 When I worked at the bank some years ago, I had the responsibility of dealing with the pandemics which came up at that time. And during that time, I worked with many colleagues in many agencies. One of whom was Dennis Carroll. I became friends and good colleague with Dennis, who was then working at USAID. And I wanted to talk with Dennis about this pandemic because Dennis has not only at that time looking at what was happening with the current pandemic, but he has always been a thinker outside the box and looking forward. As you can see here, he has a PhD in biomedical research. His first work was at the Cold Spring Harbor Laboratory. He then joined the CDC, the Center for Disease Control in the United States, World Renown Organization, as you know. And then he joined USAID, where he was in the Global Health Program. And he organized considerable funding to tackle pandemics. And you will hear about some of the things he did then at USAID in a program called Pandemics. And he has since retired and now is the chair of the Global Viral Project. And he will also tell you what that is a bit about. So colleagues, I hope you would find Dennis's discussion useful. Not only his reflections on what's happening in the current pandemic, but his views about what we might do to prevent them in the future. So let's turn to the recording. Dennis, thank you very much for agreeing to have this discussion with us today. I am delighted to be able to reconnect with you after several years. Many things have changed between us. I've left the bank and I'm now at Illry. And I understand that you have retired, but are as busy as ever. As ever, yes. You fill me in a little bit on what you're up to these days. Well, Jim, as you know, I had a long career at Centers for Disease Control and the US Agency for International Development. I left USAID just a year ago. And my primary focus has been about bringing to life a new partnership around establishing a global viral surveillance network, the Global Virome Project. And that has really occupied a lot of my time. And obviously the events around COVID-19 really highlight both a need for having better insight into future viral threats before they emerge so that we are better positioned and better able to prevent them first off, but also respond should they emerge. So the Global Virome Project is about a global partnership with global ownership to build a big database on both the viral ecology, what animals, wildlife and livestock potential threats are circulating it, and transform the sciences around virology from what you really can consider mom and pop. The world of virology is a very virus specific venture. You're focused on Ebola virus, you're focused on the COVID-19 virus. We're always focused on whatever the last big viral threat is. And what we're trying to do is to move this whole space into the 21st century, which is, as you know, is very much a century about big data. And the world of viruses is a very small data space. But the world that viruses circulate in is a very big database. And the Global Virome Project is really about creating a big data portal to understand viruses before they come to us. Yeah, great. Here's on the cutting edge as you've been in the days I've known you at USA. Then as many of us have been saying over the past several years, that is not if but when a pandemic of gigantic size would strike. But you have been more assertive on this issue than most people. So COVID-19 have been struck with this vengeance. You must feel a bit wrenched that we are in this position after so much warning. Are you? Well, you know, I think we all knew, and as you said, there's many of us who understand that the emergence of a new viral threat is not a question of if it is a question of when and where. And the emergence of COVID-19 came as absolutely no surprise. Its emergence, its spread, everything about it, the biology of the virus itself was very predictable. Obviously some of the clinical manifestations are really eye-opening. We're learning more about this virus and it's presenting in really remarkable ways. The thing that was really, to me, shocking and appalling is less to do with the virus than our response to the virus. Jimmy, as you know, we have worked over the last 20 years with the emergence of SARS to really try and position the world to be better prepared. And avian influenza of 2005-2006 further accelerated people's one awareness and sort of commitment towards putting in place the kinds of capabilities and the kinds of policies that could be drawn on in the midst of a new epidemic or a pandemic. What we saw with COVID-19 was almost a global amnesia that you would never know that there was 20 years of detailed planning, sort of collecting enormous insights into not only how to prevent these things, but what is really required to be able to effectively respond. And most importantly, a fundamental appreciation that a pandemic is a global event that requires a coordinated global response. As we've said over and over again, a threat anywhere is a threat everywhere. And what we saw with the COVID-19 response was a complete abandonment of that understanding that it is a shared global threat requiring a shared global response. It became every country for themselves. We saw that as the virus swept around the world. It was the microcosm of it was the scrambling for personal protective equipment. It was first buyer with the biggest check was getting access to this equipment. And it was total chaos. And that to me is the most appalling sort of aspect of the whole pandemic. But it also, you know, retrospectively doesn't come as a surprise. We've seen over the last five years, certainly in my country in the United States, but we've seen it across Europe and even parts of Asia, sort of this extraordinary rise of nationalism and populism and an anti-science sort of movement. And so many of the global networks and partnerships that have been the backbone of coordinating responses against avian influenza against the H1N1 pandemic of 2009 against the West Africa Ebola, all of those have been fragmented and fractured over the last five years. And essentially not in play when it came to responding to this particular virus. So yeah, for two decades, we've been speaking to the reality of a pandemic will happen. And we need to be prepared and we need to be well coordinated. That absolute failure to activate a coordinated global response to me is the most extraordinary aspect. Not that the pandemic happened, but our failed collective response to that pandemic that to me has been just appalling. Yeah, I agree. Even all we know about the infectiousness and the virulence of COVID-19 and the status for the search of a vaccine or vaccines and therapeutics, what are your predictions about when this pandemic will be overcome and what might be the new normal? Right. Well, first off, let me say that even in the absence of a vaccine, many countries have shown that this virus is controllable. And remarkably so, this is not a virus that quite frankly has the upper hand. You can look at South Korea, you can look at Vietnam, you can look at Thailand, you can look at China. And you can see that the ability to bring this virus under control with the current tools that we have, face masks, hygiene, social distancing, you can essentially disrupt and stop transmission. We don't have to wait for a vaccine, but it does mean that there is a new normal that to be able to sustain and maintain the load or eliminated transmission of this virus. We need to be hyper cautious as we go forward. We need to continue to recognize our vulnerability to this respiratory virus. So we will be requiring to practice measures of social distancing. The ability to congregate and interact on the scales that we have taken for normal, those are things we're not going to be able to do until there is a highly effective and widely used vaccine. So there is a new normal, but with that said, we can still thrive. We can still be economically robust. Our communities can be vibrant. What we need to do is practice a little bit of common sense. And what's always remarkable about common sense is that it's not all that common. People's ability to just act in their own worst interest is just amazing to me. So we are in a new world in the absence of a vaccine. We will need to continue to be vigilant, but I think we should take heart not by looking at what happened in Europe. We need to take heart about what happened in Asia. They had the first exposure. They really did draw on those pandemic preparedness plans, which they had been, you know, they took the issues of infectious diseases very seriously. And in January, the countries in that region were hearing the very same messages about an unknown new viral threat coming out of Wuhan. And they read between the lines. They understood their vulnerabilities, and they began activating the plans they had been working on for 20 years. And what we've seen is, I mean, think about this from Jimmy, Vietnam and Thailand collectively have half the population of the United States. But they don't have half the deaths from COVID-19 that the United States has. What they have is somewhere on the order of 75 deaths, sort of the 100,000, which would be half of those in the United States, 75 deaths. They did something right. And we should look and learn from that, because what they did right means it's doable. And those societies are continuing to thrive, continuing to grow. And the populations, they took strident ardent measures, but they're bearing the fruit. And vigilance is really the thing, sustaining that ability to act and control and to do it on a national level in a well-coordinated way. It can be done. It is being done. And countries across Africa, across Europe, across the Americas really need to understand why is it that Southeast Asia in particular and East Asia got it so right, and we got it so wrong. Then with respect to reactiveness, which you just described, and the rights and wrong about it, you have said over and over that we cannot expect to do the same things over and over and get a different result. I think you quote Einstein on that in one of your interviews. You advocate a forward-leaning posture and created at USAID a research program called Predict and spent over $200 million on it. Could you tell our staff in summary what Predict aimed to do and how that relates to what you're doing now? It sounds like you're continuing some of that work. Yes, well, thank you. Please tell us about that. Be glad to. First and foremost, let's make one point very clear. When we talk about future viral threats to people, those viruses already exist, and they exist in wildlife populations. They're already circulating. If we were having this discussion a year ago, Jimmy, the COVID-19 virus was in existence. It was circulating among bats. We know that. And whatever the next epidemic or pandemic virus, and there will be sooner than later another event, whether it's an epidemic or global pandemic, a new emergent viral threat will come sooner than later. It is inevitable because there is this deep reservoir of viral populations circulating in animal populations. The second point I want to make is when we talk about the threats that these viruses pose, they pose a threat to humans, but they also pose a threat to livestock. We understand that the emergence of a new viral epidemic or pandemic agent is not just one that is a risk to humans. It's a risk to our food security and food safety around the world. And the work that we did underpredict was really very much an understanding about this shared space that humans, animal populations, in particular wildlife and livestock and the ecosystem have. And the emergence of a new viral threat is very much dependent on that combustible interaction, how animals and people and the ecosystem are interacting. And predict was really about developing a richer, deeper understanding of what that dynamic looked like. And to what extent we could do three things. One, we could begin to identify in animal populations future viral threats before they emerge, go to the virus before it comes to us. Secondly, could we better understand what propels a virus to jump from a wildlife animal into either livestock or into people? Could we better understand what the dynamics that drive those events? And then thirdly, with that knowledge, could we begin understanding where and when these events are most likely to occur? Are there hot spots in the world where the potential for spillover is far greater? Because if we understand what a future risk is and we understand where that risk will play itself out, it allows us to do two things. It allows us to bring around prevention measures. Think about the COVID-19 virus. There's strong reason to believe that its initial spillover occurred in a live animal market. Now, it may or may not, but we've seen that with such frequency. Live animal markets are places where we see spillover events. OIE and the animal health community have developed really good standards for enhanced biosecurity that we could bring to those markets to prevent those spillover events from happening. So if we know what the triggers are that drive spillovers, you can use what knowledge we do have to prevent them from happening. Secondly, and if we know where these are going to happen, we can also bring a heightened level of surveillance to continue to monitor and to look for evidence of a spillover event. The COVID-19 virus that initial reports came out in the middle of December of 2019, inevitably, that was not the point of spillover. It happened months and months and months before. And that virus had a chance to circulate, move among human populations, and slowly but surely gain efficiency in human-to-human transmission. If we had brought surveillance beforehand into those markets and into that region with longitudinal sustained monitoring for a known future threat, a COVID-19-like virus, we could have picked it up shortly after that spillover if we couldn't have prevented the spillover. So predict was about a proof of concept. When we begin to shine a light on the viral dark matter, all of that unknown viral populations that pose a future threat, can we use that knowledge to better understand risk? Can we use those insights to better understand what are the practices and behaviors that trigger our practices, our behaviors that drive a virus from its wildlife host into either livestock or into people? And can we use that to make the world a better prepared to prevent and then to identify early and rapidly respond to these events? Predict was an enormously successful proof of concept. It really helped us understand each of those three points in detail. The problem with predict is that scale was too small. In predict, we began to quantify for the first time, how many viruses are we talking about circulating in wildlife? And we published a paper in Science two years ago. There's about 1.5 million different viruses across 25 viral families. And of those, we estimate half a million, 600,000 had the potential to infect us. And a very small subset of those have the potential to have adverse effects. But in predict's 10-year lifespan, they had a scale of operations that allowed them to discover and characterize about 1,200 new viruses, 1,200 versus the 500,000 you really want to know about. It's too small. So we are standing now on the shoulders of predict to develop a global venture that isn't owned by USAID, that's not owned by the US government. It recognizes that to be able to effectively mount an effort to catalog and characterize and understand these future viral threats and to translate that knowledge into policy and action. We need to have ownership of every country. It needs to be, if you will, a partnership, a federation of national virome discovery projects that are able to work together and build a shared database so that instead of knowing about a half dozen coronaviruses, we can begin to characterize and understand what we estimate to be about 4,000 different coronaviruses, similarly for, you know, the iloviruses, which is the viral family for Ebola. We can develop a deep database that allows us to have a run genetic atlas of all of the viruses. So when we begin thinking about future countermeasures, we're not spending a billion dollars to develop a vaccine against a COVID-19 virus that ultimately has no efficacy against whatever that next coronavirus might be. You now have the ability to use machine learning to sweep across virtually all 4,000 of the coronaviruses and begin designing broad spectrum vaccines, exploiting the power of gene editing that CRISPR casts and really revolutionizing the development of pharmaceuticals so that you begin developing not a vaccine or an intervention for one, but for entire families. So that's what Predict laid the foundation for and what the global virome project is committed itself to do it, to turn the unknown into the known. One is Tsangchi, the Chinese philosopher, statesman general, famously noted. To know your enemy is to be victorious in every battle. To not know your enemy is to lose every battle. Right now, the virus is our enemy and we lose every battle because we do not know our enemy and we're in the business at the global virome project of knowing your enemy and using that knowledge to create a world that's better prepared to prevent, to detect and respond not to any and all future threats. Great, great. That's very exciting and very forward-leaning as you have been saying. Now that the world has seen how destructive the pandemic of this size can be on lives, livelihoods and economies. Do you think that we are better interested or committed to making the kinds of investments in this sort of research that you're talking about? We have talked for many years about sufficient investments, not only in preparedness plans and so on, which we did a good amount about, but in this sort of preventative mode, getting ahead of the game, but we weren't able to find the kinds of resources to do it. Do you think the world is more aware now and will be committed to making the kinds of investments which are really needed? Well I would like to say yes, but I think like you, Jimmy, we have seen patterns of high levels of investment followed by severe contractions. There is a feast and famine, a war budget and a peace budget, and the war budget is when we're in the middle of a, in this case, a pandemic or the threat of a pandemic. We have seen major investments made over the years as we are in the midst of a battle, but once that battle is over or more importantly falls off the front pages of newspapers, we see the interest in governments and in the private sector in making sustained investments is an enormous, enormous challenge. One can hope that this event is so, has been so catastrophic and has been not just so impactful on our health, but when we look at the economies around the world and see the costs that this pandemic is currently bringing and will continue to bring over the course of the next year or so, that one would hope that the incredibly small relative level of investments that need to be made to provide sustained support for prevention, for surveillance, for investing in the systems and capacities. The one health, let me underscore, the one health systems and capacities. We need to use this as a moment to really bring together this diverse multi-sectoral partnership and create a new sustained robust alliance that is able, quite frankly, to bring the agility to our actions that viruses do routinely. Today without hesitation, we'll move from a bat to a penguin, to a pig, to a human. And they don't care about species, but our whole systems are stovepipe by species. And I would hope that not only do we get sustained investment, but we radically transform our vision of what and how we need to work across sectoral domains and create a truly unified partnership between human health, animal health, and I mean animal health both in terms of livestock and wildlife and the ecosystem. You know, as well as anyone, that we live in a world that the events that are driving forward, the intensity and frequency of these epidemic events are the very same forces that are also creating the extreme weather events that we are witnessing around the world. Today, in my own country right now, we have extraordinary wildfires underway across the western part of the United States. And we've had serial hurricanes pounding the Gulf states. And we have one today, unprecedented, and all of these events are driven by the same things that drive the emergence of zoonotic diseases, land use change and population pressures and inappropriate generation of energy and consumption of materials. The relationships are profound and this vision about what we need to do about pandemics is also a vision about what we need to do about being more responsible about how we live on this planet. And the work of Ilri is really important to helping us develop sustainable agriculture and sustainable livestock production. It's that lack of sustainability that's transforming our ecosystems. And that transformation that land use change is the single biggest driver behind climate change and it's the single biggest driver behind zoonotic diseases. And we can't continue to look at these as isolated, independent things. We need to not only have the type of resources you're talking about, but we need to have a vision about the interconnectedness across these different domains and take a well thought out coordinated action to create a more sustainable human presence on this planet. We don't do it. We'll continue to be besotted with epidemics and pandemics and extreme weather events on a scale that in the 21st century will make this an extraordinarily existential moment for us as a species. Indeed, I know you and Subash speak occasionally and as you know, Subash is helping us to try to craft out what might be our contributions as Ilri in this one health space. What can we do in collaboration with many partners in relation to what needs to be done? Ilri is a very small entity with minor resources, but given our proximity to the problem and the locations and so on, that we can join in partnerships in this one health space to advance some of the work that you're doing. So we're certainly trying to respond to what you're saying in many ways, not only through the one health and prevention and responsiveness and so on, but the whole area of more sustainable animal systems, production systems, raising the productivity, so we need fewer animals, lower emission intensities, and of course reducing the population pressure of human animals, domestic and wildlife animals and so on. We're hoping we can come back to dip into your long and deep experience in this area and hopefully you'd be willing to support us in this venture as busy as I know you are. I hope you would save a little bit of time for us. Well, anything I can do for you, Porto, I'd be delighted. Great. Thank you, Dennis. Let me, I can't let you go. I know we've been on for a while and you have contributed significantly to this discussion already, and of course I will point over staff to the many interviews you've been having and publications and so on, but I can't leave without asking you this final question. I have seen the collision between, we have all seen, the collision between personal liberties. I don't want to wear a mask. The government can't tell me to wear a mask. I don't want to be vaccinated. The government can't tell me. When some of the responses we need require community approach to doing this, why do you think this is such a growing collision and how do you think we can resolve that? Can we read? Well, you know, first off, you know, this rebellion against the common good, if you will, is extraordinary. I just finished reading a wartime biography of Winston Churchill, and it was describing his first year in power during World War II. And one of the measures that was forced upon Londoners and then ultimately all of Britain during those years was the blackouts. Every household had to draw their blinds. Every car had to shudder their headlights to avoid giving enemy aircraft sort of guidance as to where population centres were at night. And all Britons complied with that and they did it heroically. And all I can say is that if the world today were faced with that challenge, you know, wearing a face mask is far less onerous than walking down a street at night in a urban town with no lights, buses driving down the street in the black of night with virtually no headlights. And everyone is, you know, living in a much more difficult environment. But these people without hesitation embraced the individual sacrifice for the greater good. We live in a world today where people have forgotten about the social contract where we have begun to fragment our sense of responsibility. We don't wear a mask to protect ourselves. We wear a mask to make sure that we protect the other person. We never know whether we're infected. We have so many, you know, 80% or plus or minus of those that are infected are asymptomatic and shedding virus. And so it's the, you know, it's to reject the idea of wearing a mask because it's inconvenient and not accept the possibility that in fact you may be infected and potentially putting everyone around you at risk of infection. It's just extraordinary. And in some way as a community, we have begun to fragment and not assume the responsibility of a member of a community. And it I don't think we're ever going to get this right until we rebuild from the bottom up our sense of identity, not as individuals, but our sense of identity as members of a community. And that we're acting with the best interest of our neighbor at heart, not with this, you know, the self interest of ourselves. Obviously, when you wear a mask, you're also protecting yourself. Well, what should always motivate us is that I'm protecting you and that I have a social contract. I have a responsibility as a member of a community. So this is when you see people rebel and then ultimately it's become politicized that the adherents to these protective measures wearing a mask, social distancing, personal hygiene have become part of a political fodder that has further aggravated and sort of amplified the tension and the fragmentation of our community. And that is also appalling. So I yearn for the days when we had leaders who spoke about the collective responsibility, ask not what your country can do for you, but ask what you can do for your country. That type of vision is a vision which has been stood on its head. Don't ask what you can do for your country. Ask what your country can do for you. That is the world we live in today. We're gonna have to socially engineer and get ourselves back to a better appreciation that we live as part of a community. And let me underscore that community isn't just us as a species. I want to go back to your earlier point. We need to recognize that we are part of a larger ecosystem. And until we better contextualize that we are just one of, you know, 5,000 of 5,000 million species. And there's not a given that 10,000 years from now we're gonna be here much less 1000 years from now. Species comes these go and we have a chance to accelerate our departure if we keep behaving. But we also have a way of perpetuating our sustainability. If we better embrace our responsibilities of being a member of this planet. This epidemic has cost us dearly. You know, Benjamin Franklin, you know, Benjamin Franklin made the observation that an ounce of prevention is better than a pound of venture. And obviously we did not take that ounce of prevention. And our leadership has just flailed and left us in a terrible situation. But Benjamin Franklin, you know, I always assume that what he was talking about was some health measure. It's better to, you know, treat yourself today rather than deal with a serious illness tomorrow. But he wasn't what he was. He was a citizen of Philadelphia in the 1730s when Philadelphia was a boom town. And it was rapid growth. But with that rapid growth, it was largely unregulated. And there was just a fire after fire after fire swept through communities. And all neighborhoods would burn down before the fire brigade could get there. And what Benjamin Franklin became an advocate of was fire laws, building codes so that any future buildings built in Philadelphia met minimum building requirements that were designed to prevent the spread of fires. And so that upfront cost of putting into a building extra investment going from wood to brick to make sure that that house was less flammable became that ounce of prevention. I see. But it's I bring it up because it is a way of looking at problems and problem solving that we need to bring to this whole space around epidemics and pandemics. You know, your question earlier about sustained financing. Well, until we take the approach that it's better to invest in preventing the conditions that enable spillover and spread and amplification of deadly viruses in people in a livestock until we are prepared to make the kind of investments that improve biosecurity, improve hygiene, improve sanitation. We are going to continue to be a fire department that is racing against out of control fires and never able to effectively protect our citizenry. Franklin understood what he was talking about. And we need to transfer his notion of prevention and cure to the world of zoonosis and quite frankly, into the world of climate change. It's better for us to prevent than it is to respond. Yeah, Dennis, very profound. Thank you very much for the time. I am very pleased to reconnect with you again. It's a real pleasure for me and I look forward to staying in touch now that I've found where you are. And hopefully we can work together and I'll certainly come to you looking for help to support Hillary in what we're trying to do. Thank you very much for your time. Well, thank you. And let me just do a special thank you to your colleagues throughout ill-rate. You have done and continue to do great work and your work is urgently needed. And so thank you for the contributions you have made and thank you for the contributions you will make. Greatly, greatly appreciated.