 Hi, I'm Dr. Daniel Kraft, the chair of the XPRIZE Pandemic Alliance Task Force. The XPRIZE Pandemic Alliance has recently grown to become the XPRIZE Pandemic and Health Alliance, and it's our goal through collective action and collaboration that the XPRIZE Health and Pandemic Alliance is going to accelerate solutions and radical breakthroughs to build a healthy future for humanity and to prevent future pandemics. And as part of our Pandemic Health Alliance, we've been running jam sessions, joint action meetings. This week, we were lucky to have our key lead discussant, Dr. Larry Brilliant join us. Dr. Larry Brilliant is a leading epidemiologist, technologist, philanthropist. He worked with the WHO, the World Health Organization, to successfully eradicate smallpox. Among other roles, he was the inaugural executive director of Google.org. He also helped start off and lead the Skoll Global Threats Fund as the founder of SEVA Foundation and much, much more. So really pleased to hear from Larry Brilliant joined by some other leaders of the pandemic from Rick Bright and others to discuss what we know about the pandemic today, what's going to be needed next as well. I also suggest you read Dr. Brilliant's recent Wall Street Journal piece to fight the global COVID-19 pandemic, we need a global game plan. So over to my friend, Dr. Larry Brilliant. It's first of all, congratulations to you and your XPRIZE team, what wonderful work you've done and thank you for inviting me. I think what we've said that we would do over the next few minutes, next half hour or so, is that I'm going to give you some musings on the pandemic. And fortunately, the World Health Organization had a global advisory meeting, a global consultation that ended just a few hours ago. And I'm going to give you the real-time results of 1,000 researchers from 100 countries online. And then just a couple of observations. And then Daniel and I are going to talk a little bit. He's going to ask questions, right? I'm going to ask you questions. And then I think we have Rick Bright and Peter Singer to join us. So we're really going to have a chance to talk about the pandemic. And it is the pandemic. It's not just Amicron or it's not just Delta or it's not just Wuhan or it's all of these variants simultaneously propagating all over the world. And they are, in fact, bumping into people who have had the disease before, but which variant, how long ago, bumping into people who've been vaccinated, but which vaccines, what cadence, and how long ago, and what's their intrinsic immunity as an individual. So it's a complex multiple-egistic regression in real-time. And we're really worried about what all that means. And I'm going to try to answer the questions or begin the questions of what does it mean for you as a person as you walk through life in the next year or two? What does it mean in the near term for public health, for non-pharmaceutical interventions, for closings, for vaccine mandates, mask mandates? And what does it mean long-term? My colleagues and I wrote an article in Foreign Affairs that got us into a lot of trouble because we named it the forever virus, but it is a forever virus. That doesn't mean it's forever taking all the oxygen out of the air other than physiologically. It means it's going to be with us forever. And we need to understand what it's going to do and how we plan to live a full, exciting, wonderful life around it. So let me start off by telling you I'm a big fan of the potential for WHO. That's not to say that everybody who's worked with WHO doesn't have a love-hate relationship with WHO. But the potential for WHO is immense. And the article I did in the Wall Street Journal was the importance of having a global strategy and a global team that takes advantage of the fact that there are outbreaks happening all over the world, great scientists in every culture and every language. And when they collaborate, it's a thing of beauty. And we had one of these things of beauty this morning. When WHO is trying to answer the question, what do we know, how do we know it, what don't we know, and how do we find out those answers? And the title for this event is called a Global Consultation on how do we know that Omicron is being transmitted more quickly, that it has immune escape, and what does it mean for the future, and what research should be done to answer the questions that we don't know. It's part of something called the R&D Blueprint, which is organized as part of the Global Outbreak and Response Network. One of the things that no one loves about WHO are the charming acronyms, of which there are many, but this was a sensational meeting over 1,000 scientists from over 100 countries, at least 30 or 40 presentations, each one trying to say what does Omicron look like and reminding us that there is simultaneously a Delta winter surge in most of the developed world, in most of the West, in most of the Northern Hemisphere, in the United States, and in Europe. So inside of that Delta surge, which at this point is certainly the greater of the two outbreaks, is a nascent outbreak of Omicron that is probably the most transmissible virus that we've ever encountered, and it is doubling every two and a half days, and that means that it will be 50x the number of cases that it is today in two weeks. You can run that through the thousands of times that it will be multiplied by January, the end of January. And people say it's competing with Delta, that's not exactly right. They say it will push Delta out. That's not exactly right. They will both co-habitate and we will be subject to the vicissitudes of these two viruses. But what's top of mind for everybody, and let's get right to it, is what do we know about Omicron and what, not what Rick Bright or Peter or I think about it, but what is the WHO consensus based on the research presented this morning? So there were hundreds of slides. I've chosen three that are summary slides. And if I could have the first one. Yeah, we're putting this up just right now. And these slides are the conclusions of this meeting. And so they're asking the question, what does this day's presentation of research mean? Well, it means that it's pretty clear that vaccine effectiveness will be much more reduced, even for symptomatic disease with Omicron. And vaccines will be much less effective against transmission about getting the disease and giving it. When you look at a vaccine, there's three things you want to get out of a vaccine. You want it to stop you from getting it. You want it to stop you from giving it. And you want it to stop you from getting sick. And what we're seeing from Omicron is that prior infection, so-called natural immunity, is not even a speed bump for Omicron. If all you've had is a case of beta or Wuhan or alpha, a prior variant, Omicron looks at you and says, you're part of my marketing plan. And that speed bump doesn't stop it from infecting you. If what you've had is two doses of Pfizer or Moderna, the gold standard, the mRNA vaccines, Omicron looks at you and says, another customer. And you don't have enough immunity, especially if it's been six months or longer, to protect you from getting the disease. However, you do have enough immunity to protect you from getting sick. And if you get a third dose, the booster, and it doesn't matter whether this is a heterologist, in other words, you mix and match Moderna and Pfizer and J&J hardly matters which order that is. If you've had three doses, then your immune status is enough to bring you back to the level that you were two years ago when two doses of an mRNA vaccine prevented you from getting the prior variants. So it's complicated story. It's evolving. And I want to mention that since so much of our information comes from South Africa, and South Africa has been phenomenal. They have been transparent. They've done great research. They've been forthcoming. They've shared viruses and samples with the whole world. And yet they are a bad example because they are anomalous. They're probably the only country that I could think of that has 72% of the population had prior infection, but only 28, 29, 30% of the population's vaccinated and less than 10% of the population's over 60 years old. I can't think of a state in the United States that looks like that or a country that looks like that. So some of the data we'll present right now comes from South Africa, but they've done a great job and the lab work they've done is terrific. But when you're looking at the epidemiological data from South Africa, take a deep breath and say, okay, now we have to see how it plays out in Germany and in the UK and the United States and in China and India in order to get a big picture of the whole world. So the summary of this, what does it mean is that emerging data suggests that the disease could be less severe with lower, it says numbers hospital. I don't think I would say that. I would say with a lower case to hospital ratio and shorter duration on average. And the reason I won't say lower numbers hospital is the next slide. So even if the disease is milder, if the disease is spreading so quickly, doubling in two and a half days, 50 times increase in two weeks as I said, there's a tug of war going on between the number of cases that will be created. And even with a lower percent of those cases hospitalized, it could overwhelm our hospital system. If you remember the peak of the previous spike for the outbreak in the United States was when we went from 100 to 200 and we touched 300 cases a day and we all thought that was the highest possible. But what if we had a million cases a day? And that is actually the prediction if Omicron spreads in the way that it is, we might see as many as a million cases a day in the United States. Now ask yourself, even if the percent of people who are hospitalized is dramatically lower, that number of cases, there's hardly any number you can multiply by a million and not have a bad number of hospitalizations and how will that affect us? More importantly, the virus is constantly mutating. There's already a second Omicron, a second clade inside of the Omicron family. And every day, every replication of every case of Omicron, the virus is changing dramatically. It was born almost out of whole cloth. It emerged with 50 variants, almost 30 of them in the spike and 20 or 23 of them in the business end of the spike. So we don't know really if you're talking about a verb now, think of the virus as a verb or virologists call it a swarm, that every time you're infected with a virus, you're not infected with just one variant, you're infected with hundreds of different ones and they're all vying to see which one can infect the terrible image, the soonest. So it's against that verb, not against that noun, that we've got to predict the future. And the PHS and public health social measures, that's really what we would call MPIs, non-pharmaceutical interventions. These are the things that can keep us safe, regardless of how transmissible the disease is or how dangerous it might be. And these are, of course, masks. They're testing, routine testing. Rigorous testing. They're isolation and they're social distancing and restrictions on openings and closings. There's a lot about boosters. I think probably that's the wrong word to use for the third dose of what should have been a three-dose regime if we had had the time early on, not in the middle of a pandemic, to think about what the cadence should be. But there's not, I mean, the data that was presented is startlingly important because the takeaway is that you not only get a quantitative increase in immunity with your third dose, you get a qualitative difference in your immunity. And that's really something to consider. So the question of what should you do, first thing you should do, all of us should do is get a booster and talk to our friends and family and get a booster. And then be aware when you do that of the lack of equity and not only the unfairness of Americans gonna be looking at the fourth dose, well, for one or two billion people, they will not have had their first dose. And that's not merely a matter of equity or ethics or morality. It's bad epidemiology to have a billion people getting infected with a disease like Omicron that's growing and replicating so much and creating new variants. So we may be producing a world of super spreaders and super variant manufacturing plants if we don't make more vaccine manufacturing plants all over the world and available. And may have the next slide. And this is the last one. So what are our unanswered questions and what are the studies that we need to do? One of the questions was, is it the case that variants are emerging in individual human beings who are immunocompromised and in whom the virus is being slowly simmered for weeks or months and then producing a new variant, which has been suspected in the Alpha variant in the UK and it was suspected in beta and suspected in Omicron. We don't know if it's true, but what does it mean and what studies do we need to do? And there are 12 animal species that have coronavirus and what are the studies that tell us that we either are or are not being reinfected from animals and that they may be adding to variants. What causes variants in other words and how can we plan a world in which instead of thinking about mass vaccination which is not a strategy, mass vaccination is a slogan, how can we think about it epidemiologically to cut chains of transmission? So we reduce the chance of super spreader events and we reduce the spread of bad variants. And then what other resources should we put into understanding, as he says, the source of variants of concern and how do we prevent the variant of high consequence that we do all worry about? And I would say a lot more epidemiological data is needed. The severity of Omicron, the spread and transmissible the ability of Omicron in different cultural and economic communities. So this is just to give you an idea of what WHO is doing. It happened this morning and it was timely. I think it's a good introduction to what is the, I don't know, the state of awareness, the state of the art, the state of knowledge of Omicron. And with that, Daniel, I'll turn it back to you. Or am I turning it to Susan? Back to you for a sec. Thanks so much. That was a terrific overview where we are with Omicron specifically. And I assure for many of us listening here or in this Zoom, we wanna think about the next month and implications first for ourselves. What are your recommendations and what is WHO or this thing about Christmas travel besides getting boosted and going back to wearing masks and the other elements we should be thinking about? So I think right now, depending on where you are, we have a hopscotch pattern of vaccine coverage, a hopscotch pattern of prior illness and a hopscotch pattern of non-pharmaceutical interventions and public health interventions. I live in Wren County, which is one of the safest places in the country because we've got a great health officer, we have 90% vaccine coverage and people continue to wear masks indoors pretty much and there's not a lot of rule breaking. But there are a lot of places where that's not true. If you look at the outbreak that we see right now, it's almost on a diagonal. Going up to New Hampshire, which has one of the worst outbreaks, Michigan, which has had a horrible outbreak, Minnesota. Are these bad outbreaks there because of something that's happening in the state that the Health Department with vaccine coverage or are they simply because winter has gotten there earlier and people have gone indoors and the cadence that we always expect, the Halloween Thanksgiving Christmas New Year cadence, that's really a surrogate for winter and being indoors with friends. Maybe that's happening there sooner. But if you just do a straightforward regression, you would see that the single most important factor is vaccination coverage. One dose, two doses and certainly boosters, less than 25% of the people in the country who are eligible for a booster have had one. And we've estimated trying to look at the susceptibilities, the density of susceptibilities in the country that there are probably nearly 100 million Americans right now who are susceptible to Delta. If you ask how many are susceptible to Omicron, it's probably most of us. So those will make the epidemic near you kind of run over what the public health plans had been before. So I can't answer what an individual should do for the holidays. I couldn't for Thanksgiving. I would just say this, we know how to keep people safe. Regardless of vaccination status, regardless of the variant, the same things that kept us safe before we had vaccines still work, masking, social distancing, being careful, making sure that you test if you're gonna have a Christmas dinner. I mean, I know it's really awkward to have testing before Christmas dinner, but one PCR test the day before and one antigen test the morning of, that's a really good formula. It's the least invasive. When we do Hollywood sets and Disney and stuff like that, we've never had a single transmission on any of those sets, but we do a PCR test every single day. I think that's economically and practically not feasible, but one PCR test the day before, antigen test the day of, that's pretty good. I wanna bring others, including Rick Brighton in the conversation, but before we do that, just maybe a high level. We spoke last interactively in April of 2020 as the pandemic's kicking off and you framed it especially a practice pandemic. We're now off into what's called the pandemic of the unvaccinated, but many other folks are still getting sick and dying. Can you just say a high level thought on the failures and the opportunities that lifts into your Wall Street Journal article and any ways we can bridge this now political other divide where we have the tools, but they're not always being utilized. I don't think it's a pandemic of the unvaccinated anymore. Anacron is not a pandemic exclusively of the unvaccinated. I think we've approached this like every pandemic in history, not knowing what comes next. We've done some amazing vaccines are just sensational. They're a good bet for winning the Nobel Prize, but they're a bad bet for stopping the pandemic. If you include the one or two billion people who WHO classifies as rural remote, we talk about them as the last mile. You're not gonna get a vaccine that requires injection, requires refrigeration to reach the people who are that far away four times. That's not gonna happen. So we need different kinds of vaccines. We've missed the chance. We need nasal sprays. We need drops. We need vaccines that like smallpox could be given by any villager like polio could be given by anyone drops. And we need to have them locally manufactured, approximate, and we need to have lots of them inexpensively made. And these vaccines that we're making, the ones that we're doing right now, they can't be given to you after exposure. They don't have any effect, but we have in the past had two vaccines, at least not counting rabies, polio, the Ebola vaccine in the Congo and the smallpox vaccine that you could vaccinate, they've been exposed and that would stop the transmission and stop them from getting sick. So we have a lot more work to do on vaccines. That's not to denigrate the mRNA magic. I think that's one missed opportunity and I'm looking forward to seeing that happen. The second and the most important for me is we've got to start thinking more epidemiologically. Mass vaccination, it's the first thing you always want to do and even epidemiologically, it makes sense to put a level of one dose on everyone in the world, but we haven't done that. The rich countries have hoarded 60% of all the mRNA vaccines. So we need to think about this as a real epidemic. It just happens to be global and we need to ask ourselves, how can we interrupt chains of transmission? A pandemic is made up of hundreds of millions of small epidemics. Right now we can't see them. We can't see the little outbreaks. We can't see the causes. It's very difficult to do outbreak investigation on one dinner party when billions of people are being affected, but if we can lower the ambient viral load as we've done three times so far in this pandemic and then look at what do we do to interrupt transmission? And that will require really good surveillance, sewage surveillance, exposure notifications, satellite monitoring of the parking lots of emergency rooms, digital disease surveillance, opt-in participatory surveillance systems and so many other systems that would allow us to pinpoint our response and understand where the virus is going and then bring in the measures. And these are vaccine saving measures because you can use the vaccines, you can use the antivirals, which are really, in the Pfizer case, a real breakthrough, I hope. And you can also use monoclonals. So it's just a couple that have been made, not working so well against Omicron. But we have a basket of interventions. We need to bring it to the place where the outbreak is and decide and understand how to predict where the outbreak would become a super spreader event. We haven't done that very much. It's not fair to ask that of us, I think, the world, but soon we're gonna have to ask that of ourselves because we can't keep on like this with more and more variants having this schizophrenogenic way in which the pandemic is making us feel comfortable for a moment and then, oh, no, here we go again. I think we're gonna have to develop a really serious global strategy and a global team to implement them. And that's really what the Wall Street Journal article is about. Speaking of global team and collaboration, we also have an article looking at Rick Bright who's heading up efforts at the Rockefeller and has a long history and testing and pandemics beyond. And Rick had a question and maybe you guys can mix it up and also help us think about how do we all collaborate to move forward here, Rick? Well, thanks, Daniel. Well, there's nothing, hardly anything that you can add to what Larry has to say. I mean, Larry, again, that was one of the best overviews I've ever heard today on the current status of the pandemic and Omicron and all of your wealth and knowledge and experience that adds to it and it's just really brilliant, Dr. Brilliant. I do have a couple of additional, I know you get sick of that after 60, 70, 80 years, but... No, I'm just, I'm just preparing for when I say Dr. Bright. I'm just thinking about it. Larry, you know, one of the things, two things that comes to my mind too that maybe doesn't get much attention. You know, what are we doing in terms of our vaccines and vaccinations still adding immunological pressure on the virus as well? And also as we continually adding doses of vaccine, we're gonna call them boosts or we're gonna call them a three dose, four dose and five dose regimen. Sooner or later we're building immune tolerance as well, which some of our strategies that we might think are helpful might actually be working against us at some point. And I think one of the things that we need to add to the arsenal that you mentioned and you covered the landscape with wastewater and everything as well, but you know, our next generation sequencing genomics or valence capabilities around the world really need to be picked up, I think, so we can analyze those breakthrough infections from vaccines and vaccinations, understand which vaccines might be driving change in the virus or evolution. As we think about the antiviral drugs, which I agree, I'm so glad to see that here the Pfizer data coming through, but every antiviral drug you and I are familiar with will also drive mutations in evolution of virus. So we don't have those genomics, surveillance sequencing technologies in place at the right place at the right time. Then we're gonna continually miss Omicron. I think Omicron was caught with the astute scientist in South Africa. If we didn't have that warning, it would probably be circulating among all of us still right now and none of us would have a clue yet till it really reared its head in a big bad way even more. And so how do we tie in that next generation sequencing genomics or valence and what are your thoughts on tolerance? First of all, full disclosure, Rick and I are friends and we co-authored that article in Foreign Affairs. Nice to see you, Dr. Bright. Well, three things I think that you covered. One is the importance of viral sequencing and I can't agree more. I mean, finding something through a satellite image of a hospital that's getting more traffic into the emergency room, that tells you the problem, but it doesn't diagnose the problem. Even finding an outbreak epidemiologically doesn't answer the question. You've got to get a specimen. It's got to be sequenced. In this world where we've had thousands of variants, five of which are variants of concern, we need to know exactly what we're dealing with. You're totally right about that. The work that you're doing, putting together a network of viral sequencing in Lipkin's work, the Berlin hub, these are sensational ways to do that. I consider that part of surveillance. It's, of course, more verification than case finding. But the bigger issue that you're raising is what are we doing to cause the virus to mutate in ways that are ever more dangerous for us, that perpetuate the lifespan of the pandemic and increase the already non-zero probability that there'll be a variant of high consequence. And if I may talk a little bit about particle physics or talk about Heisenberg and the operon theory, I think a lot of people are familiar with it philosophically, Heisenberg's uncertainty principle, which is basically that if you wanna observe where in an orbit an electron is, you can't use an electronic instrument because that will alter the flight of the electron. So this is really important. We have it in sociology with the Hawthorne effect that you cannot observe something in the same way without altering it. And we are doing exactly that by creating islands of immunity. And we will have this with the monoclonal antibodies. You're all familiar with the idea of antibiotic resistance. That's a special, but we will alter the trajectory of this pandemic by trying to protect ourselves. And the virus then mutates. And the way this stuff works is there's a viral swarm, there's all these different viruses, all these different mutations. The mutation, which is the best at the countermeasures to what we are doing is the one that we'll be selected for. So we are part of the evolutionary history of the virus. And I couldn't agree with you more that we've not studied it. We've not quantified, we've not built it into our strategy. Speaking of strategy in your Wall Street Journal piece you wrote about how we need to do it for it and restructure and empower the World Health Organization, which has done amazing work but has challenges and is learning. Peter Singer just joined us from the WHO so I might put him on point, but maybe Larry, if you can mention your thoughts and what needs to sort of happen next at the global collaboration level and maybe Peter can interact with you on that topic. Thanks. Hello, Peter. Hi, Larry, how are you? I worked for WHO for decades in smallpox eradication, polio eradication, blindness, the tsunami, expanded program minimization. I love WHO's potential. It is almost not possible to design a organizational structure worse than the WHO structure. It would be for though, because there's a lot of people here who are startup mavens. You would not start a company where you put on your board of directors, your employees, your customers, your suppliers and your enemies and give them almost having to have a consensus of 100% of them in order for you to do anything. WHO structure has paralyzed it almost from the beginning. It is a late 18th, early 19th century structure, even though it was created mid 20th century. And it is not the right structure going forward. And in fact, because of its structure, these satellites that go around WHO and circle it like the Global Fund and GAVI and COVAX and all UNAs, they've all been created to try to make up for the shortcomings of the structure and the regional structure of WHO is also problematic for me. But it's some of the most incredible people great managers, phenomenal scientists from all over the world have managed to make it work. But we can do a lot better. And the slowness of WHO and responding to pandemics is not a function of willfulness. It's a function of the structure. So I'd like to give more power to WHO. I'd like to find a way to create the global outbreak response network GORN and give it more authority and more resources. But concomitant with that is that WHO has to agree to be restructured. And we have a couple of proposals like the independent panel that was created by the World Health Assembly, the pandemic consortium and the pandemic treaty. There are a lot of ways to do this, but I think we have to, there's nobody else who can do the work that we have to have on a global level than WHO. Is that a fair statement, Peter? Or would you disagree with everything I said? Well, firstly, thank you very much for the warm welcome. Obviously what you've done is well-known to everybody and it's celebrated. Let me just start. You know, I can't wait to see what's going on. Let me just start. I came from an indigenous circle just now and it's very important there for people to say who they are and what they're starting with. I'm not a WHO lifer. I'm a startup guy. I started up social enterprises and I went to WHO in 2017 with Dr. Tedros because I was inspired by his vision and by his leadership. And I went there for two weeks, five years ago when I'm there as his special advisor. Let me just say, Larry, that I think you would probably agree that everything starts with leadership. And what we have in Dr. Tedros is a voice of moral clarity about equity in the world and about the response to the pandemic. So to me, that's point one. Point two is even before the pandemic, and I think people, and I'll try and debrief, even before the pandemic, and I think people don't fully realize this because the pandemic has been a distraction, that Tedros embarked on a reform that was routine branch and very significant. So we had the strategy which has the triple billion targets. It's the only international organization that I'm aware of that has measurable targets in universal health coverage and healthier populations and health emergencies across all its activities. And not only are they measurable but they're also measured and not only are they measured but those measurements are used for change. So for example, I'll tell you something and just one factoid that I don't make anyone on this call those and everyone should. We had a target of a billion more people gaining access to universal health coverage between 2017 and 2023. We know, we're projecting now that the shortfall in that number before the pandemic is 730 million and after the pandemic is 800 to 840 million. So the attainment is less than 20% of the target and it's an heavily SDG based target. I only say that because it illustrates the point that this is about leadership which we have with Tedros. This is about measurable goals which we have with, it's kind of three by five across the whole organization but nobody knows that. And it's measurable goals and I just illustrated that and then coming to the pandemic. I think, I read with interest your Wall Street Journal piece and I think the problem is not that there isn't a plan. I think there are lots of plans. I think the issue is in execution like in most of life and you executed so brilliantly with smallpox. So take one small example and then I'll stop. You know, vaccination is not gonna end the pandemic but it's probably a necessary step. And you said in your piece, vaccinate the world is not a plan but in fact there's a set of targets that every country should vaccinate 40% of their population by the end of this year and 70% by mid 2022. Even those targets are too low they're constrained by supply. You know, the United States would not be happy with 40% by the end of this year and many countries are not on track and a lot of it is supply some of its distribution but on the supply side, you know there's actual concrete executional steps that are needed. There's an mRNA technology transfer hub in South Africa that companies haven't cooperated. You know, if you look at the amnesty report card on the percentage of vaccines that say Moderna or Pfizer have distributed to low and lower middle income countries it's less than 10%. So the plan is there. The execution is I think they're lacking and I guess to my point would be we all have to come together to fix this. You know, Rick's done terrific work in genomic sequencing which is so important as we see in South Africa. But today the governments of the world are in Geneva debating about whether WHO's assessed contributions should be 50%, you know on a budget of $3 billion which is smaller than you probably your local teaching hospital. So I want to argue for us to work together for teamwork, for execution, for doing exactly what you did with smallpox. And there's more than I could say about the ecosystem and Gaby and Global Fund and stuff that you mentioned that I won't go into that now because I don't want to monopolize and I should stop but I just want to say, let's execute. Let's execute together. Let's end the pandemic. The plans are there. If we work together, we can actually execute. We've got the metrics, the barriers are clear. We can only overcome them by joining forces. So Larry, is there anything I said that you disagree with? My friend. It's not just disagreeing Peter. I think it's a first I want for the record. I think Ted Russ is the best director general we've had. I've worked with the past five and the fact that he's got a new five year or we'll have a new five year term is really great because it means the politics get a little bit out of the equation. But I'm proud to call him a friend and I'm a big booster of Ted Russ. I know. He's got around him. I mean, Mike Ryan, so many phenomenal people. That's what I was trying to say is that you've got these great people but they're shackled by this structure. And I frequently compare WHO's budget to the San Francisco Health Department budget in hospitals. You've got one organization that's responsible for the healthcare of 200 countries and it's got a budget of less than a medium sized city a city of 750,000 just the health department. And but you're not gonna get more money going into WHO that my point it's been put into the global fund and into GAVI because WHO can't take on more duties and isn't being given the freedom to act by being shackled by the structure that it has. I think WHO is leading now some of the reform efforts. I will tell you that in the past when a reform effort was raised brought to the G7 or brought the WHO would just send it to a committee that never met. And I think Tedris is serious about it but it's really hard to do. It's hard to fly the plane while you're rebuilding it but I don't disagree with the other things that you said at all. I think we just support WHO. I think the end is we all need to support WHO. I don't think Peter that people know about things like this consortium which has opened everybody in the world. It's a webinar, anybody can attend it. And WHO's really outward facing activities have increased dramatically under Tedris. It's not as insular and WHO again is becoming the repository of the best science of the world. No single country can do as much as all countries together and WHO is playing that role. All right, we've got about 10 minutes left. So I wanna make sure we get other folks to jump in with questions. I'll just channel one for my father Michael Kraft who's on the call related to the question about vaccine hesitancy in the US, Africa and beyond as one of the hugest barriers. Larry or any others on the call wanna mention about how we might approach that or unbreak the political divide. Can I just say, Michael, you should be very proud of your son. I think people think that vaccine hesitancy is something new. The first vaccine was 1797, and I don't think there's been a bigger anti-vax movement than there was against smallpox in India. Because to make the vaccine, you had to kill cows. Because the word vaccine comes from Vakas, which means cow. And can you imagine what the anti-vax movement was like then? And the anti-polio vaccine movement was horrific to the extent that a hundred polio workers were murdered by the Taliban. So the anti-vax movement was 1797. So the anti-vax movement is understandable. You're taking somebody who's healthy and you're saying there's an odorless, invisible, tasteless virus that's gonna infect them maybe later. So we're gonna give them something that is pretty safe but not completely safe. We have to understand that, I think. We shouldn't be, this is not Michigan, Ohio State or the Giants and the Dodgers. That's not what this is. And I think that we fail to listen to each other and we need to figure out how to kind of unhook the anti-vax movement from one political party or one movement. I just wanna jump in quickly, as we're here as we've shown the convening power and collaboration of this Health and Pandemic Alliance where 80 to 100 partners, there's a lot of power in this group. So how can we help? Is it education? Is it marketing? Is it outreach? Like love to hear from people because this is what we're all about. Like we're all about not just having conversations but taking action. So we'd really love to hear from people how you think that the Alliance itself can help. I would like to jump in on that because I'd love to see you give an X-Prize for the creation of a vaccine that is the best vaccine as a global vaccine. That is designed so that it can more easily reach the one or two billion unreachable people who are the most vulnerable, the ones who are left out and the places at which variants and super spitter events will occur if we can't get there. So given the structure, because we may not change that in the next month as much as I think both Peter and I would like to, given the fact that we don't have total viral sequencing everywhere, as Rick and I would both like to have, nonetheless we have an army of workers who are willing to vaccinate people and you can increase that if we can get vaccines that can be manufactured approximately at low cost that don't need cold chains, that do not require injections, that create more rapid immunity and that stop transmission. And there are other aspects of that. We could get a group together, design it. That vaccine could save us from this pandemic becoming, not just multi-year, but multi-decade. And I'll just pile onto what Larry is saying. Yeah, again, for X price, but innovation challenge out there for novel administration of vaccines. See that through, and there's a lot of innovation right at that cusp, but it needs that push. Is it the oral pill? Is it the patch? Anything to get rid of that needle and syringe and that cold chain to get that last mile and that last inch over that home to reach more people could have a dramatic impact on society in terms of vaccine, not just for coronavirus, but for other future vaccines as well. You know, on that topic, on all the vaccines and the hesitancy and where World Health Organization is tied together, the Kaiser Family Foundation has been cracking vaccine confidence, which is very much tied to confidence in science. And it's actually not race, divide, income, any of those things that creates the differentiator between those who are vaccinated or not, it's whether or not somebody has health insurance coverage. That's what they're finding. And so when we tie that to the universal healthcare coverage movement, it pulls in everything that is primary and preventive care. So when we start tying those things together, that is where from the standpoint of this strategy of how do we overcome hesitancy? The reason why most people are hesitant is because they either haven't had access to care because of the rural nature or difficult last mile or the care that they've had hasn't been something that's built in trust and that comes into the racial elements. So if we can address making sure that people have healthcare coverage, have access to it, all of these things around trust and hesitancy and equity, it's amazing how they snowball and they can actually help solve each other. So I would encourage, you know, when we think about what can the XPRIZE do or all these others really go to that base layer of how do we make sure that every person has universal health coverage? And it's hard. I mean, that's a big deal, but it's like an all cause mortality issue that if we focused on we could fix or get better at, I should say, fix is hard. Sean, if I may, you know, why not do what we did in 2003 with the Grand Challenges in Global Health where we all came together and we came up with the suite of challenges that needed to be solved. That's something that you'd be great at. I was one of the co-founders of Grand Challenges Canada and I was involved in that Gates effort. So you guys are, what you're saying is music to my ears, but the first step would be to come together and say, here's the top 10 challenges where innovation is required for pandemic preparedness. You know, genomic sequencing, vaccine hesitancy because you want to embrace social innovation as well. And just come up with, you know, what Larry was talking about in terms of vaccine delivery, which of course was one of the early Gates challenges. A really good example on this is maternal health. The only place in the world that is not getting better at this is the US. But when we take, you know, these areas that unify us and give us an opportunity to build trust, it's amazing how many more women when we focused on the maternal health outcomes did end up getting vaccinated and got their children vaccinated. I love all these ideas. Maybe as a next step, what we do is we create a working group, you know, and anybody that's on this call that would love to continue the conversation and do sort of a deeper dive because I think there's so many great ideas here and really focus on what it is that the health and pandemic alliance can do. But I definitely think it requires another conversation. Does this, we can go, we can listen to you all for hours and hours and hours. This has been fantastic. Thanks all. My internet's back on hopefully. Thank you all for joining. We have about two minutes left. I would encourage you to share ideas on the chat, reach out to Susan at XPRIZE.org. I think we can convene some other potential prizes and challenges around vaccination and beyond. So we'll definitely circle back up on that. Susan, Larry, any, or Justin on team, any closing thoughts? No, I'm glad you're doing this. I'm really pleased that you have this convening and you have this group. I have great expectations from you. No pressure, Larry. Thank you. Well, you should. You should expect a lot out of us where much is given, much is expected. You got it. That's it. I go for it. That's true. This has been fantastic. We really appreciate, especially during the holidays and people's time and the timing could have been better, Larry. Thank you. And Peter, from really just the right off, literally hot off the press. This is really phenomenal information as Rick said, it was the best overview that I've heard. And we really want to keep the momentum and the conversation going. So we'll be reaching out to all of you and see who would like to join a working group. But in the meantime, just please everyone stay safe and have a happy holiday. And we really look forward to having impact working together next year. So thank you again. Thanks everybody. And we'll be back on January 20th for our next jam. Everybody have a happy holidays. Happy holidays, everybody. Happy holidays. Thank you. Happy holidays.