 Welcome to our press conference here at the 50th annual meeting of the World Economic Forum. Great to welcome all of you who are here in the room at this press conference and of course everybody streaming and watching us live online. Thank you for tuning in to what is a very special and major commitment and announcement this morning and we have an esteemed and incredible panel to talk you through a very crucial issue that's well in the news today as we look at health pandemics and epidemics across the world and as I said we are making a major announcement and talking about a critical issue that affects populations everywhere. So this is our press conference on global pandemics, the critical role of frontline health workers in the context of ongoing and emerging outbreaks. My name is Katie Clifter. We'll be moderating this press conference this morning and really what we're focusing in on is as I said this issue of global pandemics but the role of frontline health workers. Not only the fact that we need more of them on the ground as epidemics break out around the world but how we support these frontline health workers. It is critical that we need more of them and it is critical that they are well supported with their well-being and resources and different policies. We know that the World Health Organization just to give you some background has projected a shortage of more than 18 million frontline health workers by 2030. There are quality crises in low and middle income country health systems. We know this very well but this panel here today is to talk about what we're going to do about it in the coming years and I'm very pleased to introduce to you our panel we have Paul Stoffels, the Executive Vice Chairman and Chief Scientific Officer at Johnson & Johnson, David Miliband, the President and CEO of International Rescue Committee, Richard Hatchett, the President and CEO of CEPI which is the Coalition for Epidemic Preparedness Innovations which was launched here at the World Economic Forum and Sima Kumar who is also representing Johnson & Johnson. So again thank you for being here a very important topic especially I guess as we are seeing the news today not only the Ebola outbreak continuing to emerge but coronavirus and as we go to air with this press conference we know that it hasn't yet been declared a public health emergency but certainly a very timely topic for us to be discussing. So I will refer first to Paul who will make an opening statement for our press conference. Thank you Paul. Well good morning and thank you for joining. As you know unfortunately the world is back into a crisis and hopefully it can be limited to a certain region and get quickly under control but if not a very significant measure will need to be taken and Richard is very much better placed than I and Mr. Millaminton to talk about that but it's always if you talk about crisis in the world or whether it is the health care situation very much it's depending on the health care system and the strength of the health care system to be able to cope in the frontline with the challenges. The frontline health care workers the nurses in the hospitals the midwives the people the doctors who are in the hospitals are always the first to be confronted with the challenges and it's so so important that besides having preparedness for pandemics and epidemics and significant diseases that in parallel the health care system was strengthened. We have been involved in Ebola for a long time we have done research we have a big vaccine in the making and being tested now large scale in Rwanda and Congo or implemented in Rwanda and Congo 500,000 people will be vaccinated in Congo 200,000 in Rwanda but it's only after significantly long research and development that we were able to do that. We work there in the frontline with health care workers and you see how important it is. If you go back to the region to the Sierra Leone Liberia and Guinea epidemic in 2014 it were first the health care workers who bear the victim of the disease. They were also the multipliers of the disease because they got infected brought it over to their to the families and to the health care system and that's why it is so important that health care systems are strengthened and the and people are trained. Yeah but it's also for other diseases whether it's mental health whether it is infection other infectious diseases health care workers are always in the center and it's to that regard that we as J&J it's not that we are already since long time in the trenches to strengthen the health care worker systems and we will commit and we are committing to do an additional investment of 250 million dollars for the next 10 years to train one million health care workers reaching 100 million people and as a private sector we can make new products but we also have a responsibility for helping and training the necessary capacity to be able to implement and whether that's we have with a significant focus on midwives healthy bird and making sure that young young lives are saved but also the main system of health care primary health care workers mental health and strengthening the capacity for training in pandemics. Johnson and Johnson is one of the largest if not the largest health care company in the world. We have a history training nurses and supporting nurses in the U.S. for their entire existence and we are as a company very committed to the primary health care system and training health care workers. Excellent thank you very much for that announcement as you see an incredible investment particularly focusing on those community health workers the people really at the front line of these crises and wonderful to see such an investment not only in providing more workers there but supporting them as they do what they do. So thank you very much for being here and for the announcement David we'll turn to you. I know that your company has dealt with some of the world's worst humanitarian crises. You've seen this on the ground across the world in light of these comments this investment. I mean the topics that are going around the news today. What's your experience. What have you seen. What can you tell us about I guess how frontline workers health workers what what they do experience in these situations. Well thanks very much. Good morning. Maybe I should just explain we're not a company we're a non governmental organization so a trap a charity a nonprofit organization originally founded by Albert Einstein to help refugees come to America. Now we're an international humanitarian aid organization as well as a refugee resettlement agency. We work with some of the what are called the hardest to reach people in the world. We think we helped about 20 million people through our health care services. And I want to just say two things really one is that our partnership with Johnson and Johnson has been born of real trust building. As we've worked together over many years currently we're working in Columbia together and in Jordan really delivering some important health care initiatives. But the second thing goes to the heart of this announcement. As I said the people that we help are often called hard to reach patients hard to reach people. And I want to put to you that that is a complete misnomer. Actually these are people who are living in areas where there are hard to reach services. The problem is not the people. The problem is the lack of services. And the attraction for us of the announcement of the commitment to frontline health care workers is what we mean by frontline because what Johnson and Johnson and we mean is community health workers. In other words not simply resting on the official health care system but actually recognizing that people in a community are the essential frontline and taking health care to people is actually a far more efficient and effective way of helping them than expecting them to get the health care system. Nowhere is that more important than in some of the most fragile and war-torn contexts where we work. South Sudan, Yemen, Somalia, Afghanistan. In South Sudan we know it can be three hours trek for any patient to get to a health care centre but a community health worker who's trained properly even if they don't have a medical training themselves has been shown to have outsized impact. We know that when it comes to treating malaria when it comes to treating diarrhea when it comes to treating pneumonia health care workers have proven their worth. We employ about 13,000 community health care workers around the world. These are people drawn from the local community given some training. And so when it comes to something like Ebola we know that the biggest barrier to effective Ebola treatment with the greatest of respect to the medical experts on the panel. The greatest barrier is actually community trust. It's the fear of engagement with the health care system. We learned that in West Africa. We're seeing that in the Democratic Republic of Congo in eastern DRC at the moment. And thinking forward I think the power of this announcement today is not just about the horror or the fear of pandemics important though that is. There are also wider agendas for example in respect of the treatment of acute malnutrition. We know that half of all under five deaths in the world at the moment are related to malnutrition either directly or indirectly related to acute malnutrition. We're convinced that community health workers have as bigger role in helping to treat, diagnose and treat acute malnutrition as they've had in respect of malaria, diarrhea and pneumonia. In fact we've published studies that have shown how community health workers using community health workers has no worse impact on the patient than using a trained nurse or doctor because the essential diagnosis of acute malnutrition is actually relatively simple not very difficult and treatment is relatively simple as well. So we're looking forward to this $250 million. It's a baseline not the whole answer. We hope that other parts of the industry will join and we hope above all that will embrace this idea that it's actually people who are living amidst disease that are the first responders to coping with disease and the more we can train them and equip them and capacitate them to make a difference the more we'll prevent and have impact in the future. Just quickly when you talk about training and you talk about these people in especially fragile and you know low to middle income countries too, do you look at the well-being of these people? I mean that must be a part of it the fact that you know they're there at the front line they have to deal with some very difficult situations. Yes I mean I'd say two things about that. One our experience shows that illiterate and innumerate people can still become health care workers as long as the training doesn't depend on them being able to read or count. So we've developed a diagnostic tool for diagnosing acute severe and moderate acute malnutrition that involves no numbers and no letters only colors and it's been shown to have no detrimental impact on their capacity to work. Secondly of course we have to think about the people on the front line so our Ebola workers community health care workers they're the first in line for a vaccine in our view when it comes to an Ebola vaccine so yes there are big duty of what we would call in our sector duty of care responsibilities that we have towards our front line health care staff. But remember since they're living amidst the affected population they've got the greatest interest in being the most effective because they know it's their future and it's their own families who are surrounding them. Absolutely and they're incredible people that do this work. Richard I guess let's bring you in on on this issue. I mean we talk about Seppi. We talked about the fact that it was founded here at the World Economic Forum. You've done incredible work. How do you see this issue and what's your experience. Well so Seppi is the coalition for epidemic preparedness innovations. We were set up to develop vaccines against some of the greatest global health security threats and we do that by developing the vaccines. In terms of listening to the discussion about frontline workers we work on medical technology and I think there's an important integration of the medical technology with the protection and training of frontline workers and so you can think about Johnson and Johnson's very commendable investment in training of frontline workers but you should also think about the investments at Johnson and Johnson and other companies have made to develop products to protect those workers. I worked in Gabon back in the 1990s on Ebola in an area where there had been multiple outbreaks and I remember talking to people in Gabon at the time about the outbreaks and you know what people did during the outbreaks and they you talk to them about the hospitals. There was a hospital in Makoku and a hospital in Buoy where Ebola patients were treated and but they many people who got Ebola didn't come into the hospitals and you asked them why didn't you go to the hospital and they like people who go to the hospital die and part of the reason they died was because there was very little that you could do for all you could do is collect people and isolate them and let the course of the onus play out. The other problem and you can imagine when you don't have these medical technologies available. Both the Ebola and the current novel coronavirus and many of the other scary diseases that we work on have been associated with healthcare worker infections and if you have healthcare workers who are facing lethal diseases and are not adequately trained not adequately protected and who don't have access to to products like vaccines that can guarantee their safety many of them will not come in to work and they will not treat people and then you have a loss of trust as as as David described. So I think the you know this investment in in training of front line workers and in thinking about health security threats while doing that and helping them to prepare for pandemic and epidemics that pandemics and epidemics that may happen in the future is is tremendously important. I'll just say a quick word about our partnership with Johnson and Johnson. I was I was actually just in the Democratic Republic of Congo and Rwanda over the weekend before Davos and was had had the opportunity to visit the vaccination sites on both sides of the border. I learned something that I didn't know which is that the Rwanda Congo border apparently is supposed to be the second busiest border in the world. 50 to 60 thousand people a day crossing that border going back and forth and in a setting where you have a Ebola outbreak on one side of the border and people coming back and potentially getting ill and potentially going to seek treatment in a different country on the other side of the border where there's not known to be an outbreak. You can imagine the anxiety that that would produce in the health care workers. So Johnson and Johnson's efforts to develop a prophylactic vaccine for Ebola are at great expense to the company and but also with a great deal of public sector support you know could be critically important because it is a vaccine that was designed to be provided to people in advance to protect them from Ebola infection and what we have seen over the last 40 years not only with Ebola but with other diseases like NEPA like LASA like the coronaviruses. This is the third coronavirus we faced is a gradual expansion of the geographic range of the virus and so Ebola was first found in northern DRC in 1976 and it has now spread all across Central Africa. It has spread all into West Africa of course and you potentially have and I don't know the numbers to be honest but I would guess at least hundreds of thousands if not millions of health care workers you know at risk for potential exposure to Ebola. Well I know that you have to leave the panel before we get into a Q&A. Do you have final remarks on this announcement some of the comments you've heard today? I just want to follow on what Richard was saying protecting the health care workers to get the trust from the health care workers that they continue to operate in the health care system not being at risk to be infected is one of the most critical things to get an epidemic under control and I'm so grateful to the governments of Rwanda but also to Congo that now they enable the whole population in the region especially first the health care workers being able to vaccinate it and hopefully we will can we can follow up the patients not the patients health care workers for a very long time because there are a population which is which is working in the health care system and enables us to learn how long they will be protected and we are we are in the intention is to be there three five ten years from now and still continue to evaluate what's happening and eventually even boost if there is a boost necessary after five or ten years we would be ready to make sure people get continuous protection lifelong that's the ultimate goal that's what we're working on with the science and in collaboration with the government we hope we can protect at least the health care workers if not a broader population going forward excellent thank you very much very critical work we will open to see if there are any questions in the room we do have a few minutes left so we'll bring the microphone down just please state your name and where you're from um hi my name is Gunilla from Halima swedish journalist for swedish daily spanish dog blooded i have a question on the coronavirus or several questions how and to all of you especially mr milliband how how serious do you think how worried are you about the situation with the coronavirus and how effective do you think it is to now close off cities like they're trying to do in china is this an efficient way of dealing with it what risks do you see for health workers in dealing with this epidemic thank you thank you i mean i'm very flattered that you should think i am the right person to ask that question i can absolutely assure you i'm not the right person to answer that uh question i'm neither a epidemiologist nor a medic nor do we have operations in uh china so i'm i'm terribly sorry but i hope you haven't don't think i've come here under false pretenses but i i promise you i'm not being falsely modest when i say that the other members of the panel are much better suited to answer it than me so um no no thank you for the question i mean i think the first thing to underscore and answering your question is how much we still do not know about the novel coronavirus that has emerged we we don't understand its transmission dynamics we don't understand that completely understand the epidemiology we don't have any information yet to my knowledge about the the viral shedding from people that are infected which will determine their infectiousness and we don't understand when in the course of their illness they are most infectious all of those pieces of information are going to be critical to making an informed assessment about exactly how dangerous this virus is and exactly what we need to do to control it um if the virus behaves more like influenza where you have a wide spectrum of illness and you have some people who may be asymptomatic or mildly symptomatic but potentially infectious it will be extraordinarily difficult to control influenza cannot be controlled completely even by the most aggressive application of what are called non-pharmaceutical interventions including travel restrictions and travel restrictions and border restrictions have been shown to be almost useless for influenza so i i think we have to be very guarded in estimating the potential efficacy of stopping transmission i think the measures that china has put in place i'm not i don't have enough information to sit in judgment of those interventions i do anticipate that it will cause a great deal of anxiety in the communities affected i also anticipate that it will likely slow transmission and it will likely buy sometime but it won't buy large amounts of time and it will be very very difficult to maintain for more than a few days or a few weeks so the concern about the other thing the other really important and i hope i'm not getting overly subtle here but the other thing that makes it very difficult to assess the situation currently is that people who become ill with the a novel virus don't die as soon as they become sick they get they have a course of illness they get sicker and sicker they go to the hospital they get sicker in the hospital they're brought into intensive care units they're treated aggressively for as long as possible and then they perish and that can sometimes be hospital courses of two or three weeks and if you're in the phase of an epidemic where the number of cases is increasing exponentially very rapidly it's very hard to know what the deaths that you see today what that actually represents because it really reflects the course of the epidemic several weeks in the past and you don't know how many cases were in the past you don't know the lethality in in 2009 during the h1n1 pandemic we knew from late april that we were going to be facing a pandemic and we did not have an accurate estimate of the lethality until august and and and we're likely to be in a similar situation with this epidemic so my anxiety level about this virus is actually very high and i think it needs to be taken with the utmost seriousness and global public health authorities have responded very aggressively very appropriately working in close conjunction with who who is providing great leadership and trying to make very responsible decisions and working with the chinese authorities thank you do we have any other questions in our final few minutes oh yeah oliva vani from al-jazeera just following up on that you're talking about the difficulty of getting front-line health care workers to even come into work unless they have the correct provisions in terms of training or in the case of Ebola vaccination when it comes to something like the coronavirus where there's it's still a bit of a mystery how much harder does that make getting front-line health care workers to come in and and avoid the panic i guess well i i like david i'm going to disclaim being an authority and and david may be in a better position to to address that question um i i will say that all of you can anticipate all the anxieties that health care workers will have you can also anticipate that health care workers as a class of people are incredibly dedicated and incredibly brave and courageous that doesn't mean that at some point their courage won't crack and and so the way you maintain that courage is you give them information you train them appropriately you provide them with whatever protective devices you can and you make sure that you practice efficient and effective infection prevention and control procedures in health care settings david is agreeing very passionately well i agree i think that you've touched on all the right points look first of all they're dedicated but they're also better informed than general public so you're starting with an advantage secondly you have responsibilities for infection prevention and control which is we're working in 80 health centers in eastern drc and obviously the first priority is to make sure that the health work care workers there are properly protected thirdly i think it's um easy to underestimate the importance of effective training and it sounds simple to how you put on your protective clothing but actually that's not simple at all and um associated with that fourth point and last point and without which you sound like a too technocratic about it the management systems and the discipline associated with the routines of infection prevention are incredibly important so the hand washing the um cleaning of the boots the rigor with which you manage your systems are incredibly important because they build the culture of care that starts with the health care workers and then moves on to the patients and i think if you get the basics right you can really engage the minds and the hearts of your workers in an effective way and if i if i may add um the reason why we are announcing our commitment today to frontline health care workers is because we want to scale up the training the resilience building the integration of all of the health care workers as a community so that they can learn from each other and be connected to each other and have the respect and the recognition so i think the more we can do that and also training in leadership and management so those are the five elements of our health worker innovation centers so that we can do this and scale up the efforts to get them better prepared maybe it's just a final final comment Sima to you know this initiative and the announcement today will reach a hundred million patients what would your message be for other companies listening in terms of their support in this area come join with us partner with us because no one company or organization can do it alone so i think it's going to take multiple stakeholders to come together to really meet that 18 million gap we know that is the theme of the world economic forum obviously a very nice way to close out our panel um thank you very much to all of our panelists for being here uh today thank you very much for being here in the room live streaming as well and um with that we'll end the press conference thank you