Equitable and effective Global Distribution of vaccines. This conversation is part of a series, global inclusive recovery and rebuilding which was developed with the aspen into institute in word joining the global interveners group in this effort to present the presentation today, we are very honored that Elizabeth Cohen of cnn is leading the conversation and as a reminder and we are happy to get to the questions as part of the conversation. Thank you all and welcome elizabeth. Thank you so much im so glad to be here with all of these wonderful panelist that we are going to have with us, nearly ten months into the outbreak, covid19 is exposing equities and Healthcare Systems worldwide in hopes that the vaccines will really change things because right now this virus has killed more than a Million People worldwide and its infected more than 44 Million People, millions have been left without work and economy have been left many in terrible shape. , how do we ensure a Vaccine DevelopmentDistribution Process is unhindered like a domestic and you not politics. I like to introduce my guest, kathleen is one of the foremost experts on national and Global Executive huma services, she prs strategic advice to Companies Investors and nonprofit organizations. Mike serves for mastercard, in that role he is a responsible for growing restrictor turn Enter Partnership and scaling the Business Opportunities and other institutions to address major societal and economic issues. We also have with us anita zadie who is the director of the Vaccine Development surveillance and Diseases Program at the bill and Melinda Gaetz foundation, her teams focuses on Vaccine Development for people in some of the poorest parts of the world. And finally we have with us the managing director resource mobilization private Sector Partnership and innovative finance at gabby the Global Alliance for vaccines and immunizations, since joining gavi and 2011 her leadership has been instrumental in raising Critical Resources for equal access for vaccines for all. Thank you we are also honored and lucky to have you with us today. Thank you so much. Lets start off broadly and whoever wants to jump in, please do, are you concerned the Vaccine Development process has been or will be hindered by politics by the domestically or internationally, if so what can we do to him that down. Lets start this, maybe i can start this, from the United States, first of all its great, thank you to the Aspen Institute for organizing this conversation, im delighted to have a chance to be with marie, anita and mike my colleague from the prior administration, we Work Together on lots of issues, at least from the United States perspective i think there is no doubt that your middle of a political debate. That has a huge impact on vaccines distribution in the u. S. As well as in the world, the United States has withdrawn from our leadership effort with equitable distribution worldwide, we are threatening with this administration to pull out of the w. H. O. Which is a critical platform for transparency and distribution, we have not participated in two of the large funding conferences that have occurred for our neighbors in europe and others to look at investing in equitable distribution and manufacturing i would say also with the post2017 organization focused on a coalition focused on academic preparedness congress has not invested, we put a total of 20 million into the entity but it currently is proceeding with investment and nine vaccine candidates, the u. S. And our u. S. Centered warp speed is only investing in six of those, we have a possibility in the United States to be at the back of the line if one of the other three is actually the first to show effectiveness and safety, not only are we not providing leadership in the world, were not participating in the world effort, we are threatening to withdrawal resources in the feature that can hamper and were putting our citizens in a deeply dangerous situation if we dont rejoin the world collaborative very soon, its all about politics. Anyone else want to jump in. We are here to talk about vaccines, the same could be said about therapeutics as well and is one reason why we joined in welcome to create the therapeutics precisely to make sure there was equitable distribution of testing and treatment even as we work on the vaccine, its very important to have that, it is not just the right thing to do, if you dont have it and if you see nationalism or protectionism introduce themselves in the supply chain and the distribution youll end up driving up the cost of the drugs at the end of the day and you will diminish the effectiveness, its in our interest that people all over the world are treated appropriately, tested appropriately and vaccinated appropriately, we gotta stomp out covid wherever it is or we will see waves of it coming back to our shores over and over again. I think there are useful lessons as a former trade person, i think there are useful lessons from the trade investment world people like chad and thomas have written about applying principles from the trade world to vaccine nationalism reducing expert constraints, many countries, not just the u. S. Threatened to put on restrictions of the exported ppe and ventilators and threaten to do some of the same things with the supply chain that goes into drugs, import barriers that can be reduced tariff and nontariff, expanding the supply chain so were not overly dependent on one country or one source for some of the inputs, the compounds et cetera and will be in good steps towards ensuring there is a free flow of treatments over time and ultimately that requires coordination globally and frankly u. S. Leadership and having the u. S. Be at the table as kathleen said in demonstrating leadership in this effort with very difficult questions about how to distribute with the scarce resources will be critically important. I can add on the point of view that its very clear now without a global approach that make sure the entire world is protected by using safe and effective vaccines that we will not in the pandemic. Anything that we can do to bring the world together including the u. S. Take it astride full place is just critical. For everybody to be protected everywhere. We have been through much effort of scientists, policymakers, other people who understand how the pandemic has evolved and needs to be controlled the global organizations did and in many cases they come together and this is how we got to the act and the access within accelerator of pullback in the filler in existing entities on vaccines, gavi, Global Alliance which helps secures and delivers vaccines to developing countries in the coalition for epidemic preparedness which is responsible for developing epidemic products and government control, organizations have come together to help in the coalition pullback. Now im looking with the exception of the u. S. And russia. We hope that the u. S. Joins, then everybody can Work Together from the scientific point of view its been disheartening to see how people come together to advance covid vaccines in a safeway and to show that they are effective to control the pandemic. A lot of collaboration is happening but much more is needed. To your point, i think indeed there is concern because obviously theres never been such a pandemic of that size and the work is daunting but as you just said, weve also seen a wakeup call in a sense and a movement for coming together and to pullback opportunities which today is in 184 countries. The idea of the magnitude of the work is to pull the resources and really adopt this portfolio approach of investing vaccines that can accelerated together and because of the portfolio since we need to give the risk of the view that in 12 month or 18 months by the end of 2021 a certain number can be procured and provide a buffer to actually guarantee access for 20 of the World Population so we can vaccinate the high risk people in frontline workers and stop from there. One of the difficulties in the supply constrained environment in the first time you need to vaccine for 7 Million People, is very important the corporation that mike was talking about in a sense making sure that everybody has access at the same time even the globalization, everyone can be protected at the same time otherwise it just wont work. I a few of you mentioned kovacs, of audience member had a question, kovacs is being led by gavi which is the coalition for epidemic preparedness innovation and to accelerate the develop of manufacturing, 19 vaccines and to guarantee fair and equitable access to every country worldwide, this audience member knows as many of you have that the u. S. Has not joined kovacs in the audience member asked how can they participate in Global Developments around covid vaccines and i would add, i think you touched on this, what is the problem that the u. S. Is not joined this and what should be done about it, marie back to you you are one of the leaders f covax can you address this. Theres lots of ways that the u. S. Could contribute and the gavi board where the u. S. Is very active theres a lot of conversation and because you dont deliver a vaccine alone so theres a lot of work to be done in delivering in the u. S. Can come in and participate and also where the u. S. Has been very supportive of gavi we have set up innovative instrument called the advanced market and that will be targeted at making sure the lowincome country has access to the vaccine at the same time and theres a keen interest from the u. S. But also delivery and a lot of the initiative that are being discussed in the Initiative Work speed in the u. S. Or theres various collaboration happening that may not be inside but the ability of collaboration in the positive sign that theres a great dialogue in that space and continuing the support because he is also a key supporter of gavi and continuing with the angle to support the initiativ initiatives. I think maria is very accurate and that congress now is very committed to gavi, congress understands this global relationship, they are committed to making sure that gavi is funded in the u. S. Funds continue so regardless of what the administration has intended, i think congress is a protector and a newer entity that was focused on research and development but i think the threat that the u. S. Would not only not participate but withdraw funding from the w. H. O. Is really dangerous in terms of the world capacity, our resources are needed and i was here leadership is needed to mobilize an effort of developed countries to look outside of the borders and say we not only need to vaccinate our own population but we need a global view because diseases know no borders if somebody is ill and africa or asia, that still a threat potentially to the United States and also the moral thing to do, i think were on the eve of an election and there are two very different views of global participation and held by the two president ial candidates and i dont think theres any question that we would rejoin various global packs and resources in different places if there is a change in administration, this is not relatively new and current view that is potentially worrisome not just for the safety and security of the American Public but the safety and security of the world because without their u. S. Resources and moral call to gather together, the ae you has done to spring meetings, the United States did not participate, they did the giving conference in the u. S. To not participate. Gavi is protected by congress, that is still very dangerous when you see a Global Pandemic raging. Thank you kathleen, mike or anita do you want to chime in on the issue of the u. S. Not belonging to covax. I would just say everything that they said is absolutely right, what is interesting in the absence of u. S. Federal government involvement you have a lot of participation of private sector, the pharmaceutical companies and other biotech companies, lots of activity by fully enter p and elsewhere to try to keep the progress going, the danger think how outraged the u. S. Would be if the vaccine that emerges was produced somewhere else that we did not have access to because we did not participate in we did not support the global effort, we would be outraged, i think a lot of the research is being done in the u. S. , there is some Research Going on elsewhere and we want to make sure its part of the efforts in support of those efforts in leading the very difficult conversation on rated the first hundred million or billion or 2 billion doses go, is it the healthcare workers in frontline workers, is that elderly and vulnerable is that the children taken back to school, as a producer countries on producer, rich or poor countries, they will have to be a number of hard decisions even as you go to the 7 billion doses or 14 billion doses, how many are required and it will need to be u. S. Involvement and leadership in the effort or it will be chaotic. Thank you for that mike, you mentioned but did you have anything that you wanted to add. I would add that im really optimistic from the gavi side, it is one thing to make the vaccine in the vaccine is so important and theres a huge opportunity from the u. S. In gavi in the u. S. Social much generosity by immunizing children everywhere and theres many other Infectious Diseases like the measles and gavi plays a huge role in getting those vaccines for every child around the world so i have my fingers crossed that we will see the u. S. Play a huge role even if we missed the opportunity on the Development Side although we havent missed opportunity because the u. S. Research may find a vaccine that works or as mike was saying something from the Research Done outside the u. S. , there is much more clarity on how this research has done outside of the u. S. And get to people everywhere and not so much clarity right now from the u. S. But one can hope the private sector takes on the role on the r d side in a company that has companies all around the world with vaccines and provided to people around the world and one other point, theres an interesting analysis that was done and shows next year if all of those vaccines are used by high Income Countries and twice the number of deaths if we figure out how to get around the world. There is every side on this and how we make the decisions on who gets vaccinated first then supplies will be limited which would be the situation and to figure out at how we do that an equitable way which makes the most sense in terms of saving lives in getting the word back. I want to touch on something that anita said when his vaccine really beginning january, this was an assumption that people would want to get in fact the concern is how do we get it to everyone that wanted but in the months in the past is the u. S. In another country pulls have shown that many people dont want his vaccine because they fear that it will not be safe, in the u. S. There is polls showing that a third or half of americans say that they dont want to get it in anothers also a significant chunk of people in other countries who dont want to give it, a vaccine is only good of people roll up their sleeves and take it, anything we can do to increase the trust in this taxing . I go first, and im sure this ought a lot more color, there is an empathetic of misinformation on vaccines right now, not with just some but all vaccines and all of us will have to work really hard which involves working with communities and understanding communities in addressing those concerns and i like the confidence in communities that this vaccine is safe and will work and protect people and all of the signs that needed to be done that will be safe and effective have been done corners have not been cut which is why we communicate and there will be no shortcut when working with communities. One of the two ways is to prepare now there is a whole process of delivering the vaccine and i see the that is where all of us in particular in the private sector even as expertise especially in tracing and the measurement and also the communication that brings the right information, by really bringing International Expert that can bring the best and the approach but also having a measurement and also how we measure and countries, thats where the private sector comes in, gavi started much before coburn of being able to trace and some of the lowIncome Countries, now you know this is being turn to get information about covid19 situation, get the better sense of what we need and once a vaccine becomes available that we can use and a lot of countries to provide information and also get feedback, i think thats where theres a much bigger effort to everyone and in the real to participate in the cycle of effort, i think it would be the most important to communicating and using communitybased workers and also science and technology. I think in some ways in the u. S. At least we will be better off regardless of the outcome once we crossed the threshold of the election and its clear that vaccine approval is not tied to the campaign, fortunately that has been asserted over and over again which i think has raised the level of skepticism of some of the American Public about our safety guidelines being shortcut, is this a political trick, is this an october surprise, some ways crossing the th