 Good afternoon and I'm very pleased to welcome you all to this IIEA seminar and the online conversation with Professor Peter Piot. We'll be joined by Professor Shortley, but I just want to give out some housekeeping messages from the IIEA. You'll be able to join the discussion through the question and answers function on the Zoom, and you should see that at the bottom of your screen. And please feel free to send in your questions during the presentation if they occur to you. I just want to remind you today that the conversation is on the record, not always in the IIEA, and this time it is on the record. And also for those of you who use it, you could join the discussion on Twitter using the handle at IIEA. Now we are so pleased today, Professor Peter Piot, to have you join us for this fireside bit early in the day for the fireside chat. Professor Piot is a highly qualified person in the area we're going to talk about. He is a hand of Professor of Global Health and former Director of the London School of Hygiene and Tropical Medicine. Currently he is the Special Advisor on COVID-19 to President of the European Commission, Ursula von der Leyen. He was a Founding Executive Director of UN AIDS and Undersecretary of the United Nations. He's a clinical clinician and a microbiologist by training, although I see from your CV, Professor, who started off in engineering and then switched. He was, with somebody else, co-discovered the Ebola virus in Zaire in 1976 and then subsequently led pioneering research on HIV AIDS, women's health and infectious diseases. He has so many academic qualifications and positions that I'm not going to read them all out today, if you don't mind, because you are so highly qualified. But I would recommend to people who are on this seminar to look at Peter Piot's CV and just see how expert and how lucky we are to have him here talking to us. I want to start today, Peter, if you don't mind, first of all by saying you're a very warm welcome to the Institute. We normally get people coming to the Institute who have, as you have many of qualifications, some of them have OBEs and MBs and all sorts of qualifications after their name. But I'm delighted to say that today you are a little bit different. You have what's called the Order of the Leopard from the Democratic Republic of the Congo. You have the Order of the Rising Sun from Japan and you have the Order of the Lion from Senegal. Now I can absolutely tell you there is nobody watching today who has any of those orders and it's very, very special that you have those kind of qualifications. I also, in reading your background, you have had a really exciting life, including very nearly getting on a plane that subsequently sadly crashed. You also were on a plane where the engine fell off and you had to glide back down to the earth in the plane. So you are a man full of adventure and interest apart from your scientific interest. And having a little bit of a background myself in the science world, I started my career in the pharmaceutical industry in a company that has merged over the years into Bristol Mars. But I know for a long time, scientists and people like yourself, immunologists, virologists, we didn't really get noticed by the world. But when this pandemic, so when this virus hit the world, suddenly we needed to turn to people like you for our knowledge. So thousands of scientists were mobilized when this when this virus hit hit the world. Would you talk to us a bit about how as the special advisor to Ursula von der Leyen, you were able to get people to work together and what kind of system you set up to get the action started looking at how minimal at the beginning we thought this was going to be and then how it grew. So maybe you might start there, maybe making reference to the establishment of here. Yeah, well, good to see you, Nora. And great to be in Dublin. As we think today in our virtual world, I used to be quite a frequent visitor of Dublin meeting with government with the NGO community when I was the executive director of UNH. So I was a very fond memories. And also I've seen how people are how active you are in that community level, particularly in many, many countries, not only in Ireland. And yeah, I think first one of the silver linings of this pandemic, and there are not that many, is actually has been the the achievements of science before talking about scientists, but the science is made by scientists. But the fact that we have a vaccine and that was or several vaccines, and they were delivered in no time with very high, you know, efficacy. I always thought before we had a vaccine like in mid 2020, a good year ago, I thought, okay, if we have something that protects us for, let's say 50, 60% of the time, we should be happy. And here we have vaccines that protect us for 90% and made in no time, although that's probably not really not correct, because it's the result of decades of investment in both basic research and in industry, in order to, you know, to be ready and to develop it. But the scientists indeed have come to the forefront of this dealing with this epidemic. And it's interesting that in May, I attended the launch of the annual trust barometer that Edelman and company publish. And it's interesting that the who are the people, that's one of the questions that you trust the most and scientists came first. That was the first time on top, followed interestingly by CEOs of companies. But I think there are many reasons for that. But the big challenge of dealing with this epidemic is uncertainty, is the uncertainty. Even at the beginning, I still remember very well in January 2020, last year, when this news came from China from Wuhan, that there was this new virus, this coronavirus. I've been working with viruses and dangerous epidemics my whole life from Ebola HIV and so that I thought I knew that we would be in trouble. But I really didn't imagine it would be so bad. But uncertainty in the beginning of how is this transmitted exactly? What can we do in the absence of any vaccines and any treatment, any drugs? And that's where scientists came to the forefront, those in power and have to take the decisions. We're relying on scientists. However, I should say that the role of scientists is to advise and to say this is the evidence. But I always say the scientists, those who are unhappy because the government doesn't follow what they say is then well, then you have to go into politics and you make sure you get elected. I mean, that's the decisions have to be made by those people who have been empowered by in democracies, by the system, the elections and so on, people to take the decisions. And that's quite a difficult dynamic sometimes because one of the basic have to say features of science and the practice of science is debate and arguing. Scientists love to argue with each other, challenge each other. And if you do that in public, that can lead to confusion as well. And we have so at the same time, the strong belief in science and trust. And on the other hand, there's also a stronger anti science movement, people who don't want to be vaccinated and so on. Now coming to the to the EU and to my current position, which is a part time position as advisor. And I think what a few points there one, the health is not a, as they call it, competency of the European Union. And certainly, I would I would certainly not argue that health care would become a competency. The systems, the health care delivery systems are so different from one country to another and are grounded in history. In Germany, it goes back to Bismarck, you know, and so you don't want to, you know, change that I think. However, when it comes to cross border threats, as pandemics by definition are, I think there we it showed that we were not prepared. We were not prepared in general, but also not as a European Union. And in the beginning, there were even, you know, bands on export of protective equipment of, you know, there was all kinds of reflexes, but that's resolved. But so, and yet, no competency, but on the other hand, people rightly so expect that the EU does something because it affects us all. And I think there there have been some really serious achievements. I mean, the joint procurement of vaccines, for example, in the beginning, it was criticized, it was slower than in the UK, for example, but at the moment, in many European countries, including in Ireland, we have higher full vaccination rates than in the countries that were fast to get off the ground, you know, with this. And that's thanks to this joint effort. And particularly for smaller countries, I'm originally from Belgium, you know, we would have been at the end of the queue, you know, in terms of negotiating contracts and for procurement and so on. So that is the power of, yeah, I would say solidarity and doing it together. It's like a biosclub, basically. Also, there is now a European certificate, approving that you're vaccinated, because Europe, even if you're living on an island, you know, people travel a lot and they go and so on. So we want to have something. The recovery fund, we this is not a health issue, but there's a massive recovery fund that is supporting countries to to deal with the incredible damage societal wise mental health, but also economically of this epidemic. Now, how do we work? I think what ski is that I am an advisor to the president of the European Commission, which means that I'm not stuck in a silo in any administration in the world, you're in silos. And when you deal with a pandemic, you know, even if you would be this is a virus is a disease, you know, health is of course important. But you know, there are so many other aspects. So you need a, you know, jargon and multi sectoral approach. And that's something I've experienced with, because that's what I try to do when dealing with HIV with AIDS, and saying it's a health problem. Okay. But there are legal aspects, there are, you know, development is poverty, industrial development, just name it. And that means that we can, you know, come together and the president of the commissioners of on the land, regularly host a meeting of all commissioners just on COVID. And I give some, you know, updates. And so that's to bring everybody up to the same level. And that's to see, okay, you're into finance and you're into, you know, national development and law and so on, the many legal aspects and so on. So that is that's one aspect. Secondly, I'm co-chairing with the Stella Kiriakides, the health commissioner Cyprus and a platform and on every two weeks, it was first every week of all national coordinators and Ireland is there also, where we exchange information, because that's where it starts, you know, and I'm someone, I mean, I'm not a civil servant of the commission or so, because I'm interested in, you know, stopping this epidemic and making sure that the countries are in their older member states and learning from each other. That is really keen. But at the same time, we need to make sure that we have much better instruments. We need a stronger European Center for Disease Control, European Medicines Agency. And I know that Emmer Cook from Ireland has been, you know, a guest here. And also, it's clear that we are very vulnerable in terms of supply chains and collective R&D effort, so on. And that's why in her State of the Union address last year, a year ago, actually, is that von der Leyen announced the creation of what's now called HERA, the Health Emergency Response Agency, which, like in the US, is called BARDA. You know, we now have, hopefully it will be, you know, approved this week, I hope, that there will be an instrument at European level to stimulate the development, not only of vaccines, but equipment, have the procurement, have the necessary intelligence, and working closely with the member states and based at the commission. That's what I think, and tomorrow she's giving her State of the Union address, the president. And so that's something that I think will be a fantastic instrument for this, while the Health Union. And then we need some legal ways of making sure that for cross-border threats, you know, we can do it in a much smoother way. And so there's still a lot of work to be done, but yeah. I just want to thank you very much indeed. I want to come back to you, Peter, on that. I know it's not established yet on the HERA model. Do you think that the EU members are more open now to working together on health issues, seeing as how, this time, small countries, as you say, like Belgium and Ireland, we depended on the bigger countries to take decisions so we could get our share of PPE equipment, we could get our share of vaccines, we could get them at the prices we could afford. Do you think there is now a recognition that this area of policy, including environmental control, including the availability of all the things that are needed, not just the vaccines but even the glass vials that the vaccines are in, is that kind of coming together happening? I think I'm an optimist and I would say yes. In the beginning, the early days, what I saw was everybody for yourself and that was not so nice to see and that question you mentioned from equipment to glass vials to trucks couldn't transport food, etc. And I think that there was the reaction of many member states, governments was okay, health is not a competency of the commission. We'll do it ourselves. I think that's a change of a lot. We all are in the same boat and frankly, if your neighbor's house is on fire, you can't say, sorry, that's not my, you know, it's my neighbor's house, I'm not going to do anything. No, we need a fire brigade that will take care of the whole village and the whole community. And that's what we have. But I think we are now entering a stage where we need to discuss what's the value added of the supranational type of competencies and activities and what should we do ourselves. Because when you look, for example, at vaccination, procurement has been done at the commission level. But the deployment, I mean, you don't want a commission to get into that at all. This has to be done by from the GPs to the nurses to whoever, you know, can do that in a member state. So that's the discovery. But I think we are now, you know, there is far more commitment to do it together. Also, we had a global health summit in Rome. This was co-chaired by Ursula von der Leyen and by Prime Minister Draghi as the chair of the G20. And again, there was kind of how to say I was involved in these discussions. I found that usually it's all sovereignty. It's my sovereignty and we don't want. But here, we can say, yes, we are sovereign, of course. However, viruses don't need visas. They have no passports. And I think the creation of HERA, which I hope will be approved today or tomorrow, yeah, tomorrow, is an indicator of that. But we need to go further. And I would say what we probably need is a legal framework for, you know, for one this crisis time. That's when you need to be able to take rapid decisions and have a, I'm not saying central command in each member state, but also at European level. Whereas in between crises, one can do this in a very different way. And that's where exchange of information is really key. And even that in the beginning was not happening, you know, sharing data. And that's now all going, I would say, relatively well. Yeah. Thank you very much. I mean, what you say about the setting up of HERA clearly is an important element and I hope it does happen. Do you think then the EU will be in a better position to look at the emergence of these zoonotic diseases? I mean, I read somewhere that anything like five, well, there's millions of them out there, but this jump of the diseases from animals to humans now is become an issue that we are all beginning like many scientists to talk about. First of all, I should have told our audience that you yourself fell to the virus. And I hope and pray that you are well, you seem well, but you are now as you call an inside expert from experience and which probably makes a difference to how you work. But the zoonotic diseases about which most of us knew nothing, they are growing all the time. So will a body like HERA be able to monitor that and work with scientists working in the jungles and various areas where these diseases emerge? No, you're absolutely right, Nora. When you think of it, what do the flu, Ebola, HIV, SARS, COVID have in common their zoonosis. They're all originated in animals. I know there's some debate where exactly it's coming from. And for SARS it took about eight years to find the origin. So it's a bit of looking for a needle in a haystack, but it's coming from animals. So that's why the concept of one health is so important. If we only deal with us human animals, human primates, then we're going to miss the boat. And so we need early surveillance. And that exists, for example, for influenza. For influenza, there is a worldwide network coordinated by the World Health Organization that tries to detect problems in birds. You would say birds and in poultry and all that, because most of the new influenza strains that cause an epidemic or a pandemic now and then. And I hope we won't get that one at the same time as COVID. But they originate in birds. And so then you have an early warning system. And here it's explicit in the proposal by the Commission that it would deal with early warning, but in collaboration. You know, you can't do that just in Europe. That doesn't mean that all these viruses come from Africa or Asia. So we also have viruses and microbes that can originate here. So think of the various variants. There's another term that's now very common, you know, for COVID. First, we had the British variant or the English variant, although we're not allowed to say that anymore. It's now was alpha variant. So it can emerge anywhere. And one last point on this is it's clear to me that we're entering the age of pandemics. And why is that? It has to do with climate change. It has to do with population pressure, with deforestation, with urbanization, with high mobility, a bit less at the moment. And that makes that the opportunity for viruses to jump from some animals to us, human species, to develop into a big epidemic, that opportunity is much, much greater. I talk opportunity from the perspective of the virus. And what we cannot prevent is that viruses will jump from, you know, from an animal to us. That's always going to happen. But there's more and more contact. There's this population pressure. So we can expect more and more of these epidemics. Doesn't mean they have to become pandemics. It could be worse than we have now and it could be less. But when you look at the statistics of the new viruses that have emerged in pandemics, it's really going up in a big way. And that's not just because we are better equipped to diagnose them. That because that could be a reason also. But and that's true that we when we were isolated Ebola virus in 1976, it took us several weeks. Today, it's more a matter of hours or a day or two to find a new virus. That's because of technological advance. But it's because of this vicious circle of climate change and environmental degradation, mobility and urbanization that we we can expect more. So that means that today we need not only to need to make sure we can stop this epidemic. And that's where the vaccine vaccination is number one one approach, but also prepare for the next one. Sounds depressing, but best time to prepare for the next one is now. Yes, I see from some of the reading I've done that some of the scientists referred to chain of preparedness. And I mean, when you talk about the climate changes, we tend to look at things like flooding and fires and that as being the signal signals for climate change. But in fact, the pandemic has shown us that it is also very crucial to the loss of climate effectiveness around the world. And so I just want to ask you, do you see going on seeing as how you have quite a powerful position as advisor to the president of the Commission. And you can talk to the other commissioners about the area of climate change about overseas development aid, what work should be getting done, particularly in continents like Africa, where they really are not able to cope with this kind of pandemic. Do you see a shift in the kind of spending of official development aid on issues going forward. Yes, indeed, nor I think there is a shift but that was on the one hand as a shift that's directly linked to to COVID. And that there is going to be far more attention for pandemic preparedness, not only from a perspective of global health security, which was kind of a Western concept to protect the wealthy countries from viruses coming from poor countries. Today, it's clear that, you know, this affects everybody. So there's more attention for that. But then also on the negative side, because of all the of COVID itself and a decline in funding, other diseases have been suffering and development programs. Think of education. I mean, this is going to be a real, real long standing disaster that billions, literally billions of children have been deprived of basic education because of COVID. We know that is going to have quite an impact on development. But on the positive side, from my perspective, is that take Africa, which I'm most familiar with in terms of international development work, and we're also Ireland is, you know, very active. And when I compare today's situation with the certainly the beginning of HIV of AIDS in the 90s or 80s and 90s, and Ebola in 2014, there are increasingly strong institutions in Africa that we can work with. The capacity is more and more there. There is like Africa Centers for Disease Control. Nigeria has wonders in many countries have now institutions and very capable people. And so that is a big difference. And what we need to do is to work with them in function of their priorities and making sure that we can support them so that they can do their job. And that's a shift. And that's good. What we are struggling with, of course, is that many of the sustainable development goals will not be met. Now, some of that was already clear from before COVID. The one I was involved with on HIV. And when we have some of these goals, where like we will eradicate, I don't know how many diseases and this and that mean that was not very realistic. It's good to have to be ambitious. But the clock is being set back for billions of people. Also people pushed into poverty. I was mentioning education, but also the nutritional status. So that is quite an issue. And that's why when you look at going back to HERA, for example, one of the explicit goals of HERA in the proposal is to stimulate and to support international collaboration. Not only for international surveillance, we need to know what's going on thousands of miles from us. I mean, you know, most people in Europe had never ever heard of Wuhan. You know, but you know that some place around 10,000 miles from us where it starts can have such a devastating effect. So that means we need to know that for sure. And we need to be part of that international system. But also, for example, is supporting Africa for to develop manufacturing of vaccines. Africa produced about 1% of vaccines. But at the moment, it was totally dependent on vaccine production in India. India is a pharmacy of the world. However, since India had such a bad COVID problem, Prime Minister Modi issued an export ban of any vaccine and the whole strategy of, you know, the international community with Covax and so on, was to use Indian vaccines in Africa. And so I know that manufacturing of vaccines is not an easy thing. It's going to take time. But when you take Acid-Yupastur in Dakar, for example, they already produce a yellow fever vaccine that can buy on the market. There is capacity. And it'll take probably at least a year before, you know, that will generate vaccines. But as I said, we need to be ready for future. And that will help also develop industrial capacity, provide jobs and so on in several African countries, not every country. I mean, also in Europe, I mean, Ireland has a very thriving pharma sector, but not every country, Belgium also, but even some of the big ones don't have it. So that's why we need to play that role also internationally. But we haven't done it fully. We could share. I'm clear you've highlighted how important research and development and collaboration worldwide. We're not on our own anymore as a European continent. We are now in the world.