tv Aspen Institute Discussion on Global Vaccine Distribution CSPAN October 29, 2020 8:20am-9:01am EDT
commission, i am nadia brown. good night. >> with five days left until election day on november 3, when voters decide who will control congress and occupy the white house next year, stay with c-span. watch camping 2020 coverage every day on c-span, streamer on demand at c-span.org or listen on the c-span radio app. your place for an unfiltered view of politics. >> next, look at global efforts to develop and distribute a coronavirus vaccine. from the aspen institute, this is 45 minutes. >> welcome everyone to this important conversation that we will be having today on equitable distribution of vaccines here my name is peggy clarkgy and i'm excited director of aspen global innovators group
and vice president of the aspen institute. thank you so much for joining us. today the global conclusive growth partnership which is a partnership between the aspen institute and the mexico city for inclusive growth is presenting an important conversation on entering the and effective global distribution of vaccine. this conversation is part of a a series, global inclusive recovery and rebuilding which was developed with the aspen institute and mastercard center, and were joining with the innovators group in this effort to present this presentation today. we are very honored that elizabeth cohen at cnn is leading this conversation. as reminderel you can submit questions when you register and were happy to get to this question as part off this conversation. thank you all, and welcome, elizabeth. >> peggy, thank you soeg much ad up so glad to be here with all of you wonderful panelists thatt we arerf going have with us. nearly ten months into this
outbreak covid-19 is exposing deep inequities in health care systems worldwide and there are hopes of vaccine will really change things because right methods by risk has killed more than 1 millionca people worldwi. it's infected more than 44 million people, builds up and left without work and economies have been left many of them in terrible shape. so how do we ensure that vaccine development and distribution process is unhindered by domestic and international geopolitics? i'd like to introduce my guests. kathleen sebelius is one of america's foremost experts on national and global health issues. ceo of civilians resource that should provide strategic advice to companies, investors and nonprofit r organizations. mike froman serves as chairman for mastercard and in that role is responsible for growing strategic partnerships come scaling to business opportunities come fencing the companies efforts to partner
with governments and other institutions address major societal and economic issues. we also have with us and it is 80, director of the vaccine development surveillance program at the villa melinda gates foundation.. proteins work focuses on vaccines open t for people in se of the fourth part of the world. and finally we have with us marie-ange saraka-yao, the managing director resource globalization private sector partnership and innovative finance at gavi, the global alliance for vaccines and immunization. since joining gabby in 2011 her leadership has been instrumental in raising critical resources to put equal access to vaccines for all. so thank you. we are also honored and lucky to have you with us today. so thank you so much. let's 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, either domestically or internationally? if so, what can we do to tamp that down? >> let me start this. maybe i can start this. from the united states, because -- first of all, it's great to be with elizabeth and thank you to the aspen institute for organizing this conversation. i am delighted to have a chance to be with marie-ange and anita and mike, my colleague from the prior administration. we worked together on lots of issues. but at least on the united states perspective i think there's no doubt that we're in the middle of a political debate. unfortunately that has huge impacts on vaccine distribution here in the u.s. as well as in thehe 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 vertical platform for transparency and distribution. we have not participated in two of a large funding conference since that have occurred with our neighbors in europe and others to look at investing in equitable distribution and manufacturing. and i would see also even with cepi which is a post 2017 organization focus on a coalition focused on epidemic preparedness, congress is not really invested. we put a total of $20 billion into that entity. but cepi currently is proceeding
with investment and nine vaccine candidates. the u.s. inn our youth centered warp speed, is only investing in six of those nine. we have the 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. so not only are we not providing leadership in the world, we are not participating in this world effort. we areot threatening to withdraa resources in the future which could really have for the world effort, but we are putting i would say our citizens in a deeply dangerous situation if we don't rejoin the world collaborative very soon. it's all about politics, not about science. >> thank you. does anyone else want to jump in this question? >> if i could just add to that. first, we offer to talk about vaccines of course but the same could be said about therapeutics and diagnostics as well.
it's one reason why we join the gates to create his therapeutics excelerator, precisely to make sure there was equitable distribution of testing and of treatments even as we work on the vaccine. it's very. important to have that. it's not just the right thing to do. if you don't have access, use nationalism or protectionism introduce themselves into the supply chains and distribution, you end up driving up the cost of the drugs at the end of debate and you will diminish the effectiveness. it's in our interest that people all over the world are treated appropriately, tests appropriate and faxed it separately. we have to stamp out cold wherever it is otherwise we will just see weights of a coming back onto our shores over and over again. i think there are some useful lessons. i hate to be myopic as a former tree person but if think are
useful lessons from the trade investment world, people like chad bone and thomas have written about applying some principles from the trade world the vaccine nationalism, reducing export constraints many countries not just the u.s. threatened to put on restriction on the export of ppe, on ventilators, threaten to do some of the same things with the supply chain that goes into drugs. import barriers that could be reduced both terrify nontariff barriers. expanding the supply chain so we're nototf overly dependent on just one country or one source for some of the input compound, et cetera, would be a good step towards ensuring there is a free flow of treatments over time and ultimately of course that requires ordination globally and, frankly, u.s. leadership. and having the usb at the table as kathleen said in demonstrating leadership in this effort with very difficult questions about how to
distribute what at the beginning would be at least scarce resources will be critically important. >> i can add from the point of view that it's very, very clear now that without a global approach that make sure that the entire world this particular using safe and effective vaccines. we're not going to end the pandemic. anything we can do to bring the world together, including the u.s. taking its rightful place in the global fraternity is just critical. for everybody to be protected everywhere. we have been through much effort of situs, policymakers, other people who understand how the pandemic has evolved and needs to be controlled.
global organizations did in many, many cases come together so this isas how we got to the act, access tools excelerator of which -- off existing entities the work on vaccines. so gavi, global alliance, which procurers vaccines to developing countries -- what kathleen mitch and the coalition for academic progress and innovation which is responsible or developing epidemic vaccines. and w.h.o., both organizations have come together in this coalition which now almost the entire world is part of. with the exception of the u.s. and russia. we hope the u.s. joins covax.
that would be, anybody can work together from the scientific point of view to advance covid vaccines in a safe way and to show that their effective and they can control the covid pandemic. so a lot of collaboration is happening but much more is needed. >> so indeed, to your point, i think indeed there is y concern because there's never been such a pandemic of that size and, of course, the work is daunting. but as the colleague before just said, we've also seen actually a wake-up call in the sense and a movement for which -- for coming together and indeed gavi together with w.h.o. -- which today regroup to 104 countries.
and really hear the idea is even the magnitude of the work is to pull the resources, risk, and adopt this for your approach of investing and at the same time in ten come 15 vaccine that can be accelerated together to mitigate the risk with a view that in 12 months or 18 months, by the end of 2021, you know, a certain number of doses can be procured and that provide the minimum buffer to actually quote-unquote geared guarantees for 20% of the world population so that we can at least vaccinate the high risk people, the frontline workers and start from there. becausee indeed one of the difficulties in being first in
this supply constrained environment where the first time you need a vaccine for 7 million people, you know, and it's very important the cooperation that mike was talking about because in a sense making sure that everybody has access at the same time so that even the globalization that we have seen, everyone can be protected at the same time, otherwise it just won't work. >> a few of you mentioned covax and an audience member had a question about that. let's get to that question. so covax, just background, is being led by gavi and cepi which is a coalition for epidemic preparedness innovations, and the anus took so to the development of manufacture of covid-19 vaccines and to guarantee fair and equitable access to everyf country worldwide. this audiencent member knows as many of youou have, that the u.. has not joined covax and the audience member asked, how can the u.s. participate in global
developments aroundd covid vaccine works i i would add, i think it gets on this, what is -- this is the problem the u.s. has not joined and what should be done about this? marie-ange, since we had appeared net and you are with one of the leaders of covax can you address this? >> yes. there are lot of ways in which the u.s. can contribute, and i think that gavi board where the u.s. is very active, there's a lot of conversation and indeed, because you don't deliver a a vaccine alone so there's a lot of work to be done in delivery. there are a lot of areas where the u.s. can come in and participate, and also with the u.s. has been very supportive of gavi come with set up actually research -- instrument called
the advanced market a bit, and that will be targeted at making sure that the low and middle income country have access to the vaccine at the same time. and there's a keen interest there from the u.s. it also on the delivery. at the same time there are a lot of initiatives being discussed with our partner cepi and the initiative warp speed in the u.s. so there's there is collaboration happening that may not be inside where there is possibility of collaboration and the positive sign is that there's really a great dialogue in that space in continuing the sport. because u.s. is also to supporter of gavi and continuing to that angle to support the initiatives. >> elizabeth, i think marie-ange
is t very accurate in that congress now is very committed to gavi. congress understands this global relationship. they are committed to making sure that gavi is funded and the u.s. funds continue, so regardless of what the administration has intended i think congress is sort of a protector. cepi is a new entity that was focused on research and development, but i think that the threat the u.s. was not only not participate in cepi, but withdraw funding from the w.h.o. is really dangerous in terms of world's capacity. our resources are needed, and i would say our leadership is needed to mobilize an effort of developed countries to t look at
outside of the borders and say we not only need to vaccinate our own populations, but we need a global view because if somebody is ill in africa or asia, that still is a threat potentially to the united states and it's also the right and moral thing to do. we are on the eve of an election. there are two very different views of global participation in health thatt held by the two presidential candidates, and i don't think there's any question that we would rejoin various global packs and put resources in different places if there is a change in administration. but this is a relatively new and current view that is i think potentially worrisome, not just for the safety and security of the american public but for the
safety and security of the world. because without thehe u.s. resources and kind of moral call to gather together, the eu has gone to mix bring meetings. the united states didn't participate. they giving conference, the u.s. did not participate. so while gavi likely is protected by congress, that's still very dangerous when you see a global pandemic raging. k. do you to try an while chime in on the issue? >> i would just note that everything they said is absently writes even in the absence of the u.s. federal government involvement, that a lot of participation in the private sector. obviously there's a pharmaceutical company and others, biotech company. others like our own support these efforts.
lots of activity by philanthropy. chief among them. the gates foundation and number of others. and elsewhere to try and at least keep the progress going. the danger is, just think how outraged the u.s. would be if the vaccine that emerges is being most effective was produced somewhere else. and we did not have access to it because we did not participate. and because we did not support the global effort. you'd be outraged. so a lot of the research is being done in the u.s. there certainly research going on elsewhere. we want to make sure the u.s. is part of those efforts and supportive of those efforts. as far as leading a difficult conversation worded the first 100 million or 2 billion doses go? is it to healthcare workers and front-line workers? is it to the elderly invulnerable? is it the children setting back to school?
is it in producer countries, non- producer countries? rich or poor countries? it's going to be half dead be a number of hard choices made as were building up to the doses, however many doses are required. it will need to be more u.s. involvement in that leadership effort. or will be quite chaotic. : : : by immunizing children everywhere and there are many,
many other infectious diseases such as measles and it plays a huge role in getting vaccines for every child around the world and so i have my fingers crossed that we will see that u.s. play a huge role even if we miss the opportunity on the development side although we haven't totally missed opportunity because the u.s. research may find a vaccine that works and it could be from the research done outside of the u.s., there is much more clarity on how the research is done outside of the u.s. and against to people everywhere, and there is not so much clarity on the u.s. but one can hope that the private sector takes on that role on the r&d side so a company that has developments around the world and the
provider to people around the world and also one other point is there is a very interesting analysis that was done by northeastern, and the next year we have 2 billion doses of vaccines, if all of those vaccines are used by income countries that is where there is quite the number of deaths and if they distribute those equity around the world. the side of this and mike was referring to this how we make the decisions on how you get vaccinated first then supplies will be limited and would be the situation in 2021 in the world to come together and figure out how we do that in an equitable way which makes the most sense in getting the word back on its feet again. >> i want to touch on something that anita said, when the
vaccine effort began in january, there was an assumption that people would want to get it in the fact the concern was how do we get it to everyone who wants it, and the months that have passed in the u.s. as well as another country. shown that many people don't want to get this vaccine because they fear that it won't be safe, in the u.s. there is pull showing that a third or half of americans say that they don't want to get it and i know there is also a significant chunk of people in other countries who don't want to get it, can you comment on that vaccine is only good if people roll up their sleeves and take it. anything we can do to increase the trust in this vaccine. >> i go first and i'm sure my panelist will add a lot more color, this is a big one where there is a pandemic of
misinformation on vaccines not just on coping vaccine but all vaccines, all of us will have to work really hard which involves working with communities, understanding communities in addressing those concerns, i really like the vaccine confidence in communities of this vaccine is safe and will work and protect people. and that is all that needed to be done to show that these vaccines will be safe and effective in the corners have not been cut which is why but there is going to be no shortcut with working with communities. >> anyone else.
>> i think one of the ways is to prepare very well now and were seeing this with the vaccine but a good process of delivering the vaccine and that's where all of us in particular the private sector even expertise especially in tracing and that measurement but also of course the communication, that will bring the right information that we have been coming up, we talked really and that's part of reaching out by bringing international expert that can bring the best the finance and an approach and also have varying entered very measurement but then also about how we measure and country and that's
where the private sector can help a lot and being able to trace in the low-income countries within vaccination and now this is being able to get information about covid-19 situation and get the better sense of what is needed and i'm sure once a vaccine becomes available this is a platform that we can use in a lot of countries to provide information and also get the feedback to. i think that is where there is a much bigger effort and a call to everyone in the sense of having to participate in this type of effort because it's a most important preparing community
using community-based workers in 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 it is clear that vaccine approval is not tied to the campaign, fortunately that has been asserted over and over again about the american public in our safety guidelines being shortcut, is this a political trick, an october surprise, in some ways crossing this threshold of november 3 and letting the scientific process fully be on the front line of vaccine approval will be helpful to a number of americans, i do
think the whole communication strategy around vaccines has helped in that only means enormous help in the u.s. but globally and fortunately we have seen in my colleagues here much better diverse msn im but vaccine workers an are killed ad parts of the world where they're not trusted with her seen as trying to undercut the leadership in a country or actually bring illness to people rather than bringing health and safety and were bringing health and safety workers being chased out, we see it here in the u.s. and people refusing or resisting they refuse to answer. there is a growing skepticism, is this going to be helpful, is this going to be beneficial and
hopefully we can get not only a communication strategy in the u.s. but worldwide that is on the same page that reinforces the science to get the politician out of the way and lets a scientist lead in reinforces the notion that as long as the virus is twirling somewhere it is twirling everywhere. but in some ways getting past the week in the u.s., they hopefully diminish the political concern that have been raised about whether or not the vaccine is too closely tied to the presidential election and whether corners will be cut. >> thank you for that, mike do you want to talk about vaccine confidence. >> the only thing i would add in this area greater than many other areas, it is all about trust and we see surveys of people of what institutions and
societies have performed well when it comes to covid, interesting the private sector has done quite well, people feel like their employers have been sharing a lot of information and are in support of them, local governments has fared quite well, and how it's felt with covid in the trust is built but to go to his point, looking at how do you deliver with trust and using the tools of a trusted network to be able to reach out, to collect privacy focused way with the data that helps governments understand where the country program is working and where it's not working, to be able to mind a parent or an individual and it's time to come in for the second shot or the booster shot, there is a lot of that could give people confidence if they participate in this program they're going to
be protected and that will be absolutely critical going forward. >> thank you offer those insights, let's talk about distribution, in the u.s. what are some of the inherent social and racial inequities with vaccine distribution what can we do to counteract those inequities. >> want me too start? >> sure, go ahead. i think covid unfortunately has unpacked or shined a bright light on lots of racial inequities in this country, not the least of which the death toll on black and brown communities is astounding, what is happening in native american communities is more troubling and its underlying health concerns in density concerns, lack of access to healthcare and
social disparities in really front and center in covid and if anything it when we get to a national plan which we still don't have in some areas of the country local leaders are focusing in chicago the current mayor who has put testing hotspots and additional health personnel in major underserved areas in the city of chicago and that seemed to have done a pretty effective job in lowering the virus transmission and making sure that people who were positive and had safe and secure places to live in isolation and other parts of the country that has not happened at all, the death toll is extremely high and it just highlights whatever our covid recovery plan in the u.s. has to have real focused
attention on healthcare access, testing, tracing, safe places and isolate and vaccination in densely populated areas who often don't have the luxury of working from home in the luxury of being in the zoom meeting in a private space, people who have to go to work need to be on the front line of the vaccine and the critical healthcare workers, right now we don't have a national plan for vaccination, each state is submitting their own plans there is no transparency around those plans and again, hopefully we will get back to the point of not only having the cdc identify priority vaccination groups but making sure the delivery system is well-equipped to get into areas
that typically lack access to healthcare and providers and identify folks who need to be on the front line, that is a big order and we have not done it very well in the virus in the eight months it has raged but we have a playbook of how to do in the future. >> anyone else have any thoughts on racial and social inequities that will affect not just anywhere but the u.s. >> this is an issue of this virus to expose the inequities that are racial, where you live, it's in nursing homes, it's been unbelievable to see how the virus has affected society and shown a light on all the
inequities that exist in countries around the world so that particular legacy in the u.s. is particular difficult issue of access and information in the system, it's an extra effort and it will be needed in the u.s. to reach out to communities and to make sure they understand the importance of vaccine and have access to the vaccine and don't have to worry about access to testing access to care, from the foundation we are historically back in the colleges to testing for urban populations of color and also information, access to information about a vaccine in similar efforts have to be made in other populations and around
the world to decide how to distribute the vaccine in 2021 and based on the criteria because that is the most approach to protecting people and saving lives. >> before i move on to the next question does anybody else want to talk about racial and social inequities and how they relate to vaccine distribution. >> if you look back over the last eight months, this is been the unfortunate perfect storm of the health disparity, economic disparity and racial disparity among the george floyd murder and the combination has shined a
bright light on the structural issues in the country that create this disparities. when there's a vaccine available it's going to be totally important to the governments private sector all come together in a way that recognize that to make sure this is not another fourth disparity in terms of how treatment arsonists fenced to this community. >> you and mention priority groups in the flipside of what were talking about, we might have a lot of people who don't want to vaccine and we might have people who were getting in line for vaccine who are not a part of whatever priority group is being prioritized at that moment, do you folks proceed any issues with that with verifying that people belong to the priority group that is first in
line at the moment, is not going to get messy or is not going to go smoothly, for example if it just healthcare workers or if it's just people with underlying conditions, is not going to get messy. >> i just quickly say this is why you could not have a state-by-state approach, and figuring out what the strategy to vaccinate in the u.s., everybody is doing the same thing, if you are competing which we saw you will have very messy. >> the state-by-state approach to put a fine point on it is pretty nuts as far as i'm concerned, it leaves a hyper
stability the u.s. we had an issue with the h1n1 vaccine in their part of the group identified at the front of the line were healthcare workers and yet it was an objection from any of the healthcare workers to be vaccinated, i think this is a situation which ramps up the contagious possibility to a higher level and whether or not the u.s. will actually have a mandatory vaccination, that conversation is very complicated but maybe essential in this ca case, it's very difficult to think about healthcare workers dealing with covid patients and not being vaccinated themselves and things like that, nursing
homes and the aides who work in nursing homes, are the essential workers or not, we have a lot of internal decisions, the rest of the world, anita might've said this that having a worldwide discussion of where the priority groups are, a worldwide discussion of what the protocol looks like, i think it would be a normatively helpful to get out of u.s. centric view but help workers and vulnerable population are likely to be at the front of the line, there's no way possible to identify from the outside people with pre-existing conditions, that is self >> and that's really sort of self-identified because sort of all ages and all stripes of folks, but i worry more about the groups of individuals than some people that would say i'm not going there or choosing not to partip