on pandemic preparedness, just so that people know this. People talk about a cycle of engaging and preparing for a pandemic is consistently on the international level. We have in terms of the support federal government has given states on pandemic preparedness that has gone down on where it was in 2005. Public health departments, local Public Performance cut 86,000 physicians in the years before this pandemic so when we have spent trillions of dollars in responding to this pandemic i think its fair to say that sylvias point about federal government needed to spend more in the space is well demonstrated. Even though we have spent in thepast. That said the report does put inforward some ideas on other sources of financing as well. It does talk about leveraging more International Finance institutions whether its special drawing rights or looking at possibilities of mobilizing innovative resources around the fact that clearly so many of our International Activities are ictied to adequate pandemic preparedness whether that be travel or so for. That might provide this case they provide the momentum to actually mobilizesome of those potential sources of financing as well. If i might just briefly add on just sort of a relative policy of us funding for Global Health in general. Report does note that the 5 million annual budget at the World Health Organization is smaller than the budget of new york presbyterian tahospital and obviously theres a lot of discussion in the Global Development arena about the importance of domestic resource mobilization to make sure International Assistance and external assistance does not crowd out National Resource mobilization when it comes to pandemic responses. That should be on the table. Our next question will come from gregory. Thank you very much and thanks for a great conversation. I wanted to ask about Early Warning, it struck me there are lots of groups and people including me have said for generations now pandemics were one of two existential threats out there, the other being climate change. We had each one and one, we had sars we still didnt have good warning in this case. As i read the record the first warning sign was done by promed, and ngo at the end of december area that was probably two months after we should have noticed him thing happening in china so my question is do you all suggest major changes in the way cdc works, the way the National Security council approaches these issues, the way the Intelligence Community works for the way all of those interact with the private sector . Thank you. Tom. I can start and then fran may have some views on this too so ill quickly say that on this issue as we talked about before, there does need to be other sources of surveillance anthat can bolster the system other than nations self reporting. It is unfortunate that when we went through a revision of International Health organizations to address a past episode in which china was late inreporting and not sharing information to have that happen again. We dont need to make that mistake twice. That said, i do want to be clear here. The who did declare an International Healthemergency on january 30. Every nation from that point on felt was not the same hand in many nations dealt with it better. So surveillance can help, Early Warning can help and im looking forward to leveraging the private sector in that regard but we also do want to recognize that the fundamental failings for most nations particularly in the west was they didnt respond in the same way to the information that wasavailable to everyone else and not just a matter of reporting. Ill pick up on toms comment. I do think that there is too gregory , there are multiple layers of responsibility in terms of earlymorning. We need a global Surveillance System that more effectively sort of hold that information together and makes, the docs into a picture so we understand whats happening . Absolutely. The private sector has a role there because the extended supply chain, we saw the vulnerability of that. But the private sector can see that beginning because they are responsible largely for the movement of goods and have having the supply chain and then gregory asked the question of the Intelligence Community, every year the National Security council, you set what are the intelligence priorities and requirements. Nationally this has never been on high up on the list. It just hasnt been and when you see the Economic Impacts that weve suffered as a result of covid you realize thats the argument for why surveillance has to be there in high, much higher than it has been historically on the list of intelligence priorities for the us Intelligence Community because there really by and large the ones who will trigger the policy community to begin to think about whats in response will look like. Our next question will come from patricia rosen. Ms. Rosenfield, you canunmute your microphone. Thank you very much for this important and timely report. I wanted to pick up on sylvia , just almost as a throwaway point so that you mentioned it is in participation and getting a vaccine, a flu vaccine. Im wondering about individual and Civic Responsibility as one of the links and how youre addressing that and go especially with the future pandemic because it seems to me as you mentioned foundations are working at Different Levels but theres also a Civic Responsibility and democracy but we have in new york state for instance where theres good leadership communication and a strong Public Health situation we have people who kill other people or asking them to wear a mask. It just happened the otherday. How do you Public Health understanding and perspective in an individuals who feel that their rights are being abrogated if theyre asked to wear a mask or take a vaccine or get a vaccine and its not only in the United States happening in other countries as well but it seems to me this is aweak link that requires some additional attention. That basic clarity of communication about those things and that those are simple things. I think in our country we do a number of things that are about our health and communicating from a science perspective and a factual base perspective. I think if you think about the number of deaths that we have had and as we are inching closer to the number of deaths caused by cancer and a number of years and if you communicated clearly to most of the u. S. Population that you might be able to not die of cancer this year and ifea you took these steps, it is about basic Public Health communication and connecting the actions with the outcome and making sure that people have the information and that information is clearar. In pandemic situations and epidemic situations communication clarity and this was one of our largest learnings in ebola as we did the studys afterword that important of clarity of commute occasion that is factbasedmm and gets to the public because they do play a role as you are indicating is more important than ever and also important, not just because of the role but because in pandemics the information evolves and we learn and these are different and new in the science and we are learning every day more about transmission and we now know almost 40 of the cases are a symptomatic and retransmitted. Doesnt that tell you about how you should think about your behavior because you could be doing something unintentional. That clarity of communication is both about that role of all levels of our nation but is also about the fact that things evolve and so clarity becomes very important in a world where things evolve and there is uncertainty. I dont know we have time for another question but briefly to that point what do you do in a world where there are disinformation. Actual actors trying to muddy the waters of what could be communication. Sylvia. Look, you know we are suffering in the election and wt did in 2016 and we know that russia, china and iran are trying to influence operations during the current president ial election and this is a we struggled with this in many contexts. This is no different. Part of this and speaking personally i absolutely believe there is an education component that goes back to Early Childhood education and teaching children to be critical readers and thinkers that its much harder the older we get and the harder it isnk to learn new tris but we ought to be scriptable about everything we read and everything we see in terms of, i think many kids now are relying on social media for their information and we just have to be skeptical of what is motivating those who are writing what they are writing. These would tell you are very sophisticated but what Foreign Intelligence Services are looking to do is look for the existing positions in our society whether that is race, economics, gender and then they drive a wedge taking advantage of these divisions that exist in our society and not creating them. I just think we have to be skeptical consumers of information far more so and more a notice of it now. All right. We will have to ended there and want to thank you so much for joining todays Virtual Meeting and thank you of course to sylvia, francis, tom and stuart for that incredibly important and enlightening report. Please note the audio of todays meeting will be posted on website and have a wonderful afternoon. The competition is on. Be a part of this years cspans student cam video competition. Middle and High School Students be the start of a National Conversation by making a fivesix minute documentary exploring the issues you want the president and congress to address in 2021. Be bold with your documentary, show supporting and opposing points of view include cspan video. Be a winner. It serves 100,000 in total cash prizes including a grand prize of 5000. Deadline to submit video is generate 20, 2021. Be informed of you will find competition rules, tips and more information on how to get started at our website. Book tv on cspan2 has top nonfiction books and authors every weekend. Saturday at 5 00 p. M. Eastern law professor jennifer tell potter book, big dirty money looks at the repercussions average americans face in the rich break the law in order to accumulate more wealth. Then at 11 55 p. M. In his book the spymasters chris talks to former cia director provided inside look at the Intelligence Organization operation and on sunday and 9 00 p. M. Eastern on after words political commentator Health Workers<\/a> and most vulnerable populations and that will leave a legacy that isnt just about thishad. It will undermine Global Cooperation<\/a> on a host of other issues. If we cant cooperate in this situation on it sharing a vaccine, what hope do we have to cooperate on climate change, what hope do we have on otherproblems and with that ill stop and let sylvia talk about the other aspect. I think that the transition to the rule about philanthropy and how do we make sure we get the most of that in terms of the private sector entities in philanthropy and now the bill and Melinda Gates<\/a> foundation is engaged in ensuring that Vaccine Access<\/a> can occur in the developingworld , but its a part of what theyre doing things when one things about philanthropic organizations is spread across a number of different elements of fighting a pandemic. When one talks about the conditions of the previous questioner in terms of Global Health<\/a> , when the people up, when we found there were cases ofevil law in nigeria it was one of the darkest days for me. Knowing the density and the challenges that one would face in a country as populous as nigeria, also with an economic anchoring it does in west africa and however, what happened was they were able to control it and they control it on the back of the polio work that had been done to cause basic Public Health<\/a>, things have been put in place that what they used to do the context raising, to do the other things that what happened was they control those things were investments. The Gates Foundation<\/a> had io invested in polio in nigeria in terms of trying to wipe out polio for many years and so everything from the vaccines and the scientific, the Gates Foundation<\/a> and others have invested in this reduction of those vaccines and their therapeutics and parts of the science that were using, philanthropy does that. Places like the nih does that and i think your question of how you bring it all together is an important one. One of the things that asthe who moves forward as he said , there were things that were challenging and things that they did right. One of the places the who needs to continue to improve his the willingness to think about partners that are broader than governments that are those that mainly fund them although philanthropy also contributes, the bill and Melinda Gates<\/a> foundation has historically also supported the World Health Organization<\/a> and making sure it does have capacity to do things so i think what we need is we need places where those conversations can occur with the private sector, with philanthropy and with governments at the table important issues from vaccine. We seem to have lostsylvia for a moment. Lets while we wait to get her back lets go to the next question. Our next question will be from brad. Thank you and i should maybe note that im with the Gates Foundation<\/a> but my question was about financing and i was curious to hear your perspective on Public Financing<\/a> and while i havent had a chance to read the full report i appreciate knowing that covid19 has highlighted this is more than a Health Crisis<\/a> and requires more than Traditional Health<\/a> sources particularly globally looking at how we can move pandemics possibly to an overseas Development Issue<\/a> and how we can mobilize those resources globally and domestically. To be able to support what is truly Holistic Society<\/a> and i would just want to hear about how you think we can do that more effectively. Who wants to take this one . Im happy to. In terms of a number of different places in ways that we think about the public pfinancing of the effort in the preparedness, i think what fran has said earlier and others have said is it is the importance part of taking this to the level of it is a National Security<\/a>issue. Its a National Economic<\/a> security issue and the resources we put against those things on a regular basis, we need to as a federal government but those resources against those. The same thing needs to occur at the state and local level. We know the spending on Public Health<\/a> and gone down to a place where most of the funding all comes from the federal government and even that money has been reduced over period of time in terms of the priority one of the things we need to do is we need to have a system that is funded at the federal eelevel but also state and local communities need to because whats different in terms of one of the things that difference is we compare these things to defense and National Security<\/a> in this way. A pandemic is fought at the government level, at the state level, at the local level and we all know as citizens in the middle of this we all need to do our part and i would recommend everyone get their flu shot sas a part of that. But we all have to do our part so as you think about the funding think about it at all those levels and think about the base and the core of whats happening in Public Health<\/a> and that the health of different communities and that brings us back to some of those disparity issues we were talking about or the issues in an International Scene<\/a> that the gentleman marks raised the question about the broader Global Health<\/a>. We had a strong platform of Health Across<\/a> countries whether its the us or in the developing world. That is the part of the funding when you describe it because you have that ace to build off. Go ahead, i was just going to add some numbers illustrate sylvias already great points. We have never since 1995 and more than one percent of global assistance on pandemic preparedness, just so that people know this. People talk about a cycle of engaging and preparing for a pandemic is consistently on the international level. We have in terms of the support federal government has given states on pandemic preparedness that has gone down on where it was in 2005. Public health departments, local Public Performance<\/a> cut 86,000 physicians in the years before this pandemic so when we have spent trillions of dollars in responding to this pandemic i think its fair to say that sylvias point about federal government needed to spend more in the space is well demonstrated. Even though we have spent in thepast. That said the report does put inforward some ideas on other sources of financing as well. It does talk about leveraging more International Finance<\/a> institutions whether its special drawing rights or looking at possibilities of mobilizing innovative resources around the fact that clearly so many of our International Activities<\/a> are ictied to adequate pandemic preparedness whether that be travel or so for. That might provide this case they provide the momentum to actually mobilizesome of those potential sources of financing as well. If i might just briefly add on just sort of a relative policy of us funding for Global Health<\/a> in general. Report does note that the 5 million annual budget at the World Health Organization<\/a> is smaller than the budget of new york presbyterian tahospital and obviously theres a lot of discussion in the Global Development<\/a> arena about the importance of domestic resource mobilization to make sure International Assistance<\/a> and external assistance does not crowd out National Resource<\/a> mobilization when it comes to pandemic responses. That should be on the table. Our next question will come from gregory. Thank you very much and thanks for a great conversation. I wanted to ask about Early Warning<\/a>, it struck me there are lots of groups and people including me have said for generations now pandemics were one of two existential threats out there, the other being climate change. We had each one and one, we had sars we still didnt have good warning in this case. As i read the record the first warning sign was done by promed, and ngo at the end of december area that was probably two months after we should have noticed him thing happening in china so my question is do you all suggest major changes in the way cdc works, the way the National Security<\/a> council approaches these issues, the way the Intelligence Community<\/a> works for the way all of those interact with the private sector . Thank you. Tom. I can start and then fran may have some views on this too so ill quickly say that on this issue as we talked about before, there does need to be other sources of surveillance anthat can bolster the system other than nations self reporting. It is unfortunate that when we went through a revision of International Health<\/a> organizations to address a past episode in which china was late inreporting and not sharing information to have that happen again. We dont need to make that mistake twice. That said, i do want to be clear here. The who did declare an International Health<\/a>emergency on january 30. Every nation from that point on felt was not the same hand in many nations dealt with it better. So surveillance can help, Early Warning<\/a> can help and im looking forward to leveraging the private sector in that regard but we also do want to recognize that the fundamental failings for most nations particularly in the west was they didnt respond in the same way to the information that wasavailable to everyone else and not just a matter of reporting. Ill pick up on toms comment. I do think that there is too gregory , there are multiple layers of responsibility in terms of earlymorning. We need a global Surveillance System<\/a> that more effectively sort of hold that information together and makes, the docs into a picture so we understand whats happening . Absolutely. The private sector has a role there because the extended supply chain, we saw the vulnerability of that. But the private sector can see that beginning because they are responsible largely for the movement of goods and have having the supply chain and then gregory asked the question of the Intelligence Community<\/a>, every year the National Security<\/a> council, you set what are the intelligence priorities and requirements. Nationally this has never been on high up on the list. It just hasnt been and when you see the Economic Impacts<\/a> that weve suffered as a result of covid you realize thats the argument for why surveillance has to be there in high, much higher than it has been historically on the list of intelligence priorities for the us Intelligence Community<\/a> because there really by and large the ones who will trigger the policy community to begin to think about whats in response will look like. Our next question will come from patricia rosen. Ms. Rosenfield, you canunmute your microphone. Thank you very much for this important and timely report. I wanted to pick up on sylvia , just almost as a throwaway point so that you mentioned it is in participation and getting a vaccine, a flu vaccine. Im wondering about individual and Civic Responsibility<\/a> as one of the links and how youre addressing that and go especially with the future pandemic because it seems to me as you mentioned foundations are working at Different Levels<\/a> but theres also a Civic Responsibility<\/a> and democracy but we have in new york state for instance where theres good leadership communication and a strong Public Health<\/a> situation we have people who kill other people or asking them to wear a mask. It just happened the otherday. How do you Public Health<\/a> understanding and perspective in an individuals who feel that their rights are being abrogated if theyre asked to wear a mask or take a vaccine or get a vaccine and its not only in the United States<\/a> happening in other countries as well but it seems to me this is aweak link that requires some additional attention. That basic clarity of communication about those things and that those are simple things. I think in our country we do a number of things that are about our health and communicating from a science perspective and a factual base perspective. I think if you think about the number of deaths that we have had and as we are inching closer to the number of deaths caused by cancer and a number of years and if you communicated clearly to most of the u. S. Population that you might be able to not die of cancer this year and ifea you took these steps, it is about basic Public Health<\/a> communication and connecting the actions with the outcome and making sure that people have the information and that information is clearar. In pandemic situations and epidemic situations communication clarity and this was one of our largest learnings in ebola as we did the studys afterword that important of clarity of commute occasion that is factbasedmm and gets to the public because they do play a role as you are indicating is more important than ever and also important, not just because of the role but because in pandemics the information evolves and we learn and these are different and new in the science and we are learning every day more about transmission and we now know almost 40 of the cases are a symptomatic and retransmitted. Doesnt that tell you about how you should think about your behavior because you could be doing something unintentional. That clarity of communication is both about that role of all levels of our nation but is also about the fact that things evolve and so clarity becomes very important in a world where things evolve and there is uncertainty. I dont know we have time for another question but briefly to that point what do you do in a world where there are disinformation. Actual actors trying to muddy the waters of what could be communication. Sylvia. Look, you know we are suffering in the election and wt did in 2016 and we know that russia, china and iran are trying to influence operations during the current president ial election and this is a we struggled with this in many contexts. This is no different. Part of this and speaking personally i absolutely believe there is an education component that goes back to Early Childhood<\/a> education and teaching children to be critical readers and thinkers that its much harder the older we get and the harder it isnk to learn new tris but we ought to be scriptable about everything we read and everything we see in terms of, i think many kids now are relying on social media for their information and we just have to be skeptical of what is motivating those who are writing what they are writing. These would tell you are very sophisticated but what Foreign Intelligence Services<\/a> are looking to do is look for the existing positions in our society whether that is race, economics, gender and then they drive a wedge taking advantage of these divisions that exist in our society and not creating them. I just think we have to be skeptical consumers of information far more so and more a notice of it now. All right. We will have to ended there and want to thank you so much for joining todays Virtual Meeting<\/a> and thank you of course to sylvia, francis, tom and stuart for that incredibly important and enlightening report. Please note the audio of todays meeting will be posted on website and have a wonderful afternoon. The competition is on. Be a part of this years cspans student cam video competition. Middle and High School Students<\/a> be the start of a National Conversation<\/a> by making a fivesix minute documentary exploring the issues you want the president and congress to address in 2021. Be bold with your documentary, show supporting and opposing points of view include cspan video. Be a winner. It serves 100,000 in total cash prizes including a grand prize of 5000. Deadline to submit video is generate 20, 2021. Be informed of you will find competition rules, tips and more information on how to get started at our website. Book tv on cspan2 has top nonfiction books and authors every weekend. Saturday at 5 00 p. M. Eastern law professor jennifer tell potter book, big dirty money looks at the repercussions average americans face in the rich break the law in order to accumulate more wealth. Then at 11 55 p. M. In his book the spymasters chris talks to former cia director provided inside look at the Intelligence Organization<\/a> operation and on sunday and 9 00 p. M. Eastern on after words political commentator Candace Owens<\/a> on why black americans should vote republican in her book, black out. She is interviewed by the chairman of the american conservative union. Watch book tv this again on cspan2. Next, nasa administrator jim bryden sign talks about future emissions and changes at the agency due to the coronavirus pandemic. This is one hour and 40 minutes. 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