 We have here the first question in the back. Thank you. Thank you, Marit, from MSF. I have a question for Gabrielle. Why in the context of elimination in Cambodia, why have you chosen for a 28-day follow-up, and not for a 42-day follow-up, to really... I mean, the ones that would go back after so many weeks will probably be the most resistant ones. So why have you chosen for a 28-day follow-up? Can you hear me? Yeah, it was an operational question. Let's say a question I need, because we wanted to... well, acknowledging that day 42, or even day 63, is even better to understand about the treatment failure. Also, we are aware that in the context of multi-drug resistance, if we lose the patient in follow-up, then he can spread further at the museum resistance. So we wanted to ensure that the day 28 was there to catch as soon as possible any possible accrues of infection treated with second-light treatment. We have this lady in the... perhaps? Hi, Kate from MSF. My question's for Ruby. In terms of the reactive hepatitis E vaccine, you mentioned the ideal point being 50 cases, but given there are so many asymptomatic hepatitis E cases, is that in terms of practical implementation during outbreaks? Thanks. That's been taken into account. It's the 50 symptomatic cases, so it's the cases that we would see in our clinics. OK, next question. You... Sorry, and then... Can we go? Yeah, Jeff from MSF. So a question to both David and Ruby regarding the comment that was made previously in your presentation, David, is that for operational decision, should we trust results from a mathematical model, because if what you presented last time was out of a mathematical model, or should we at the end wait a little bit and try also to have more evidence and impact? So that's my question. Yeah, the work that we presented previously was a mathematical model, showing that we probably responded too late in Uganda with our water and sanitation response. But I agree that actually we need an opportunity where we actually respond much earlier with our water and sanitation response and see if it actually does have an impact. We haven't seen that yet. Right, thank you. As I was mentioning before, hepatitis E is an extremely challenging disease to study and to figure out the correlation and causation issues involved with the interventions. I think we have to react. We have to do something, and we know that the Watson activities that we do have an effect for a lot of fecal oral diseases, and so our best assumption is that these are the right things to do in this context as well. We tried to react quite quickly in Chad to put these programs in place after we had just 20, 30 cases. We were moving quickly to put these programs in place, and so hopefully what we did had an effect, and I think that it did. And then I just wanted to also say that we talked about the vaccine in Chad. It's something that's kind of on everybody's radar, but it's not available yet, not approved in that context. Not WHO pre-approved, and so it's not something that we were able to implement quite quickly. But if anyone of you who hears of a hepatitis E outbreak think about a vaccine study, okay? Thank you. Hello, thank you. This is Hillary. I'm from the London School of Hygiene and Tropical Medicine, and I'm afraid it's another question for David. Really nice presentations on hepatitis E and actually all the presentations. My question would be is, are you able to put in the dates at which you introduced the hygiene kits, the various water interventions? Because I mean, I guess I didn't realize quite how long the incubation period would be, but if you were able to do that on your EpiCurve, you might be able to see something interesting or not. Yeah, great question. I think the interesting thing that I saw in the project relating to that EpiCurve was how contextual it is. Some of the spikes early on relate to the weeks that we started surveillance. So when you hire 180 people to walk around the city looking for jaundice cases, you find lots of patients. Likewise, at the end, when you start wrapping up your programs, if there's still jaundice patients, you may miss them. That's the first comment. And then the second is, yeah, we gave out these kits in early December by around the same time we had had full water chlorination programs up. And so six weeks later, we were hoping that the cases dropped. They were still high for another month or so. So what that means exactly in terms of the incubation period being an average of six weeks, it's hard to say. There's, of course, this issue of secondary transmission as well. So you may be having continuing transmission between the population, even if you've stopped transmission through the water supply. I think you were the first, and then we could come to you later. Hang on. Can you give this gentleman the microphone? Bern, MSF, my son-unit. My question is to Amadou. So can you just explain to us whether there was a conversation when you're deciding to have a placebo-controlled trial given that there are other vaccines that have been shown to work elsewhere and whether you could have considered comparing those vaccines and maybe not, I don't know whether it's always the case to look at the CVA cases, but whether other vaccines would have allowed you to look at other impacts, apart from just the CVA cases. Thank you for the question. First of all, I just want to let you know that by the time we started the study, there was no other vaccine, revised vaccine available in Niger. There was not at all using it in the EPI program. And the second point is also because of these existing vaccine are not perfect, the sample size would be massive. So this is the second point. And that's why we compare it to the placebo and have the real vaccine efficacy of the BRVPV. Okay, who is next? In the back, sorry, who was there? There, here. Yeah, you with the blue shirt. Thank you. My name is Oscar from MSF Canada. My question goes to Amadou Sek. Most of the time in Africa, we have vaccines campaigns where different vaccines are being combined. And I don't know what would be the possibility of combining a rotavirus vaccine with other vaccines. There is a potential for accepting that combination. Thanks. Well, the secondary objectives regarding the interaction of the vaccine and the vaccine at present time in the EPI program is ongoing. But if you look at the inclusion period, we start from six weeks up to 14 weeks. And the aim is also to introduce this BRVPV vaccine in the EPI programs in these settings. And yeah, we are still awaiting these results. But if we consider the existing vaccines, there was no interaction with the OPV or the vaccines used in the EPI program found with the other rotavirus vaccines. Now, we are still awaiting. And hopefully, maybe someday, we'll be able to introduce this in these national programs. Thank you. Okay, next question. Who has won? The lady with the black shirt was the first one I saw. But keep your questions. Don't despair. You come. Your time will come, for sure. Hi, I'm Charlotte from the London School. I've got a question for Amadou. You said about HIV status and whether the mother was breastfeeding. I was just wondering, firstly, did you collect that data on each of the subjects? And then, if you did, have you had a chance to adjust the efficacy for those? Excuse me, could you just... Sorry. Did you collect data on HIV status and breastfeeding? And if you have, have you had a chance to adjust for that, for the efficacy? Well, we have performed HIV tests on these participating children. And also, we have a subgroup of mothers, pregnant women who are included in a sub-study. And we are following all the data relating to these mothers and also the vaccine efficacy on the children. As you know, the low-device vaccine has a low efficacy in developing countries. And we have lost... We assume that maybe lots of causes could justify this. But once again, we are... The results are ongoing, but you're right. We are waiting for these results. And we consider the breastfeeding, the HIV status, malnutrition, other enteric infections in these settings. And maybe in a couple of months you will have all these answers. Thank you. You are the next here. Hi, I'm Geraldine Ahara. I'm an infectious diseases physician in the NHS. My question is for the HEPI experts on the panel. And it may be a display of my ignorance. As I understand it, the vaccine's based on genotype one. Are we certain that it has the same protective efficacy across all the genotypes? Yeah, it's based on genotype one, but the study, it was actually in a setting that's mainly genotype four. So it was effective against genotype four and genotype one. It's... I'm not an expert on this, but it's expected to have effect on all four genotypes. Okay, next question. You, I think we're the next. Sorry, I hope I... Okay. Thomas Dennis from MSF here again. Ruby, I have another question about the vaccine model. So you pointed out that in the Chinese trial that a single dose was not effective. I'm just wondering whether in the reactive setting in the outbreak setting, where you can expect a much higher frequency effective infectious contacts and where long-term immunity may not be such a priority, whether it'll be worth it or whether any modeling has been done on the effect of a single... on a single or off a single dose? Yeah, that's a really good question. We wanted to explore a single-dose vaccination. Apparently the... we actually approached the authors of that paper for single-dose effectiveness data. They don't have it. The study was empowered to look at that. So it would be something that's worth looking at in an outbreak setting and exploring that. All right. I'm afraid we are coming to an end here. Thank you very much to the panel. Thank you very much for your excellent presentations. And thank you very much to all of you for staying to the end. Thank you.