 Good afternoon ladies and gentlemen and welcome to this press conference. Thank you for joining us here in the room and on the live stream The press conference from this annual meeting of the World Economic Forum in Davos is dedicated to the question Are we prepared for the next epidemic and in order to answer that question? We have assembled a wonderful expert panel here. Let me quickly introduce them to you To my immediate left we're joined by Jeremy Farrar who's the director of the welcome trust based in The in the United Kingdom. He's also made member of our global agenda council on the demographic dividend Right in the middle of the panel. We're joined by see a Khan who's the vice president? initiatives and strategy at Rockefeller Foundation and He's also a member of one of our global agenda councils on social innovation and last but definitely not least We're joined by Victor. So who's the president of the National Academy of Medicine in the USA? And without further ado Victor, let's start with you last week. You launched the global health risk framework Tell us a bit about This framework and how it's related to the question. We're trying to answer here Thank you so we Was was sponsored by The welcome trust the Rockler Foundation Gates Foundation and Auto seven foundations Plus USAID and they really asked the National Academy of Medicine To create a framework and recommendations for the future. I think what's unique about this particular report is we consider Independent and very comprehensive Forward-looking and of course timely Let me say a few words first about the commission and then I would like to tell you about the report the commission is made of International group of 17 commissioners with a with covering six continents including Africa continents and Also importantly, it's has people with all different expertise including banking. In fact, the chair of commission is Peter Sands who's the former Chief executive of the standard Charter Bank as well as we have real insurance In addition to health experts Policy experts and so on so forth. So it's very comprehensive to get the work done. We actually had to hold Four separate workshops 11 days of public hearing plus it interviewing some 250 experts So I'd say this is comprehensive and it's not charged for example by say WHO or one agencies The important issue is that we not look not only looked at Ebola, but we looked at other Epidemics and pandemics including SARS MERS H1N1 and others And I would say that the main message of this is that the world is grossly underinvested investing in the preparedness for infectious disease outbreaks for example through an analysis we perform looking back in 10 years of all the pandemics and infectious epidemics the cost per year lost Globally is about 60 billion dollars. That's an astronomical number and Importantly when you look at that size You can imagine that this is not only a health issue, but in fact it disrupts life Disrupts the economy. It's a national security issue Consequently our report is called in fact neglected dimension of global security Now I just want to point this out because this morning we heard from Jim Kim in another meeting when you talked about that Pandemics and epidemics can actually cause global GDP loss of somewhere even up to 4% We heard from Larry Summers last week. It could be as high as 1 to 2% But whatever it is I think the message fairly clear as Larry Summers says this is as big as climate change and how come the world is not looking at very closely Larry put forth a think what he calls severity of seriousness to policy issue and this ratio is very high because There's not enough policy and there's of course the issue is greatly Very important. So the report actually went through analysis and put forth a number We know that this is going to be controversial But with the analysis it felt that the world needs to invest 4.5 billion dollars a year in order to prevent this global security And it's a fraction if you think about when we think about military investment in war and even in climate change and And if you want to look at how to divide this most of it is in fact in strengthening health systems nationally But as Jeremy will talk about we also asked for R&D investment as well as cause emergency preparedness and emergency funds So I just want to quickly tell you about the three main issues on the framework First is strengthening public health as a foundation of health system and the first line of defense Because we look at what's happened is when you don't when that breaks down You have no proper surveillance, etc. Obviously the effect is going to be that's devastating. So we felt that WHO need to be strengthened be the place where there should be more core Capacities that should be therefore develop an external objective Transparent and accountable assessment mechanism to measure country compliance. In other words IHR is not sufficient one should look at whether additional other mechanisms such as the global health security agenda But also that we should have to hold The member countries accountable and one way to do this is to look at World Bank and other donors support of these country contingent on the country's participation and the country's performance We also argue that IMMF should assess the country Economically in terms of how prepared they are in dealing with pandemics, etc And so that's the number one issue. The second is strengthening global and regional Responsiveness in terms and alertness and preparedness and here we argue that in fact there should be a High priority watch list that should be reported every day To national focal points and weekly to a public and this will therefore get people to be constantly looking at how things are Happening but also importantly, there should be a center a dedicated center for health emergency preparedness response Which is governed by an independent technical governing board, although chaired by the Director general of WHO That we support a contingency fund. We support the World Bank's pandemic emergency facility Finally, we talked about accelerating R&D because at the end of the day, you know prevention Being able to come up with the vaccines and the drugs to treatment is critically important We propose that it should be an independent pandemic product committee made of experts In fact, it will try to define priorities coordination mobilized and allocate resources Creating in fact guiding principles in terms of harmonization protocols approval processes Importantly, we said a billion dollars a year should be committed to R&D which will come from different sources So to summarize the report calls the attention Globally that this is not just a health issue This is a global security issue and it's really important that Considering the amount of global impact it has that they should be investing in this and that investment should be going to R&D preparedness as well as in fact strengthening a most important strength national health systems Thank you very much Victor see over to you Victor mentioned the the global GDP loss and he also mentioned that it's not only a health issue It's also a question of security What's the business case actually for better preparedness for Epidemics sure. Thank you, and I think that's a great question first. Let me just start by saying On behalf of the Rocklar Foundation how happy we were to co convene the global health risk framework Commission And also be a lead supporter of this process The Rocklar Foundation has been interested in global health for a hundred years now helping build the field of public health And it's wonderful to work with partners now on this next frontier and this next frontier really is about resilient health systems Something that's increasingly important in the world that we live in today Victor outlined the report perfectly and to pick up on your questions specifically on the implications for business We live in a world now where all these systems are very tightly Interconnected and so what affects the health system will affect the social system will affect the economic system and the business system So for example, we saw in the Ebola outbreak that happened recently in West Africa How local markets started to shut down and people were just not going to bring fruit to the market because they were Starting to feel afraid of being in public and contacting this that starts to create a food security issue It starts to create a livelihood Issue and there's all sorts of interesting data of how prices were were falling and rising accordingly It even gets even more indirect to global business There were cases where travel insurance companies because they didn't understand what was going on We're canceling insurance policies for business travelers international business travelers So they could not go to these countries to conduct business So these countries became disconnected from international business flows much less all the difficulties They were facing internally and the report has a wonderful statistic about how at its peak SARS in Hong Kong Airport traffic went down 66% When that was happening so you can see how all these effects start to cascade quickly And that is why it's so important for us to think about Health systems that are resilient to these sudden shocks and these sudden shocks are becoming more unpredictable and more acute over time So so the report lays out, you know the recommendations beautifully We know how broad the implications are and why business should care why government should care Why the public health community should care and really right now what we're Hoping for is to see some action the report was designed for that It had such a transparent process in terms of how it was making its recommendations so that they wouldn't be interpreted politically The logic and the rationale are very transparent and it gets quite specific about what needs to be done and how much it would cost And that's all laid out as Victor highlighted So now we're really looking forward to the business community in addition to the UN the G7 and others to take this up as Call to action because it is directly relevant to them and impacts what they do Thank you. See you Jeremy. Let me ask you I mean, it's very clear that the Ebola epidemic we were not prepared the loss of life the economic damage the societal damage Were were were massive and what have we learned from that Ebola epidemic that we can now apply To be better prepared for the next one. I think you're all your words sum it up well and And That we There are many lessons to be learned from the Ebola epidemic and we were not prepared but actually I think I'd take it back earlier than that I'd actually take it back about 10 or 12 years to SARS and if we came if we come forward. There was SARS There was bird flu. There was the pandemic of 2009 There's MERS CoV virus that's circulating in the Middle East amongst camels now and coming over into humans The zika virus in Brazil There's a number of these epidemics and and sometimes pandemics and they're actually not that rare I could name you a dozen that have happened in the last decade or so and The truth is today whilst we're convening and the report that Victor talks about which we Along with the Rockefeller were absolutely delighted to support and I think it's a very important message that the Rockefeller the Bill and the Gates Foundation the Welcome Trust other foundations including in in Hong Kong and other parts of the world supported this and And I think that is a coming together of civic society philanthropy and business and Governments because this is a crucial crucial issue So we need to look at the sequence of these epidemics going back over the last 10 years and appreciate that whilst the focus might be on For instance Ebola the truth is that it affects the rest of the healthcare system You can appreciate there will be measles outbreaks in West Africa over the coming years as vaccination Levels drop in those countries and it will have the wider implications for economies of those countries as well We are not prepared in terms of our research and development agenda at the moment So again, if I go back SARS MERS zika ebola And ask yourself are we do we have a vaccine for any of those diseases today that we could deploy the answer is no Do we have a specific therapy for any of those diseases? And the answer is no and that leaves the world very very vulnerable to those Epidemics and we need to address that and we need to address that in the inter epidemic period Rather than waiting for the epidemic and then trying to play catch-up So the period of time now Ebola has come is coming to an end It's not over yet and we should remember that there are going to be more cases of Ebola in the coming weeks and months Until the epidemic completely disappears But these epidemics are inevitable in the future and we need to conduct that critical research For drugs for diagnostics for vaccines for understanding the anthropology and social sciences behind epidemics such that when an epidemic comes We're not scrambling around trying to respond in a crisis when it's chaotic, but we've thought about it ahead of time We're ready to go within hours or days and we can respond and bring epidemics to an end quicker If we don't put that in place after all the lessons of the last decade in the net in 2016 I don't think we'll ever have another opportunity to galvanize the world Bring industry to it bring governments to it bring philanthropy to it and really set in motion a structure that allows you to prepare for an adequately respond to epidemics so Thank You Jeremy Do you want to add to that I? Think my colleagues are right on this spot on I mean that's what we found If you look at the paper that's on the chair actually has a diagram looks at all the last ten years of Outbreaks and it's really quite amazing and perhaps with getting better detection or perhaps a transmission much faster because of travel You can see the last few years is a surge of number of outbreaks pandemics and epidemics There's no doubt there's been an improvement in surveillance, so you will identify things more regularly, but but with the changing world urbanization travel Changing dynamic of relationships between humans and animals environmental change climate change changing habitats There's no doubt that these epidemics are going to come truly more frequent exactly and be able to spread more rapidly Thank you in a press conference earlier this week It was discussed this was about the SDGs and was discussed that basically every global business needs an SDG strategy How about epidemics? Do you think global business need to develop their own strategies for cases like that? What's your feeling about that? I'll take first pass So I believe and this has been a big theme of the conversation here at Davos about businesses thinking with a range of SDGs And how they should be prepared and what they should do I think it's imperative for businesses to be prepared for these situations But they can't take it on just themselves in terms of their own response teams or how they evacuate their own employees They have to take an interest in this public infrastructure So of the amount that was outlined in terms of four and a half billion per year Which is really not that much They need to find a way to invest in that because they'll get a much higher return on their investments If they coordinate it according to this framework if they work with government and they work with civil society Then if they just build their interior response plans that just relate to their organization I was just saying that actually WEF the forum Had a I think what we called a task force or maybe a working group which Jeremy and I both served on looking at the public-private Partnership or collaboration and came up with the following one is that the in-country Experts or in-country Employees etc. Can work closely in fact with the regional areas in order in terms of response top falling But then bring in the greater expertise that they have Particularly in communication telecommunications and others. They can work together in a global fashion Which is being discussed as public-private partnership And I think Jeremy's beginning to think about area in the vaccine. In fact, he started discussing that as well So now that is obviously more focused on the biotechnology industry or farmer But the broader issue is everybody can play and should be thinking about how to prepare the world Thank you So we have time for some questions from the floor. We have a microphone here if I can see a show of hands Yes, the lady in the front if you could state your name and organization for the sake of our online audience, please Hi, I'm Natalia Lofos from the Agence France press when you say we need to be ready for the next epidemics when it comes if I take the case of Ebola for instance 20 years ago We already knew about the virus, but nobody Nobody I guess suppose could predict that the epidemic would Come to that scale. How do you when you say we need to be ready? How do how do you identify? the viruses or That could potentially turn into large epidemics like the one we saw in Ebola Yeah, it's a very good point And I think one of the crucial messages is to think forward not backwards We we tend To prepare for the previous event not the next event So after bird flu H5N1 in Southeast Asia in 2004 2005 the world prepared For a bird flu epidemic coming from Asia, and what did we get we got a virus that probably originated in pigs coming from Central America and and it just reminded me at the time that whatever you prepare for has got to be flexible enough for new events Ebola also I think is a very important message for us to learn when we think forward and that is Ebola was was first identified 1975 or 1976 by Peter P. Austin colleagues It was a rural disease It was on the whole those epidemics were controlled in rural communities and the epidemic did not spread The virus has not changed in the intervening 30 years or so. What's changed is the society in which it operates in so urbanization movement of people across borders International travel has changed the dynamic of these epidemics such that what could be 25 30 years ago a Ruraly contained epidemic once it gets into an urban setting and you've got that infection occurring amongst Two or three million people living in very close proximity All bets are off in terms of the previous thinking about the epidemiology So the lesson I learned from Ebola was don't think backwards that you'll be able to control an epidemic based on 1976 thinking about the epidemiology the world has changed society has changed and that's the driver of those new epidemics And that's what we should be prepared for for the future may expand on that a little bit Following what Jeremy said and really what we're talking about is Having the right people together to plan together to finance To also create platforms which allows you to plug and play So that you can actually end up with a treatment much faster a vaccine much faster to have the agreement that prior to Infection that is peacetime that there's agreement about what's the proper standard of clinical trials Regulatory harmonization all that is preparedness That's what are you talking about? And I'll just add one more point For something to be truly resilient. It has to be prepared for the unknown So it's not a question of predicting exactly what virus is going to and what pandemic will happen But a real resilient health system will be prepared for multiple scenarios and it'll be adaptive and flexible So people can figure it out and drop on it as the situations unfold Thank you Benjamin you had a question can get the microphone, please Yeah, I wonder if you could say a bit more about what kind of in-kind in-kind help Non-healthcare companies should be providing and also what feedback Response if anything you've had in Davos to this idea Yeah, I'm I'm personally very keen to see this broader than just the biomedical biotechnology industrial partners because Again, there are there are new players in this that could be critical to how epidemics are prepared for responded to so for instance data companies Mobile phone companies there are big questions about the ethics of that and ensuring that communities appreciate what's being done But but you can't argue the fact that the data coming from mobile phone Transmission and movement of people is it would be incredibly helpful to tracking epidemics and that will increasingly be important Logistics firms one of the major problems of Ebola in West Africa in 2014 15 was actually getting resources into West Africa because as you know many of the airline industry decided to stop flying despite Guidance from WHO to suggest that it was okay to keep flying and tribute to the Belgium Airlines for continue to fly throughout the crisis But you know, this is not just about a vaccine or a drug or a diagnostic This is about understanding that broader space and how industry can play a role in it both the ones I've mentioned but also the industries that are dependent and Contributing to those economies so West Africa for instance the mining industry was critical So I think we've got to see it beyond the biomedical And I would just add not only is there the operational capacity of various industries including media and logistics There's also perhaps some innovative finance mechanisms. So what we've seen in the climate Space in terms of how there are Catastrophe bonds and other innovative mechanisms to help people build resilience to climate events ahead of time and fund them ahead of time There could be similar opportunities in the space as well Thank you Are there any more questions? Yes Please follow up question For question, obviously nobody can predict which is the next epidemic, but which are the Viruses for which you think there is not enough research done at the moment Whatever I end up saying here somebody will criticize so just accept that as a starting point I You're right. You can't necessarily predict everything, but you can predict some things and and I think the viruses in particular Of course bacteria parasites could cause nasty things as well, but but the viruses particularly those viruses Which could be spread by mechanisms which allow it to be spread easily by coughing over somebody so a respiratory virus So the MERS like virus in the Middle East at the moment would be pretty worrying to me SARS was devastating for Asia and Canada and and other places So a respiratory virus would be high on my list of priorities And the other is as the environment changes necology changes those viruses which are spread by mosquitoes So, you know, we've had dengue. We've now got chicken gunia spreading across many parts of the world We've got zika virus in Brazil at the moment and other parts of South America and the Caribbean Those are all spread by the same mosquito ADs that mosquito is beautifully adapted to living in urban dwellings So, you know, the the the vector-borne viruses I think are also high on the agenda for the ability to spread globally Well, I know that we try to tackle this in our report and that there was an agenda to look at list the top 10 and People's reaction was exactly what Jeremy said we can't list the top 10 although they exist and bother and also WHO So you can say that's a starting point Can I just come back to you though because And I should have said this earlier The number one of the things we know about and the number one underlined has to be influenza It's still influenza and it will be influenza for the the near future influenza is the one virus I think we know could cause that global catastrophe. It's done it in the past It can change it can come out of the animal kingdom and into the human population We we don't have perfect vaccines and we don't have perfect treatments and it can spread around the world very quickly So for me, whatever else we come up with influenza has to be high on that list Thank you very much mindful of the time. We're closing the press conference here Thank you all for watching and for for being here and special. Thank you to our wonderful panelists. Thank you very much