 Good afternoon to you, Professor Peter Hotez. Thank you very much for joining me and for taking this opportunity to speak to the staff of ILRI, which is the International Livestock Research Institute in Nairobi and Kenya. Professor Hotez is a vaccine scientist, a tropical disease expert, and has worked on many tropical infectious diseases, and is based in Texas in the USA at the Baylor College of Medicine. So, Professor Hotez, very good afternoon to you today. Good morning. Thank you. By the way, Eric, I got my start in science as an undergraduate working on sleeping sickness and tropenosomiasis. And my mentor, Frank Richards, worked very closely with what was then called ILRAD. Now, of course, it's ILRI. So I know the story of, I know the story of the institution that you're at, which is an amazing, amazing treasure internationally. Great. So Professor Hotez, I wonder if I can ask you about your work on vaccines, if you can just tell us very briefly how you came to be a vaccine specialist and what sorts of vaccines you normally work on? Well, ordinarily, I'm an MD, PhD scientist who's always been enamored with the idea of developing vaccines for tropical infections and parasitic infections, especially. So we have a schistosomiasis vaccine that's in phase two clinical trials, shagas disease vaccine. And that's always been our major, my major interest, and focusing on the poverty related diseases that the big pharma companies have no interest in. And then about 10 years ago, we got connected with a coronavirus research team at the New York Blood Center who, you know, they felt that coronavirus vaccines were orphaned that they were important to develop yet. Nobody was really interested back then. And so we began to adopt it and began a program supported by our US National Institutes of Health. And that was very important because we showed then that the spike protein of the coronavirus that back then it was SARS and Mears was the soft target of the coronavirus, how you deliver the spike protein, how you induce virus neutralizing antibodies and virus neutralizing antibodies were critical for protection, maybe not the only thing but essential. And all of that work led to us developing various prototype coronavirus vaccines. And the reason I tell that story is because many people are always worried about COVID-19 vaccines. They think they were rushed and popped out of nowhere. And how could they be legitimate? When everyone knows it takes a decade to develop a vaccine. Well, guess what? It takes a develop took a decade to develop COVID-19 vaccines, because it was all built on the research and development program that we started another group started on coronavirus vaccines. And that's very important for people to hear because I think what happened was a lot of the drug companies, when they send out their press releases, remember, they're not writing them for you or for me, they're writing them for their shareholders. And of course, they spectacularize their accomplishments. But the reality is all of the COVID-19 vaccines, whether it's the Russian Gamalaya vaccine or the AstraZeneca vaccine builds on at least a decade of R&D research and development. Great. That's really great to hear. And I'm sure very reassuring for people listening to that. And we'll come back, Peter, to the COVID vaccines. I just wanted to give you an opportunity to tell us a little bit about some of your other work around trying to help the public understand vaccination, just to put your your your work in a bit of context there. You're very well known for speaking in public about vaccination and the importance of vaccination. Can you tell us very briefly why that's the case? Well, in addition to being a vaccine scientist, I have four adult kids and my youngest daughter, Rachel is an adult now she's 28 years old and has autism and intellectual disabilities. And the reason that's relevant is for more than 20 years, one of the central assertions of the anti-vaccine lobby, that's getting better funded and organized every day as they claim that vaccines cause autism. And I wrote a book with the straightforward title vaccines did not cause Rachel's autism to go through all of the fake assertions from the anti-vaccine groups. And because they keep on changing their mind, first it was the measles mumps rebella vaccine, they claimed cause autism, then it was thimerosal preservative, then it was spacing vaccines too close together, then it was alum adjuvants and vaccines. And one by one, we provide the scientific evidence showing there's absolutely no link. And also what autism is and how it begins in early fetal brain development through the action of more than 100 genes involved in autism. And we even did whole exome sequencing on Rachel and my wife, Ann and I, and we're able to identify a related gene. So the point is, you know, the anti-vaccine groups are opportunists, they're very aggressive, and they dominate the internet with more than 480 fake anti-vaccine sites. And so social media is more or less owned by the anti-vaccine groups. If you go to Amazon.com, which I'm sure everyone is done and look at the books. And if you look at the books on vaccination, it's overwhelmingly fake anti-vaccine COVID conspiracy books. So the disinformation is dominant now. And that's important for people to realize and not get stucked in by all of the misinformation. Okay, great. Well, thank you for being a light, a scientific light in that, in that very difficult to understand world for most people. So at Ilri, we're spending a lot of time telling the staff, telling our colleagues about COVID, how to protect themselves and really trying to keep everybody really at the cutting edge of information, which is of course very difficult because things change on a daily basis. So in Kenya, now where Ilri's headquarters are, there's another principal campus in Ethiopia and also offices around the world. But in Kenya, as of yesterday, staff at the Institute started to get vaccinated with the AstraZeneca vaccine for COVID. So the first question I want to really ask you about COVID is whether you have a view as to why up to this point, the African continent seems to have been less affected by other places. It's something we've talked about a lot, people have a lot of questions about that. And I just wonder what your view might be. You know, this to me is one of the, there's several unsolved mysteries around COVID-19. And one of them is why has Africa over well, overall not done, not not, not has been a badly affected by COVID-19 is to Brazil or even the United States. And I don't think we really understand. First of all, I think we don't know the full extent of reporting of COVID-19 in Africa. And, and whether we're failing to attribute COVID deaths to COVID and whether we're doing that for other causes, I think that's that may be part of it. Or, or it's there are climatological factors that we still don't understand or host genetic factors, or the health systems have are better than many people in North America and Europe give, give Africa credit for and, and whether people are respecting social distancing mandates more in Africa. So it or a combination of those factors, but we really don't know the worry that I have is that's going to come to an end because the, the so far we've seen the pandemic mostly from original lineages. And now we have two or three variants of concern that have emerged, which in the case of the, the one from England, the B117 is clearly more transmissible by about 60% and more lethal and higher mortality. And then you have the South African variant, which also seems to be of equal concern. And so that I worry Africa's grace period is coming to an end. And we're going to start to see this decimate the continent. So I'm quite worried and that's why I was eager to speak with you today, Eric, because I think there's a new urgency now to get the people of Africa vaccinated. And I'm worried we're not going to have enough vaccine for Africa. And that's another problem we can talk about. But I think we're seeing we have to think of this pandemic in a different way from now, from now on, because of these variants of concern. Okay. So Astra AstraZeneca vaccine, as I say, is now here through the covex scheme. There is a there are concerns amongst some people about the use of that vaccine and its safety. So could you comment on that on whether anyone should be worried about that, particularly given, was it last week or the week before the concerns in Europe around blood clots, for example, in the European Medicines Agency, pronouncements on that point. So the first point I want to make is all of these people wring their hand about which vaccine to take. And one of the points that I always make is it in some ways, it doesn't really matter because based on the work we showed over the last decade, all of these vaccines, whether it's the Gamalaya Russian vaccine or the AstraZeneca Oxford vaccine or our recombinant protein vaccine, or the mRNA vaccines from Adirna and Pfizer or the J&J vaccine or the Novavax vaccine, they all work the same way. They all work to deliver the spike protein of the COVID-19 virus, the SARS coronavirus type two and induce virus neutralizing antibodies and T cell responses. So I think the first point is not to overthink it and start saying, hmm, I want that vaccine. I'm going to wait for that one. Don't wait. You'll have limited accessibility, especially in Africa right now. And all of them will, those virus neutralizing antibodies, which is how the vaccines work, are the one practical guarantee that you'll have to stay out of the hospital and the intensive care unit will save your life. It will save the lives of your family members. So that's point one. The AstraZeneca vaccine we know works really well against the UK variant to be 117 variant. The public messaging around the AstraZeneca vaccine has been horrible. It's a good vaccine. If I were offered it, I would take it. But the messaging has been poor. And it's been poor from the beginning, beginning with the CEO of the company has not been a very effective communicator. And there were leaked phone calls that didn't make any sense. And then you had what went on in Germany and France, they suspended use of the vaccine because they noted some issues with thrombotic illness. And then the European Medicine agencies reviewed the data and showed quite clearly that the that thrombotic those thrombotic events were not due to the vaccine. In fact, if anything, it could have been due to COVID-19, which that's what COVID-19 does. It causes terrible cardio. We people often think of it as a respiratory virus. It's a cardiovascular illness. What scares me about COVID-19. The reason I was so eager to get my vaccine was all the thrombotic events, the pulmonary emboli, the coronary artery thrombosis leading to heart attacks, the strokes that result from clots and the cerebral vasculature. That's why you're getting a vaccine to avoid getting clots. I think that that's a really important point. And then there was a lot of mismessages and how they handled how they handled submission to the US regulatory authority. And, and that's unfortunate because, you know, the vacuum vaccine ecosystem is quite fragile. And, and as I often say, it doesn't take much to erode public confidence in a vaccine. Or we have a very famous TV show here in the US where if you lose, you get voted off the island. And, and I often say doesn't take much for a vaccine to get voted off the island. And I worry about it. But I think it's a good vaccine. I personally know with the investigators at Oxford who've led a lot of that work, they're the, you know, some of the best vaccine scientists in the world. And so I have a lot of confidence in that vaccine. And even the Russian Gamalaya vaccine, again, that that one has not gone through WHO pre qualification yet, they're working on it, but it more or less works the same way. And so the I often get asked about the Russian vaccine, would I take it? And I said, Well, if there's nothing else available, I would take it. My first choice would be the AstraZeneca vaccine just because it's, it's, it's gone through a little more rigorous rigorous stringent regulatory authorities. But I think the Russian vaccine is probably okay as well. And again, they both work the same way, they both induce virus neutralizing antibodies, both vaccines are going to save your life. And I focus on those two for our conversation, Eric, because my understanding is those two vaccines are what's available now in Kenya. But quite honestly, all of the COVID-19 vaccines more or less work the same way. Yes, you're right on that point. The AstraZeneca vaccine is in Sub-Saharan Africa through the covax initiative. And the Sputnik vaccine is, is for, is here through the private sector, I understand, primarily at the moment, and has been given approval by the regulatory authorities in Kenya. I don't know about the other sites where where Ilri has offices, but in Kenya, certainly, it's been given regulatory approval for sale by by hospitals. Okay, well, thank you, though. So my next question really was about about the Russian vaccine, you've answered that. I wonder whether you have any, any thoughts about the way vaccine has been distributed globally, and and how we're getting vaccine now in the last week or two weeks in Sub-Saharan Africa, whereas other parts of the world have been seeing vaccination uptakes for several months now. Yeah, for me, it's very disappointing to see Africa is still only getting a few crumbs in terms of vaccine. It wasn't supposed to be that way. This is when why the covax sharing facility was established. And I think it's a sound mechanism and actually well thought out. The problem was this. I think the policy makers when considering which vaccines to support when very heavy on the innovation and did not give an adequate consideration to what was feasible for scale up production. And so for instance, those two mRNA vaccines from Moderna and Pfizer, they're good vaccines. I took the Pfizer vaccine, but it's a new technology and it's still not robust enough to scale up. I mean, look at look at the scope of what we need to do for Africa. There's 1.1 billion people in Sub-Saharan Africa. Let's say we're going to try to vaccinate a majority of those and most of those will be two dose vaccines. You're looking at roughly 2 billion doses of vaccine. So you know, Pfizer, BioNTech and donated 238,000 doses to Rwanda. And I think that's great, but it's let's face it, it's a drop in the bucket. And so, so who's going to make the vaccines for Africa? So we're now working with Biological E, which is one of the big vaccine producers in India. So a lot of the AstraZeneca vaccine is being produced by the Serum Institute of India. They're one of the world's largest providers and producers of vaccines. Another one is Biological E and our vaccine hopefully will is now finishing phase two clinical trials and hopefully will be shown also to be as safe and effective or even more so. It looks great and non human primates. And that's a simple one to scale because it uses the same technology as the hepatitis B vaccine that's been given for decades all over the world. And, and, and I'd wish there would be more emphasis on kind of simple less fussy, durable technologies that we could provide for Africa. So hopefully that will that will get through. I have an article that I've written now in the Los Angeles Times that makes the statement, you know, one of the things we really have to consider is the fact that right now no vaccines are made on the African continent. And that's terrible. I think we need to build capacity in Africa and to have that kind of self sufficiency for events like this. I mean, Africa should have the capacity to build their own vaccines for for threats and not only the pandemic ones that we're dealing with right now with COVID-19, but a lot of local regional diseases of regional importance that the big pharma companies would never make those vaccines. So the big pharma companies are not going to make us just to some ISIS vaccine, which is predominant after they're not going to make a brule ulcer vaccine. They're not going to make a number of vaccines for diseases that are predominantly African problems. And and we need to fix that. And so hopefully that that's going to be one of the long term outcomes of looking at lessons learned from COVID-19 that we start thinking about those kinds of things. Okay. And the other thing I wanted to ask you and you mentioned the vaccine that you guys have been developing, do you think we're going to reach a stage where there's a lot of choice for the consumer of vaccines, I suppose, with respect to COVID and the private sector will take care of the distribution of these vaccines in a way that states are struggling to do at the moment? I'm talking maybe a year, two years down the line, maybe. It's hard to know right now. We've got you've got a very fragmented system of some vaccines available through the private sector, others through the public sector. You know, I'm worried, given the scope of of what you'll be facing. I mean, what's the population of Kenya? Roughly 50 million people nearly 40 million vaccine 40 million people to vaccinate in order to halt transmission, two doses of vaccines, maybe a third boost later on. So you're you're easily looking at 100 million immunizations. And you're so far away from that. And and I'm frustrated because this problem was predicted and predictable. And we didn't give enough attention to providing low cost, non fussy, easy to deliver vaccines. And again, it's not the fault of the COVAX sharing facility. I think it's a really ingenious mechanism and really important. But the supply of vaccines is just not there. And and how we're going to fix that hopefully vaccines like ours may come through in a more substantive way. But it's good. So I would say to the staff of Hillary, if you have the opportunity to get vaccinated, if your family does, take advantage of that because this is going to be awful as the B117 variant starts to accelerate and and not the South African variant. We don't know how well the the the AstraZeneca vaccine and the South African and the Russian vaccine protect against the B1351 the South African variant. It's got an extra amino acid substitution that makes it more resistant than the B117. The numbers out of South Africa and mild and moderate infection with the AstraZeneca vaccine did not look good. But the thinking is it may still give high give adequate levels of protection against serious illness and may still keep you out of the hospital. So so get it because you know the B117 variant is here and there's a good chance it's also going to lessen the disease impact of the South African variant. Great. Okay, well that's a very important message. That's where I want to end. Peter, is there anything else that we haven't covered that you feel is important to tell us today? Well, just remember that there is a very aggressive anti-vaccine lobby that's now internationalizing. It used to be kind of walled off to the U.S. and in the U.K. and and now it's expanding aggressively. It's moving into Africa in a big way. So there's a most of you know when you put the word vaccine into your search engine, more likely than not you're going to get garbage. You're going to get misinformation and that's unfortunate. But that is a reality and and so you know speak be careful about your sources of information and make sure you're listening to sound science and remember the the importance of of these vaccines to save your life. And and so I think that that's number one. And second, the effectiveness of the vaccines looks really good. And and so as soon as you have that opportunity, I strongly urge you to get vaccinated. And remember we learn new things about this pandemic six months ago. We barely even knew about these variants of concern. And so the flavor of the of this pandemic does change. I do I'm optimistic we'll be able to vaccinate our way out of it. It's going to happen a lot faster in the U.S. and the U.K. and Israel and a couple of other Western European countries. But hopefully in time Africa will have access to to these vaccines. Great. OK. Peter Hotez. Thank you very much indeed for your time. I know it's very early in the morning for you. We really appreciate the time you've given us and a very good day to you. And thank you. Thanks so much, Eric. And thanks for all your great work.