 Hi, everybody, and welcome to the World Economic Forum's issue briefing on how we can ensure vaccine equity. It's a very important topic and it's a very important week. And I'm joined here by our head of health and healthcare, Arno Bernhardt. Arno, thanks for joining us today and helping us set the scene. Can you tell everybody why is this world immunization week so different from the rest and set the context for the panel that's about to happen? Thank you, Amanda. It's very, very different. You remember before the crisis, we were discussing and we were discussing together. We were actually worried because we saw trends in vaccination trust decline. We saw many countries where missiles crisis erupted and we saw people dying from missiles. And in the current period, there is a silver lining. People want vaccines. They have understood the benefits of vaccines and they want to actually benefit from COVAX vaccines. That's important because CEPI and GAVI were created at the World Economic Forum. CEPI was launched in 2017. It has been the first investor in mRNA vaccines. GAVI was born in 2000. It has vaccinated to date 800 million kids, saved 14 million lives. And guess what? Together, they are managing COVAX, the only instrument for equitable access to vaccines with equity at its core. So we need to help them mobilize funding for COVAX. And we hope in turn, COVAX will also be able to invest in solidifying vaccination infrastructure in the many countries in the world that still needs that. Because there is COVID, but there is also HB. There is tuberculosis. There is hepatitis vaccination campaign. You need to think about cervical cancer, diphtheria, and hopefully one day a vaccine against HIV and one against malaria. This is a global issue of global importance. And so now I'm gonna hand it over to Juliana from CNBC. Thanks for joining us. I'm gonna hand over to you. Thank you so much, Amanda. I'm Juliana Taddlebaum, an anchor here at CNBC and I'm very pleased to be bringing you through this session on how to ensure equitable vaccine access. And to discuss this really important topic, we have an excellent panel for you. So let me introduce those panelists. Dr. Abubakar Campo, Director of Health at UNICEF. Heidi Larson, Professor of Anthropology, Risk and Decision Science, London School of Hygiene and Tropical Medicine. Garth Graham, Director and Global Head of Healthcare and Public Health at Google. Julie Gerberding, Executive Vice President and Chief Patient Officer at Merck and Genia Dana, Acting Head of Health and Healthcare at the World Economic Forum. So very pleased to be talking about this topic and let's get right to it. First we have the COVID-19, a pandemic and the vaccines that have been created to fight the pandemic. And then we have vaccines more broadly and the work that needs to be done to ensure equitable access to a broader suite of vaccines. Let's kick off talking about COVID. Thanks to his heroic scientific effort, we are here today with a number of highly efficacious vaccines to fight COVID-19, but we don't have enough. And so far what we've seen is high income countries take the majority of doses and that has come at the expense of low and middle income countries. So let me kick off with you Abu to set the scene and give us your definition of vaccine equity. Thanks, Joanna. I think it's important that, I mean, COVID-19 has shown us that no one will be safe if everyone is safe. So I think from this perspective alone, equitable access for vaccines is basically important. Let's also remember that we have, if you're not distributing vaccines equitably, we are not stemming new mutations. I think we need to make sure that everyone gets access in the same manner or equitable manner for those vaccines so that we avoid mutation. What is it good for? If a country has 100% of people vaccinated and then we have a new variant camp was coming up against which those vaccines are not effective anymore, you're back to square zero and have to start again. So I think it's important that equitable access is basically taken into consideration. It's the same with not just COVID-19. We have a lot of diseases which are basically epidemic phone or pandemic phone like measles, like polio. So equitable access, even for immunizations that's equally important. Julie, I wanna come to you as a representative of the pharmaceutical industry. What are the main barriers at this stage to getting the vaccines that we need and getting them to where they need to go? Thank you. And I think one of the things that we probably need to think about is how to reframe this conversation because it isn't really a matter of supply or access. It also needs to include uptake and the process of distributing vaccines and getting them that last few inches into the arms of people. But let's start with supply because I think we're living in a world where even for influenza vaccine it just really indicated for every human being on earth. We've never manufactured more than 2 billion doses a year. So the challenge of getting this vaccine to really address the needs of the global community is a daunting challenge. And I think the glass half full answer is that we've come a long way. But I totally agree that no one is safe until everyone is safe. And we really have to be global citizens and think through how are we going to not just get doses out there but how are we gonna support the systems and the trust necessary to get them into the arms of people? Well, Julie, you've segwayed beautifully into Heidi who has done a huge amount of work looking at trust in vaccines. So Heidi, based on the work that you've done looking at COVID-19 and take up of the vaccine what would you say are the most common concerns and biggest challenges to getting people to trust the vaccines and take the shots when given the opportunity? Well, I think one of the first things we've learned is it's not just about trust in the vaccine but trust in the system, trust in the people delivering it. And I think that we call it the trust chain is really important. And we have as Julie mentioned supply is one piece of that picture. And clearly if you're not getting a supply you start to lose trust in the system. That's they're kind of interrelated but we do have for instance in Africa right now boxes of vaccines sitting there and not being used because the demand is not there and because people aren't confident and that we had plenty of time to prepare for them but that wasn't there. So I think we also need equity in the preparedness and in the investment upfront to build people's confidence to make equitably informed because that's another piece of the picture. Heidi, when you talk about systems and the fact that we need trust in systems not just trust in the vaccines themselves what specific types of infrastructure and what types of organizations are really responsible here in terms of policymakers, government what do you mean by systems? Well, health systems, governments I mean particularly marginalized populations who feel like in general they've been left out I mean, Abu was talking about the broader health picture I mean, we've faced this also in polio trying to get to the last mile for eradication people are saying, you come knocking on my door you want me to do this vaccine you were never there when my children were dying of measles we have absolutely dirty water giving us all kinds of other things and now all of a sudden you want us to take polio vaccine or COVID vaccine where were you when my daughter had fever or why didn't you treat me nicely when I went to the clinic and this isn't just in the poorer countries these are in communities here I mean, here I'm in the UK but in Europe, in the US so I think that it's that trust in you know, what's your motive? I mean, trust is made of two things basically trust in the ability of an institution or an individual to do what they say they can do and trust in the motives and that's sometimes where we've got some real some real doubts from people they feel like the vaccine is because you want it not because it's necessarily good for me so we have to we need to work on that more broadly I guess a big part of the solution has to be in terms of how we disseminate and control the messaging and social media platforms play a huge role in how people get information these days so I want to come to Garth for your take on what role the private sector in particular social media companies like Google, like YouTube can play in ensuring that credible information about vaccines and about healthcare systems get out there into the public so we have a huge role to play the ability to bring trusted information to communities as Heidi and Julie others pointed out it's not about vaccines, it's about vaccinations and so the concept of having people have trust in the science of trusted information our capabilities and abilities to bring information to scale to people in an engaging form in a way that they understand in terms of information is particularly important I will say also that the thing to think about here as Heidi kind of alluded to is the long history that communities have had with the healthcare system and vaccines have been one of the greatest public health achievements that we've made in our lifetime and it's important for us to be able to make sure that communities have trust and confidence in the process not just with COVID-19 but in health and public health in general Jenya I want to come to you and circle back to a point that Abu made that no one is safe until everybody is safe which is the key message that healthcare experts have been trying to drive home since the beginning of this pandemic do you think that governments fully appreciate that notion that no one is safe until everybody is safe and I want to just take it to current events as we all watch the dire situation in India right now and we see governments around the world taking action that they haven't taken thus far in terms of sharing medical supplies and really paying attention to the threats that loom outside of their national borders Thanks Juliana and at the World Economic Forum we're really pleased to be able to play that convening role to get all voices to the table when it comes to understanding the criticality of the issues and the multi-sectoral role that everybody has to play I think when it comes to government engagement we've been very successful in bringing those voices to the table and are I think very heartened by the movement that we are starting to see from some of the countries where we do have enormous supplies of vaccine that are in need of getting to more of the places where those shortages are so I think that from a governmental point of view that there is realization and cooperation that we are starting to see increase and improve in that space and I think from the forum's point of view we've always been a huge proponent and supporter and convener to facilitate that kind of cooperation particularly such that mechanisms can be put in place like COVAX where you would be able to work out the details of equitable distribution of vaccines which I am optimistic that we are starting to see more of particularly as the world recognizes the vast disparities in who has these vaccines and who does not right now Julie I want to come back to you because I think your initial point around the issue not necessarily being a supply issue will sound new to some people given how much emphasis there has been on the limited number of doses and not necessarily where those doses are going what do you make of the current debate around waving IP rights as a means of accelerating the manufacture of vaccines do you think that is something that needs to be done or is that just one small part of the puzzle here the answer is complex for example given the incredible humanitarian tragedy in India right now many of us this morning work put out a press release that we're making our antiviral experimental drug for treatment of COVID available to five voluntary licensed organizations in India to try to help them accelerate hopefully approval and access to that medicine so I think there is there are many situations where that is an appropriate step to try to improve availability of medicines and accelerate their underground use but on the other hand when you step back away from it the reason that we have vaccines in less than a year from the recognition of the pandemic is because companies had confidence in the investments necessary to move that intellectual property forward and if we remove the protections and the de-risking mechanism that our system provides we'll have a lot fewer people ready to roll when we have our next crisis and that's something it's hard to think about in the middle of a pandemic but we certainly need to be thinking about it going forward this is not the last pandemic we're going to face well on that note let's talk a little bit about what's happening on the health agenda beyond COVID-19 while of course the disease is responsible for the suffering of millions of people the pandemic has also taken attention away from other health risks and other key topics on the health agenda including other routine vaccination so Abu if you could give us a sense of the scale of the hit to routine childhood vaccinations as a result of the pandemic well yes I think Joanne you said it rightly I think no the other diseases are not taking a break just because of COVID-19 I think everything else is going on I think in terms of maternal health for example and you know we have reduction in services close to in some of the countries close to 40-50% immunization services have been hit very very hard at the beginning of the crisis they were the first to bounce so to get back on track but still human resources have been shifted to other sectors financial resources have been shifted to other sectors and I think it has been taken total and it takes a little bit of time to get back on track we are still the attention is still very much focused on COVID-19 and I think they are appealing in a lot of governments you know to really step away a little bit of this psychosis or just on COVID-19 and really resume those services because otherwise it has an impact on child mortality yesterday we launched with Gavi and UNICEF the immunization agenda 2030 which is basically also focused on has a very big chapter on equity and what we are looking at in terms of equity we are looking at the zero dose child and what we mean by zero dose child is basically the child who has not yet been vaccinated or has not yet received any of those vaccinations let's just remember still even before COVID-19 we had at least 20 million children who have not received a single shot of vaccines for the other diseases as well and what is important to know they said where you have zero dose children how we call them there is a zero dose community this is a community where it's not not just health services they are lacking in terms of infrastructure education services nutrition services it's a complex situation of deprivation of those communities which also feeds into the trust issues which Heidi has mentioned so what is UNICEF doing to build more equitable access to try to address some of those issues in particular around building trust in healthcare systems yes I think from the UNICEF perspective I think we are trying to zero in on those zero dose community and bring in those necessary services I think it starts with building the starving the primary healthcare systems are really making sure that we have a primary package of health services in particular in supply in Africa and South Asia where still system strengthening is basically needed it goes not without human resources it goes not without advocating for more financial resources from the governments themselves to invest in those systems and I think it is high time that everyone doesn't look at health just as the health sector as an expenditure bucket but more as an investment bucket as an investment sector for the future because if we don't invest in health if we don't invest in health systems every other single program which we're basically implementing becomes just more expensive or becomes verticalized as we have seen with polio we're not necessarily reaching the results which you would like to have so investing in systems is probably as important as investing in all the other infrastructure where politicians are basically spending most of their money but I think investing in health systems is probably a smarter way smarter way of developing society certainly a different way of framing the issue to think about it like investment for the future Heidi I want to come to you in terms of how you think trust in vaccines and trust in health systems is likely to be impacted by the COVID experience I think many people have read and listened and watched the discussion around vaccinations in a way they had never done before so do you think that this is all going to lead to improved uptake of vaccines and health health mitigants in the future or potentially a deterioration in trust? Well I think it's a huge opportunity and we have a choice I think I personally I think we should be using every moment around COVID to to work on that trust building to help people understand I think we should I'm really don't think we should be shutting down people's questions I'm very concerned about that the suggestion that we should be discouraging people from questioning in the context of such partial information we have right now now is the time that if we listen to them if we engage with people with questions they'll remember that we are making history right now this is a period of time that the world will remember and if they remember that they were heard that they were engaged that's going to stick if they hear that they were left out that they were not part of this equitable system and they were judged for their questions that will be remembered and we have a choice and we are at the beginning we're in kindergarten in terms of global vaccination right now I mean if you look at the where the vaccination is and where you know what we need to get the world vaccinated and by the way there's more candidates more vaccines coming into the pipeline it's going to be a confusing landscape so I think we have to have a lot of empathy and be there for people and they'll remember that where does the onus lie what types of organizations can and should take a leading role in addressing those questions that people have around vaccines and their nervousness well I think it needs to be a lot of different organizations I think the problem has been when it's become one mega organization and that maybe people don't trust that organization we need to diversify the different sources the reason that some of these more anti-oriented vaccine groups are getting so much traction is because they can have 100 people where we have 10,000 in the pro community and those 100 people will splinter into 10 different little groups to be there for all the different questions and say we hear you we're not doing enough of that we need to diversify there's also I mean there's an awful lot of focus on getting one single message the public doesn't want one single message they want a message that's relevant to their lives and there's a lot of different experiences out there so I think it's not I think it's everyone in different ways from you know employers and in companies looking at their employee base as a community to schools to you know health we have an opportunity in COVID to go out of the health system it's affecting everyone I mean taxi drivers barbers the shopkeepers everybody's talking about vaccines in a way that we have a huge opportunity really important message I think in terms of trying to offer nuanced responses to address different questions not necessarily a one answer fits all when it comes to these vaccine concerns Garth I want to come back to you here because obviously again the platforms Google YouTube can play a huge role here how are you thinking about partnering with health organizations to try to do some of the work that Heidi just talked about yeah we're partnering with a number of health organizations to get out information and to meet communities where they're in fact we announced with Heidi's group yesterday a campaign directed towards younger audiences 18 to 34 around vaccinations to get back to what you love campaign and it'll be a global campaign and our goal there is to again and to reach communities with trusted information science based evidence based information but that is engaging and then reminding people just the benefits of vaccines vaccinations COVID back the COVID vaccine in particular and how that can serve as an avenue for people to get back to their normal life and as Heidi said there's different messages for different communities you know things resonate differently and I think we want to work with community based organizations academic institutions experts like Heidi's group and others to be able to bring that information to scale to communities but at Heidi's point again is well taken I want to kind of emphasize and draw a line under that we have to work together we have to cross silos cross industries think uniquely think differently to meet the needs of communities and I think you know the campaign we launched yesterday to get back to to what you know campaign to what you love campaign is a part of that in terms of being able in industries crossing and working together with community based organizations Well, Jenya on that point in terms of the partnerships we've seen I think it's fair to say that we have seen unprecedented collaboration between public and private sectors throughout the pandemic and you could argue that that is what enabled the fast development of these vaccines which are now creating a path out of this pandemic What do you think has worked best when it comes to private public partnerships and how do you see these moving forward and beyond COVID? That's precisely right in that the public private partnership space has been incredibly successful and very active I am extremely heartened by the the actions across sectors media mobility healthcare systems large employers small employers coming together to understand their role in the system and I think in terms of the work that we have been doing with all of our partners and in bringing Heidi into more close contact with a lot of our partners the role of employers has been particularly exciting and I think very helpful in this particular space so there are a lot of signs that people trust their employers to deliver a lot of this kind of information which has been something that has been really very helpful for us at the forum to be able to mobilize chief health officers chief human resource officers of companies and have them on board and helping us to spread the message and answer questions and get out the most relevant information and so we're really we're really heartened I think that's been one of the most most striking and most satisfying pieces of working during this time is to be able to watch those partnerships come together and to find new voices that we can leverage and mobilize to get the information out and to basically explain that vaccines are one of the most effective public health interventions that there are and it's never been more true I think than during this period of the COVID pandemic Julie you made a similar point sort of looking ahead in terms of preparing for what could be the next pandemic or the next crisis in health what steps can countries take at this point to not only recover routine vaccination programs but also ensure that they're better prepared should a crisis like this emerge in the future Thank you for emphasizing the vaccination at base case issue I'm aware that some 28 countries or regions have temporarily suspended their measles and other childhood immunization programs measles is as transmissible if not more transmissible than SARS-CoV-2 and I predict we're going to see measles outbreaks as kind of the canary in the coal mine of a failing immunization system so I think first and foremost countries do need to reinvigorate their base case pediatric immunization programs and then of course there are adolescents and adults that are succumbing to vaccine preventable diseases or at risk for them so that's the front line of health protection in most countries and we need to make sure that we don't let that front line fail while we're working on the pandemic but beyond that I think there is in a sense the opportunity for a global mind shift to really recognize that biosecurity isn't a once in a generation or a once in a century issue it's something that's going to be part of our world our communities our businesses our societies and certainly our governments so in the same way that we all understand the importance of national security and investing in the efforts that are necessary to protect our countries we need to think about biosecurity in the same sense all of us in a multi-stakeholder way need to prepare ourselves that the level of investment that we need to secure the doctrine of biosecurity which is basically invest more to try to predict where these things are going to happen be prepared to preempt them at their source improve and modernize surveillance systems so we know when something has happened and we can get on top of it and then work on the nuts and bolts the operational requirements for containment and mitigation which is of course the face we're in right now those are heavy lifts but it requires a different mindset and a different level of investment and I think we're ready we need to really now tip into a state where we're much better prepared for the future events than we were for this one let's talk about that preparedness Abu you talked about what UNICEF is aiming to do to better ensure more equitable access in the future what help does UNICEF need to meet its goals I think it's it's not just UNICEF I think it's thinks it's really you know building back the health systems better you know needs basically support first of all there needs to be commitment from those countries themselves and that they talk about financial commitments of governments in particular in low and middle income countries to really strengthen them their primary health care systems so that what Julia has talked about in terms of surveillance you know in terms of being able to respond prepositioning you know stocks of vaccines and medications you know in case if you have a pandemic that you can basically respond and not necessarily you know diverting the entire resources but it's financial of human resources you know to just another pandemic so we shouldn't be trading of pandemic for another pandemic because as we have said you know means this is probably as much as transmissible even if not more than COVID-19 and is epidemic point disease so in that regard I think financial resources are important I think the governments cannot do it alone so there should be a way to public-private partnerships to basically contribute to that as well and really making sure that you know the relevant systems across the globe are basically prepared and not just prepared in one part of the planet and the other part of the planets are not really prepared as I said at the beginning it doesn't matter if the country reaches 100% of immunization coverages if the rest of the world you know is not basically able to do so because variants in terms of immunization or for diseases were happening anyway and if a new variants comes out for which the vaccines are basically not working on you know then this basically means even the country has been vaccinated and has a coverage of 100% gets back to square zero because they have to restart again with the new variants and then finding new vaccines for against those new variants and that is one of the reasons why I think there needs to be international solidarity of making sure that we are getting prepared for the next pandemics because there will be next pandemics coming anyway Well I think that's a great note to end on right where we started that nobody is safe until everybody is safe when it comes to COVID and when it comes to other health threats around the world so I want to on that note wrap up this panel I think one of the key takeaways here is that this should be seen as an opportunity COVID-19 as an opportunity to build trust in our health systems to build trust in vaccines and we also can't forget that there are many other health risks and health threats on the agenda we can't forget about those as we try to combat COVID-19 so I want to thank our panelists Dr. Abubakar Campo Heidi Larson Garth Graham Julie Gerberding and Genia Dana it's been an absolute pleasure thank you so much for watching