 Good morning, everybody and welcome to this press conference if we've been too subtle with the branding You're joining the first press conference of the annual meeting of the World Economic Forum in Davos 2016 and It is a very special press conference because the question we're trying to answer today is how can we prepare a vaccine for Ebola? How can we be better prepared for the next outbreak and It's especially in the sense that we're joined By Gavi today and whenever we are asked at the forum. What is actually the impact you're having? Are you more than a talking shop? We're always happy to mention Gavi, which was born I can say 15 years ago here at the World Economic Forum in Davos and Has has done fantastic things just to give you a couple of numbers in the 15 years Gavi has vaccinated 500 million people in over 70 countries let let just let that number settle in So very pleased to have this press conference and without further ado I'm happy to introduce to do today's panel to you on my immediate left is Seth Berkeley Who's heading Gavi the vaccine alliance? Right in the middle is Julie Gerberding who's joining us from MST or as it's known in the Esmerich She's the vice president for strategic communications global public policy and population health Next to her. We're joined by Nungosi Oconio Iviola who is the chair of the board of Gavi? So thank you for joining us today and last but not least we're joined by professor Jeremy Farah Who is the director of the welcome trust and completes this panel wonderfully? Jeremy Sorry Seth. We'll we'll start off with you. So The question for the Ebola epidemic that I want to ask you is why was no vaccine available when this happened and And also if you could elaborate a little bit, what is your partnership with Burke or MST outside the US? please So Ebola is a disease that's been known now for more than 40 years and There's been lots of outbreaks, but they've been in the poorest countries in small numbers and as a result There is a complete market failure. There's no commercial market for such a vaccine I suppose I can say luckily but During the anthrax outbreaks in the US some investments were made because they thought Ebola might be a bio-terrorism Weapon and those were not completed of those vaccines were put in mothballs But when this very large outbreak occurred all the sudden those vaccines were pulled out plus new technologies that were there and It's amazing and I have to hand it to the pharmaceutical sector because the acceleration of this was done in record time normally we take 10 years to do a vaccine and As you saw here, we went into an efficacy trial and finished it in just a few years The the partnership with Merck is really about trying to make sure that in this interim until we have a licensed product Which of course is the critical outcome. We want that vaccine is available if there's another outbreak So the agreement is and it's an advanced purchase commitment against licensed product at the end Three components connected to this advanced purchase commitment The first is that they should submit a emergency use authorization listing with WHO That's a regulatory authority that would allow the vaccine to be used In the case of another emergency declared by by WHO second that they would produce 300,000 doses of vaccine and have those doses available in case there was an emergency these are Investigational doses obviously and then third that that they would make sure to submit a full regulatory application Lastly about this it's very important obviously for the world to have this vaccine Which is the only one that had efficacy trials and therefore is is the most promising available But also the science around this vaccine is critical because any other product that is being considered since this has human data As well as animal data and all the great work that the Merck scientists usually do it will frame You know all vaccines and so it's really important to do that I just want to lastly acknowledge that gail Smith who's here the USAID administrator the partnership around Gavi is quite broad It includes you know all of the major donor countries the recipient countries all the pharmaceutical companies and you know We're all committed to make this work and to try to make sure our vaccine is available So something like this doesn't happen again Thank you says Julie. Let me let me put you on the spot How how close how far away are we from from having enabled a vaccine? Well, first of all, I am very happy to be here to celebrate the 15th birthday of Gavi because I didn't realize It's a if that's all that the World Economic Forum did it's a miracle so congratulations on your 16th birthday sweet 16 I would say the the serious nature of the Problem that had to be addressed the Ebola outbreak was a wake-up call to a lot of people I think we had gotten complacent about Ebola as something that was usually a small problem in rural areas and could be fairly rapidly quenched but the scale and speed of what was really a far storm of Ebola in Western Africa really Reminded us once again that mother nature is the best terrorist and that we do need to take much more seriously our ability to Prepare in advance, but also to respond when something like this occurs. So The truth is this is an unprecedented speed to develop a vaccine product the fact that we have submitted the Necessary paperwork to the WHO and they've accepted our paperwork for review for the emergency use assessment Process it happened faster than it has for any single other product So in that sense the partnerships that grew up between Industry Gavi the WHO the governments of the affected countries USAID all of the various players CDC NIH Is really an unprecedented example of global collaboration and this speed would not have happened if we hadn't had that Capability and I will say that while there are many actors in that process the fact that Gavi was there at the center and had experience in Understanding what is necessary to bring a life-saving vaccine quickly to people who need it really was kind of the glue that kept the partnership Together, so I think Gavi for that for that leadership from a from a murk or as it's known here in Europe MSD perspective we We need to get this vaccine licensed and so our highest priority right now is to continue to assemble the science the safety data the immunogenicity data the efficacy data and Have full licensure both so that we can obtain a WHO recommendation and meet the requirements for the advanced purchase agreement But also so that we can use this product more broadly even in advance of an emergency so that where it's appropriate We could have pre existing protection For example among health workers or others who might be at risk and that is first and foremost our leading priority We are also Certainly ramping up to be able to make sure that we provide you those 300,000 doses In in a few months so that if there is a Recurrescence of the outbreak that we have doses of vaccine available and ready to roll when people need them And we know now how to use this in at least one way with the ring vaccination scheme so that we can Hopefully rapidly quench Subsequent outbreaks before they reach the size and scale that we experienced and then the last thing That we have committed to as a company is that when we have a licensed product We will make it available for the people in the poorest countries at the lowest possible Not for profit price and that means that we intend to be able to provide Wherever people need it a vaccine that is affordable and that the cost of the vaccine will not be a barrier to the kind of public health protection every Everybody deserves Thank You Julie. No go see In your native country in Nigeria Which is one of the most populous countries on earth out of the 11,000 people roughly we lost to abla I understand there were only eight people who died of abla. What was what was the what were the measures? You took what was the success story if you will in Nigeria? What happened there? Well, thank you very much Let me also use this occasion to say this is my first major public engagement as the Gavi Board chair and I'm really proud to be here to welcome Gail and as well and Say that one of the reasons that I'm excited to be chair of this board is because of the kind of public private partnership That we see Gavi involved in the fact that you can really use innovative ideas and Financing mechanisms to bring the public and private sector together to deliver and on an issue That is so important as they're bullet pandemic You know that the Afri whole of Africa was very very much impacted by this Particularly West Africa and as you see my country Nigeria We were lucky because we had a strong health system in place That we had used to deal with the polio We were able to deploy that to be able to manage this Pandemic and only eight people died, but let me say that 11,300 people were killed in West Africa 28,500 infected and there at least 17,000 survivors who are dealing with the Complications and the social state stigma that is attached to this So there's the loss of lives the fear You know that we all experienced about this pandemic And just to share terror of it That's on the human side You also as a former finance minister also paid a lot of attention to the economic side of it And you remember that the for Guinea, Liberia and Sierra Leone The the World Bank estimated Losses, you know in in a couple of of a couple of billion dollars In these countries the UN development program said that for West Africa as a whole it might even exceed three billion dollars So we this is just a lesson that if we don't pay attention and prepare ahead for these kinds of Pandemics, it's not only the loss of human life, but can devastate the whole region economically So to conclude I'm really proud. I think this is the kind of thing we need to do They using the advanced purchase commitment Preparing ahead and I want to also thank the pharmaceutical industry for what they are doing with us Thank you Jeremy, let me ask you The the welcome trust your your lifeblood is is R&D Why was the why was the process so difficult to get to the vaccine and one of the steps that you think Should should be taken to improve this for future cases It's very important to put Ebola in context since the since 2003 or 2004 These are not rare events. So In fact, I may be one of the few people in the world that's been involved and seen patients through SARS through bird flu through The pandemic of 2009 influenza We have MERS CoV in the Middle East at the moment, which is continuing to circulate we have zika in South and Central America I mean They these are regular events and actually if you ask yourself for any of those we actually we actually don't until today Have a clear Vaccine available for any of those. So in some ways we're using 19th century interventions When we come to have these epidemics and I think in future we need to see an Ebola And what Merck and Gavi have done in relation to this I think needs to set the precedent that we absolutely have to commit ourselves for those epidemics that we know about That we have vaccines that have been into man in the inter epidemic period such that when we come into an epidemic Which can be very explosive can disrupt society as we've heard and impact on both health and economic Economics that we have those vaccines ready to go and they can go at a moment's notice And I think that's what we've all got to commit ourselves to for the for the knowns The chicken goon years the the zikas the MERS the SARS And then we have to also think about the unknowns that we can't yet predict HIV Remember was an epidemic that that started and it's devastated the world And there are a number of those that we don't yet know about that we need to be prepared for Thank You Jeremy Maybe maybe one question to all of you quickly So, you know the forum is always keen to to have a multi-stakeholder engagement and that was mentioned that that Gavi is So so successfully doing it. We have about 40 something heads of state in government here If you had one wish to do these Gentlemen and ladies here representing the public sector in a nutshell. What would it be? Who stops it? Thanks. I think it's what Jeremy said is to take this seriously I noticed on the risk register for this year at the global economic forum Infectious disease is not in the top 10 and that's because it's not top of mind right now But when this happens and if you look at what HIV's done to the world And of course if a flu pandemic occurred a really severe one like the 1918 Spanish flu epidemic We could have 50 to 100 million deaths and the World Bank has said that the cost of that could be over a trillion dollars So we need to make sure that everybody has this top of mind And then that the resources and the political will is there to create the systems like Jeremy has talked about I Think we're all probably going to answer the question the same way and that really is from the framework of leadership commitment I too have gone through SARS monkey pox Wesson isle and so on and so forth and I can tell you that what happens when a government sees an emerging problem There's a very rapid response and in a non-partisan way people kick in and do the right thing But as soon as the problem goes away, so does the investment in the level of interest and we've got to get global leaders to stay the course We don't necessarily need citizens to be in a constant state of alarm about emerging infectious diseases But we do need the political leadership to keep this front and center on the agenda So that we can get out of this kind of her key jerky funding process and get into a situation We are truly prepared to manage these inevitable outbreaks I Thank you. Well, I just have maybe two very Precise messages one is No, one is safe The world is so small now that I would want all the leaders to pay attention You cannot say I'm at this end of the world or the other end. So it wouldn't affect me Whatever breaks out these days can affect anyone. So it's important to pay attention The second is in addition to the human dimension Remember the catastrophic financial and economic losses that could emerge and that can really Damage the economy in a way that has leaders probably don't think about I mean, you know thinking through the ball and what it did to really undermine the Economy of the country countries that were most affected should be a wake-up call to every leader I think the only comment I would make is that it is true This is a so-called market failure, but we've got to see this as public health and and that is the responsibility of all of us Governments USAID diffid the other governments around the world need to as they are doing Continue to support this. This is public health industry has to be a partner from the start And it also shows and today shows this again the importance of global organizations that bring us all together With it, you know, Gavi has played a critical role in moving this vaccine forward And if we don't have those global organizations where countries come together for the common good Sometimes we get cynical about those organizations. I think they remain absolutely critical to the future of public health Thank you very much We have a couple of minutes for questions from the floor if I could have an indication Yes, can we get a microphone if you could state your name and organization, please? Yes, my name is Isabelle Sacco I work for the Spanish new state and CFA Could you please remind us what in what country this vaccine was used during this last epidemic And how many people were vaccinated in these Trials that were what happened there. I heard last week from the WHO official that this vaccine had a 90% of Efficacity and could you please confirm this? I think the Published data available about the trial which are really the only efficacy data that we can speak to at this point in time Demonstrated a hundred percent efficacy and the Lancet report that came out at the end of July of 2015 of course there are more data that have been assembled since that point in time and the final Efficacy submission to the regulatory authorities is still in progress Good science takes time and getting all of the data together Including data from ongoing trials is still a work in progress. It's going as fast as I think we can expect it to go given the Timeline that we've been operating under but we we don't want to make any claims about the established efficacy until we have the science But it but it has been it was used extensively that the study was done in Guinea But studies have also been undertaken and people within Sierra Leone and in Liberia have received this vaccine Also, of course in the United States in Germany in Gabon in Kenya I mean this vaccine has now increasingly in more people and as Julie says that safety data will is all being gathered And that's the critical bit that adds to the efficacy data that you know about I think that also speaks to Seth's point earlier that this is the first vaccine to have Information about efficacy, but it helps understand additional vaccines that may emerge and helps create the standards for evaluation So it's not only helpful in getting a vaccine available for emergency use But it's also helpful in expanding the whole repertoire of what we know and need to know about future and even more advanced vaccines It's not also reiterate Seth's point earlier that that to do this in the confines of an epidemic Which is terrifying to be part of is chaotic and is a crisis to have got through and got efficacy data on a vaccine Is an enormous amazing tribute to the people in Guinea to Merck to MSF to WHO and Diffid and and Norway and welcome trust it who funded that I think it is a remarkable achievement Which really does need to be celebrated I would have to go back and check. I hate to say it, but I think it off top of my head. Is it 4,000? It's between 4 and 6,000. I can give you the number The exact number afterwards if you want but it's between 4 and 6,000 in that study in that study And then and then well over 10,000 if you look at all of the use of the product in different settings and and tests Yeah, thank you. Do we have any other questions? No, all questions have been answered wonderful. Thank you very much to a fantastic panel It's been it's been encouraging to hear about the great work that's being done there and thank you for the great partnership Thank you for watching