 Welcome to this session where we're going to be looking at the deployment of a COVID vaccine around the world. Now, a second wave of COVID-19 is unfolding across parts of the world and that's focusing minds even more acutely on the urgency of delivering a viable vaccine. Once approved, of course, now hundreds of candidates, 10 are in phase three trials right at the moment and it's a frantic scramble that's exposed the best and the worstness COVID-19 and the desire for vaccine access has laid bare nationalistic tendencies and brutally exposed the safety, underpinning access to health. Also serious and legitimate questions are being raised over whether some nations are disregarding safety standards in a bid to be the first to develop the jab. Yet in the midst of all of this we are reminded of the selfless excellence of our scientists and burgeoning solidarity shown by some who remind us we are in the same boat, rich and poor. And for this to work, we all need protection with a COVID initiative covax initiative is a shining example of that. We've got so much to discuss so little time so let's get going and please do get involved using the hashtag hashtag SDIS on slido.com to send us in your questions. So we've got a fantastic panel this evening and together we'll be looking at the solutions the pitfalls facing the world as it tries to meet the challenges of making a vaccine globally available and joining us this evening we have Richard hatchet now he's an American medical officer and coalition for epidemic preparedness and innovation that's sepi and it's based in Norway and sepi is co-lead of covax with the WHO and Galvy. Now Julie Goverding is an American infectious disease expert and the former director of the US Center for Disease Control she's now executive vice president and chief patient officer at Merck so absolutely fantastic to have her thoughts and insights that this evening. We're also joined by Mr Seth Berkeley now he's CEO of Galvy that's the vaccine alliance, and also covax co leading organization and of course covax is going to be central to our discussion this evening. We're also joined by Cyprus side now he is the president of developing countries vaccine manufacturing network and president of quality operations at bar at biotech international limited so very, very big welcome to that. And finally we're joined by Heidi Larson Professor of anthropology at the London School of hygiene and tropical medicine. She's director of the vaccine confidence projects are also an essential issue that will be evoking. But before we get stuck into our discussion we're absolutely privileged to be joined by Professor Klaus Schwab now he's the founder and executive chairman of the World Economic Forum is going to be making some opening remarks. To very much is about this session deploying a COVID-19 vaccine is actually part of our social development impact summit which started four days ago and we are at the end. And I have to tell you, in the 60 sessions, which we had over the last, over the last days, with great public participation, see issue of COVID-19 vaccines. I think it came up practically in every session, because many of the issues we discussed are dependent on what progress we are making in the development and deployment of the vaccine. So I'm looking very much forward to this fantastic panel where we have all aspects integrated. I just would add one personal note. I'm so happy to see this because 20 years ago, Gaby was created and the first place was Davos and in a similar way, Richard, three years ago, CEPI was also had as a first place Davos. And I think your two organizations have done a fantastic job in advancing the notion of, let's say, importance, but also practical action around the vaccine. So back to you, Isabel. Thank you very much, Professor Clashor. I'd like to bring in Seth immediately because the countries representing two thirds of the world's population have now signed up to COVAX. Now, there are obviously more countries are in the pipeline to join, but can you tell us what the next steps are for COVAX? And for those joining us, explain to us briefly if you can, the importance of this COVAX facility. Well, of course, thank you and thank you, Klaus, for those comments about our birthday and CEPI's birthday that we celebrated earlier these years. You know, the critical issue here is a vaccine is the way we're going to get out of this pandemic. Of course, there are many other interventions that are critical, but that is the best way we have to go back towards normal. And science has done an incredible job. You went through the statistics and normally it's, you know, seven to 10 years to make a vaccine. We're within one year still. We're now nine and a half months into it. And we have all of these vaccines and efficacy trials. The challenge is, should those go to a few countries who are able to pay and get high coverage leaving the rest of the countries with no vaccine, or should we have a distribution across the world? And of course, from our belief in a fast moving pandemic, you're not safe unless everybody's safe. So what the COVAX facility is trying to do is to get vaccine out to all countries rich and poor at the same time. Initially, small amounts of doses to protect healthcare workers and those most at risk, but of course eventually the broader sets of the population that are going to need access. And to do that, we have to work with the pharmaceutical industry to have them scale up and we're looking to try to have 2 billion doses by the end of 2021, which would be an extraordinarily never before done. And lastly, of course, is going to be the challenges in delivering them. Okay, so it is an absolutely humongous task, let's say, Seth, but if I could bring Richard on board now, Richard, what do you see as the main challenges as you push ahead with COVAX? Is it purely financial or do we veer into the political as well? Well, there are a number of challenges. The political challenges are, of course, everyone is aware of them. What we have seen are countries that really until COVAX was created, and they didn't have an option to work together to solve the pandemic, at least where vaccines were concerned. And so the countries were behaving in their own rational self-interest, but as Seth was describing, that was going to result in misallocation of vaccine and concentration of vaccine in a few rich nations, leaving the vast majority of countries without access to vaccine at all. That would have been a tremendous problem. It would have been inequitable and it would have resulted in the perpetuation of the pandemic. The challenges that COVAX has faced are that we have had to devise the institutional arrangements in real time to develop and create a place and a space for international collaboration in the development, procurement, and delivery of vaccines. And each one of those elements is a very hard challenge in and of itself, designing a system that can solve all of those elements at the same time, a tremendous challenge. But I think what's encouraging is the emerging momentum around global solidarity, global collaboration to meet these challenges, and a willingness actually to work with us as we have designed the COVAX facility and accept that not all questions are answered at this time, but if we work together in a collaborative and transparent spirit, we'll make progress to move forward. Absolutely. And just a very quick question there, Richard, and as you talk about this multi-layered approach that's having to kind of draw together at the same time, just how many people are working on COVAX just to try and get this vaccine, once it's approved, distributed in an equitable way? Well, I mean, it certainly depends on how you count people. I mean, I think, Seth, our latest numbers are up to 167 countries that have 157 countries, sorry, that are collaborating together. So within those countries, you probably have hundreds of people that have been working on it. And within GAVI and CEPI and WHO and our partner organizations and our industry partners, I would say thousands of people working together to bring this to fruition. It's a phenomenal project and a phenomenal effort. Now, Julie, could you just come in here and just tell us about what's in the pipeline at Merck, because you're also developing vaccines and treatments against COVID-19. I'd like to just start by acknowledging that in just the first six months of this pandemic, more than 700 products for either treatment or prevention of SARS-CoV-2 went into pipelines at various stages. This is absolutely unprecedented in the history of the world. Just think of the AIDS epidemic where it was several years before we even had a test and it took 15 years to get highly active antiviral therapy. So we're living in an era where the science has brought possibilities. At MSD, we are prosecuting two vaccines that we hope will be relevant. We have kind of the mind that it's not likely that a single vaccine is going to solve the world's problems because they're different populations and different requirements, both in the early phases as well as potentially for a more sustained engagement and coronavirus prevention. But I also want to mention antivirals because, of course, if we could take the mortality of this disease down quickly, it buys us a lot of time to really get to that global overall prevention platform that we're looking for. So MSD is working on an oral antiviral that we're hoping will be relevant and others are working on modalities including antibodies and other small molecule approaches. So I don't think we should put all of our eggs in the vaccine basket, but clearly it's a huge component of really securing global protection and we have to prioritize it. And I just want to thank Richard and Seth for their leadership of the COVAX effort. It's just game-changing. That is an absolutely perfect segue. Thank you very much. I'd like to bring it in sight. And my question is for you in terms of developing countries. Now, is COVAX going to be that game changer? Is everything in line now as you see it to be able to provide that change that needs to be unfurled in the developing world quickly and effectively? Thank you. Thank you, Isabel. I think COVAX is that game changer because if you look at the history of vaccines and if you look at this response by the global community to COVID-19, it's extremely important how we react to this and COVAX is right in the epicenter of that reaction and it's extremely important part of this response to COVID-19, not just in high-income countries, middle-income countries, but also in low-income countries. And where this is bringing to bear is that this is, we are at the, I would say we are at the beginning of the beginning. As you know, vaccine development takes decades. We are just at the end of the first year and we have a few candidates that are moving forward. None of them are successful yet. Time will tell. The next three to four months are very crucial as to which one of these candidates will be successful. But I would say that's the end of the beginning, I would say, because once you know what is successful, then you need to manufacture that at scale. Some manufacturers are already working on manufacturing these vaccines at scale. Some of us can maybe make it in the tens of millions of doses. Others could maybe make it in the hundreds of millions of doses. That remains to be seen. But the next, the devil is in the details, I would say, the next steps after you manufacture, you need to get these products approved by international regulatory agencies, U.S., Europe, the WHO for pre-qualification, many low-income country and middle-income countries and then you need to distribute it. Because many of us, Gavi, many of us are used to manufacturing and distributing vaccines for routine immunization, which is for childhood immunization, which is a subset of the population that we are targeting. And so now we are in the gamut of delivering these vaccines to pretty much all populations or the high-risk populations at first. So that is something that we have not done before at the kind of scale that we are talking about. I think that needs a deeper discussion. There has been a significant discussion on R&D, innovation, product development, clinical trials and manufacturing scale up. But we also need to talk about distribution and getting it to the populations that need it most. Thank you. Thank you very much, Sai. So that's definitely something we'll be bringing up. But before we go any further, I'd really like to bring in Heidi who has joined us. And Heidi, one of the issues that is going to be holding people back from taking a vaccine are just a whole load of concerns that can't be really just pinpointed and put into one category. And I was just reading some research in the UK that a lot of people won't even have a vaccine, even if it is available. Now, I know that you've looked into the issues of rumors, etc., that stop people getting vaccinated. But if you could just outline for us one of the main reasons why people will just not go and get this inoculation, even though the government advice is to go and do so. Well, there's a real mix of reasons and some of it is, frankly, quite understandable. This is a brand new virus and there's a lot of uncertainty around that itself. And if people aren't even believing that that's a real virus, why would you be caring about a vaccine? And the other part of it is that the information is uncertain. So we have to have a little bit of empathy with the people who say, I'm not sure. I think a lot of the surveys have put into their headlines, overstated refusals, because they lump together those who really say I would not take it to those who say I'm not sure. When, in fact, that's, it's pretty reasonable to not be sure in the current environment. So, but, but there are, it's highly varied by country. What concerns me is that some of the countries that are starting to say they are not going to take it more. We've seen Nigeria, Pakistan, DRC was the least willing. And the knock on effect it's having on some of the overall vaccine confidence. So I think that the good news is we have time. I'm just finishing five years of working on trust building and rumor management around Ebola vaccine trials in multiple African countries. The thing that was an absolute asset was having time to start to build that. I think we, you know, we can get in there and start communicating engaging around some basic vaccines we've lost so much time on really childhood vaccines the flu vaccines. I just got data back from our EU study 15% increase in willingness and confidence in the flu vaccine. We're seeing, you know, other confidence rising around pneumonia vaccine. Let's encourage the, you know, people around things they know they're familiar with. And in there, in that interaction, start having a conversation about COVID. I think we have time we can change, change the grounds. I just like to bring in Julie here obviously because you're developing some of these vaccines and treatments isn't one of the major concerns when it comes to the pickup of this vaccine is as everyone has been brought up is the phenomenal speed of the vaccine will inevitably be brought online and that that has sparked a lot of concerns in people. So Judy you can involve this what could you do to reassure people that really safety checks. Most countries are not going to neglect safety checks. I think people are concerned and as Heidi said it's a very understandable concern that in our race to get some additional population protection that safety shortcuts will occur. And that is not the case. In fact, the major vaccine manufacturers signed a vaccine pledge just very recently promising that they would adhere to the safety requirements of the regulatory agents and not jump ahead of the curve in an effort to so get a product out there and race or get a product out there as quickly as as the efficacy would allow. So I think we ourselves are self policing and making sure that we don't overstep that confidence barrier, but there are a lot of other things that need to be done I thank you for bringing up the Ebola virus situation because as MSD developed our now licensed Ebola vaccine and utilized it both in West Africa and the DRC. We learned so much ground troops about what happens in cultures that aren't used to investigational products or aren't used to new launches and how much community engagement and local leadership really matters. But I think the opposite end of the spectrum is also true. We need to involve the really important opinion leaders, the trusted incredible doctors at the local level as well as scientists, more broadly, to first of all be informed of the actual facts not the mythology or the political interpretation of those facts, and then really stand strong, honestly and transparently explaining what we know what we don't know and what we're doing to try to assess the safety of these new products. Trust is everything. Trust is everything and Seth I would just like to bring some of the issues that Heidi was also bringing up about that the vaccine reticence in countries like Nigeria like DRC. When you want to distribute the vaccine or new COVID vaccine in an equitable way. This is going to prove a real challenge for you is it not. How are you going to prioritize distribution in countries and how can you try and convince those populations that it is absolutely necessary for them that frontline workers are actually vaccinated. Of course we have a great panel here, each of whom are working on these topics and I want to start by building on what Julie said because you know with the Ebola vaccine this was done at minus 80 degrees delivery in a war torn area, and it was a vaccine that wasn't licensed initially, and they were able to under a clinical trial protocol roll it out collect more information on safety under informed consent and get it out but it took this intense engagement with the community. And the only reason I wanted to mention all that is it is possible to do it even under the most difficult situations, but one has to plan for that. So, I think if we look at what's happened, you know, 2030 years ago vaccine coverage was low today, it is quite high it's the most widely distributed health intervention in the world, and we've introduced 496 new vaccines. Yes, I is right, most of those are pediatric vaccines, but we've also had vaccines for epidemic diseases population based you know things like yellow fever things like meningitis, and we've been able to do that the way to do that is, as Heidi has said so clearly is the commitment with the community is having trusted spokespeople is making sure there are facts available that facts alone don't make this happen. What we really need is to also move with people's hearts and that that trust issue is absolutely critical so it is doable and requires attention. The last thing I'll say is that, you know, the alliance it's not just the Gavi secretariat, WHO UNICEF, the World Bank, the CDC, all of these partners are going to work together with countries to help and that that work has already started tool kits have been built to help country begin to plan for these vaccine rollouts and to understand what's going to be needed. I'm Richard in here now we are getting receiving questions on slide and I've received this question which is, what is needed and it was something that cyber to establish a global mechanism and the leadership of the WH own Gavi to ensure to ensure an global and criteria that's based on the distribution of the new vaccine so I guess the question is, how do you actually establish such an intricate and complex global mechanism to distribute this vaccine and and if that work is obviously underway already what has been established so far. I think there are two pieces to the answer the question one one is the logistics and I'll come back to that in just a minute. The second, and I think the more interesting piece and the piece that will probably if it works will be studied for years is how do you create a system that uses the different incentives of the different stakeholders to work together in a collaborative way. A lot of observers have noted that the scramble for vaccine in many ways, you know, is a real world illustration of a prisoner's dilemma and and we myself said, Sumia Swaminathan from WHO Dr Tedros and other colleagues have been thinking, you know, very hard about how would you design a system that incentivizes our industry partners to work with us to incentivize these countries to work together and to collaborate with us. And that brings all of that together in a way that is self supporting. That's a really interesting problem. The problem of actually then once that system is constructed and functioning and you know, vaccine is beginning to be provided into that system. Now you actually solve the logistical challenge of having let us speculate and say we end up with five or six COVID vaccines that have different characteristics in a complicated global environment where different countries have different regulatory regimes may have different on the ground challenges in terms of delivering certain kinds of vaccines. The, you know, based on cold train requirements or other challenges, how do you how do you make all of that system come together so that vaccine is efficiently distributed in a way that also achieves this goal of population equity. That's a huge challenge. We to be utterly candid. We are still working through that as as we go and we haven't solved all of the challenges yet, but we are beginning to identify them and we have partners lined up and as covex has achieved momentum and even I would humbly suggest a sense of inevitability that this is going to be one of the very important mechanisms for delivering vaccine. We have more and more help to solve these practical logistical challenges. And just very briefly now how much of a blow is it for covex that big players like the China China and us aren't on board and are you any closer to persuading them to join. Let me let me answer first and then and then Seth can certainly jump in and I think other other colleagues may have valuable opinions to put in. But I mean I think in many respects it was not a surprise to us that in particular that the United States and China because of their extensive internal vaccine development efforts and their investments in vaccine development might feel that they had any a sufficient number of candidates that they would be able to account for the needs of their own populations. So may not view covex as a necessary delivery mechanism for their domestic needs, but there is also a way that these countries can continue and can still contribute to the global effort that covex is trying to lead and would do so. I have enlightened self interest because it will help in the pandemic sooner and help them restore their economies and that's through contributing either funds or doses to support distribution, particularly to developing countries and of course they are contributing scientifically. I mean we are working. Some of the covex portfolio companies are based in the US summer based in China, and we continue to have productive dialogues with with scientists, you know, in those countries but also globally. So there are many ways that countries can contribute to the global effort they don't all necessarily entail, you know, buying doses for domestic use. Can I just add to that Richard that while the governments may or may not at this point in time be joining the covex. In the US for example the vaccine inventors are part of the International Federation of pharmaceutical manufacturers and associations and by virtue of our membership in this international association we are very much involved in contributing to covex so there are other avenues to contributing to the science and the inventiveness to to be helpful even if a given country is not actively participating in the procurement efforts. And then I was just actually then tacking on from what you were just saying sigh as as an outside observer I suppose and when you look at covex. There may be a conflict of interest and I imagine maybe Seth and Richard will have something to say here, but that high income countries are developing their own vaccines in this kind of so called, you know, vaccine nationalism are also part of covex. Can the two work together. I, you know, I think I think they can work together but it's matter of the kind of product development they do and it's a matter of kind of the delivery systems and the delivery mechanisms that companies have in mind, because what may work for, let's say US or Europe, or China may or may not work in middle income and other low income countries. For example for Ebola may not work for COVID-19 vaccines I mean if a vaccine has to be stored at extremely low temperatures, or if it has to be, for example, say lyophilized and to be having an edge, I mean, diluent to be carried along with it. Then all of this adds to the burden of distribution, administration, biomedical waste disposal, all aspects of vaccines and vaccinations and that WHO and UNICEF and Gavi and PAHO know very well about this and it's not just the fact of making a vaccine but you need to transport it with care. It has to be delivered with care. The biomedical waste has to be disposed. So there are many, many, many aspects of this. A simple concept of a vaccine vial monitor that is really required by WHO that is an important marker of vaccine safety and quality at the point of views is very important. If a company is not able to put that on to a vaccine, then it poses difficulties down the distribution chain. Very quick, simple question here but I've just been seeing that Johnson & Johnson is developing a single dose vaccine. Now surely in terms of distribution and getting this out across developing countries, that's a development to be welcomed isn't it? Absolutely, absolutely. Anything that's a single dose, anything that is stable at, I would say either at room temperature, not at room temperature but at least at 5 degrees or there is also extensive experience in shipping vaccines at minus 20 because the oral polio vaccine is stored at minus 20 and it's shipped around the world. There are many companies still that have minus 20 coal chains so that can be leveraged. So I think countries also have companies also have to look at what are the issues of the developing world during product development. I think after licensure it might be a bit too late because you are already committed to your product development and manufacturing and formulation schemes. I think you need to look at it right during the product development and that's what I think many companies are doing around the world. But if they only have a US or a European focus they may not see the requirement of what is needed in middle income and low income countries and I think Coax will bring that out. I think WHO's target product profile has already brought that out. I think companies have to look at that and cater to those requirements. Heidi, I just have a question for you that we have received on Slido and it's about this question of trust that we were talking about and this is a question I think it comes from Politico Europe and it says do you think there needs to be more transparency on the deals between countries and drug makers so that it can be more easily scrutinised. Now is there an opacity there already in the first place and do you think especially the drugs that need to deal with COVID that there does really need to be more transparency given the speed that this whole vaccination and drugs are going online? Well, I totally agree with the trust issue and overall transparency. I often say we don't really have a misinformation problem as much as a relationship problem between publics and industry and science. But I don't think that I mean I think that's been actually quite a bit of exposure about the different negotiations going on. I think actually where some of the transparency is really going to need to happen is in deciding who gets it first. Because I think that and what are the criteria and not just announcing things at different times but I think any way in any part of this, the multi phase processes we have to go through as Richard outlined very clearly in the beginning. Throughout all of them, the more that we can be transparent and sharing without I mean we don't want to create another infodemic. I mean, infodemic is not just bad news, it's just an overload of information. I mean, you have to find a fine line between being transparent when it's appropriate and when it resonates because you don't want to also contribute to this sea of different stages of information by putting out pieces of pieces of it. At the same time you don't want to wait until the 11th hour so it's not easy but I would just encourage transparency but one of the things that's also frustrating the public is that the rules keep changing and there seems to be conflicting guidance and so you don't want to keep putting things out and then changing them all the time so it's finding a balance I think. Finding a balance now I'd like to bring up something that you've just brought up and put it to Seth actually because Seth you, I know that Covax has actually already decided in some respects who does get a vaccine first. What have you put into place there and who will be your priorities and how will you implement that fast what is going to be the rate at which these vaccines will be deployed. Of course WHO provides normative guidance for most countries and they will continue to suggest and particularly as we learn more about the virus what the risk groups might be in different situations. But where we started was frontline health workers because unlike in the West where you have a fair number of them but we've seen what happens when they get sick or they have to go into quarantine how that can you know increase the overwhelming of the health system in developing countries and we saw this in the Ebola outbreak in West Africa. Countries were devastated because there's so few health workers so one of the questions was, could we get vaccine out to all those frontline health workers across the world and that's a relatively small number comparatively we think kind of a maximum number of 3% and then from there to go into higher risk populations and the question we got asked early on is, is that realistic are people going to follow guidelines. It'll be up to individual countries of course but what I think we learned from the Ebola situation we might have thought also in DRC that, you know, it would have just gone to rich people and people wouldn't have gotten it but actually there was pretty good attendance to having those vaccine used for the people who really needed it, and to be able to help control the epidemic and for health workers and. So, you know, I think we learn from the experience, and it's going to be important to make sure everybody understands why, but that's how we'll follow it the last thing I'd say is, the reason we need a bespoke plan for every country is in the US for example, it might be prisons or meatpacking plants or other, you know, situations obviously the elderly and risk groups in developing countries you may not have a very large elderly population but you may have urban slums or or displace people or refugees and so that's why we really have to understand the local situation, even though we can have global guidelines. It's absolutely fascinating. Sally we really don't have much time left so I'd like to ask you all a question because you will you we've all about Ebola this evening and so there's been a number of epidemics pandemics this obviously the most serious but if we draw upon what's been learned do you think we're any more prepared as a result of this given that we're warned by the WHO and other organizations that this could become the new normal. What lessons have been learned from this that can be used to be drawn upon in the future to make an actions against any future pandemic epidemic more efficacious and faster. How about starting with you Julie. If we haven't learned our lesson this time I don't think we're ever going to. I've been watching this from AIDS to SARS to monkey box of the pandemic in 2009 and feeding forward each time we have a new challenge we promise to do certain things and we do bring our level of preparedness up a notch or two, but that sustained commitment to truly creating global health security we have not tipped and I pray and I'm personally doing everything I can in my network but also in my role as the co-chair of the commission on global health security to really try to make sure that while we're being this pandemic we're preparing for the next because I do believe it's only a matter of time before we face another one of these situations or potentially something even worse so now is the time to prepare. Now is the time to prepare Heidi I'm just wondering given these issues of vaccine nationalism we've seen it in Europe borders went up as soon as COVID-19 struck. We've seen countries develop and buy up billions of doses of vaccine. Do you think that is the beginnings of an understanding particularly if you look in Europe that there has to be more unity when it comes to health we hear about a European Health Union and the burgeoning European Health Union possibly. Do you think that that might catch on or do you think we're possibly going the other way. Well, I think it's, it's all about bad timing because this COVID happened to land in a most hyper polarized political landscape that we've had in a long time we were in an era of anti globalization. But it just fits right into all the current environment I think, you know, if we can get the underlying ferment to, and we could be able to switch our gears and be less polarized I mean the challenge with epidemics in general is, you know, what else is going on, and what's what's going to. In DRC COVID landed in the middle of the Ebola trials and another country there was an earthquake while there was a well they're trying to work on COVID so in the politics of it all is, I mean historically vaccines were the epitome of health diplomacy it was used to stop you know people fighting in wars they would put their guns down for, for, you know, a few days so that people could be vaccinated. I think there is there are some new innovations and there are some new, certainly trust building efforts. I think that what I've seen in the positive sense is community volunteerism. I mean, we talk about a lot of the descent but you know there have been people have been incredibly resourceful innovative. I don't, I'm sure many of us know our neighborhood much better than we did before COVID. There are, and that's I think, I think even locally to start there I mean I remember, you know, working on some of the same epidemics that Julie talks about and I even, well not just natural epidemics but the like 911 but you know have you stocked your fridge do you have water you have some really basic things but I think we will not forget I mean the world will not there will be the pre COVID and post COVID world. We should remind ourselves that the reason we have set B is because of Ebola. You know, I remind people about that, but there's so much anxiety about fast but I said well you know what did you, are we talking about why it's faster, because we did learn things from Ebola. And, and I think one of the things moving forward on this is is is trust, I mean the importance of trust I, and I think we, you know, the bigger answer has to do with current politics that are a bit bigger than the, unfortunately undermining some of the situation right now. Certainly a very big question for me the subject of another whole session. We're getting very low on time unfortunately but set I'd like to bring you in do you think we're going to come out of this. Any wiser in terms of how to deal with pandemics. Do we learn every time something new will be able to act faster and more efficiently. So three quick answers so first of all it is evolutionarily certain we will have more outbreaks, so I agree with Julie. Second, the way to build better is to build routine systems and that's why having a strong routine health system that a resilient health system having delivery for vaccines those types of things are really important the last thing though is to have continued investment. And the challenge in the past has been, we invest we invest we invest then we stop because you know there's no longer an epidemic this time the cost has been somewhere between $9 and $12 trillion. I do hope what Julie said is right is that people will now say oh my god a little bit of investment, a little bit of preparation during peacetime is exactly the right thing to do to make sure that we are prepared and we can work with the new systems that are built, but we will even need to build new ones better surveillance systems you know better understanding of disease, but we need to fund it in peacetime. Oh, I am so disappointed the time has gone so fast and I haven't even had a chance to speak to Richard or side just to get their final thoughts but the conversation is continuing anyway but we're going to have to wrap up this session and I just want to really from the bottom of my heart I found this absolutely fascinating, and it's been wonderful talking to you may thanks to Richard hatchet Seth, Berkeley Cypress are duly the birding and of course Heidi Larson brilliant discussion of course Professor class Schwab for your opening remarks. Thank you very much. Is about thank you all it was a fascinating discussion. I wonder whether I should go out of this discussion more optimistic or let's say there is cautious, at least with cautious optimism that I think you contributed to it. Let's hope that we have a vaccine and that we can distribute it in a fair way, and in a fast way. Thank you.