 good afternoon or good morning good evening wherever you are it's my great pleasure to welcome you to this very important session to discuss women's health my name is Shyam Bishain and I head up the Center for Health and Health Care at the World Economic Forum it's my great pleasure to welcome your Excellency Minister Smriti Irani esteemed speakers as well as all distinguished guests here we all know gender health gap affects everyone it affects our families our communities our workplace our societies it has been mentioned that there are many implications for gender health gap for example a woman will spend an average of nine years in poor health affecting her abilities to work at home and in the community we just launched a report earlier today together with our knowledge partner Makinji it's called closing the woman's health gap that we published this morning it shows that not only we are able to avoid 75 million years of life loss due to poor health our early death per year but also we can significantly boost global economy the report finds that closing the gender health gap would enable women to participate more actively in the workforce and this can lead to 1.7 percent increase in GDP we are calling it a trillion dollar opportunity we close the woman's health gap we are calling it a trillion dollar opportunity so this is huge today we also launched our global alliance for women's health together with the some of the board members here it's a collaboration with Bill and Melinda Gates Foundation we had our first board meeting today co-chaired by her Excellency Nisia Trinidad Lima health minister of Brazil and Dr. Anita J.D. president of gender parity at Bill and Melinda Gates Foundation we have other board members that are present here we have fairing CEO we also had the managing board director from Siemens we have few other board members the executive director of UNICEF president of National Academy of Medicine health minister our secretary from Kenya finance minister of Morocco so these were other board members that participated in the discussion now without further do I would like to hand it over to our great moderator Gina Sufand senior anchor from Ashok news who will moderate our discussion and properly introduce each panel speaker here so over to you thank you so much she am ladies and gentlemen esteem the panelists distinguished guests and dear audience watching us live on Ashok news television and digital platforms welcome to a pivotal discussion on an issue that lies at the heart of our shared future closing the gender gap in health today we stand on the cost of making history as we launch the global alliance for women's health and the groundbreaking women's health investment case here at the world Economic Forum imagine a world where investing in women's health fosters a windfall for global economies boosting them by an astounding one trillion dollars just as she I'm just said annually a 1.7% increase in per capita GDP that fosters societies where everyone thrives for too long the profound disparities in women's health have cast long shadows over our progress underscoring a dire need for change females form the bedrock of robust families dynamic communities and flourishing economies they often bear the brunt of a legacy marred by gender bias from the persistence of the male default in medical research to systemic underfunding of women's health yet within these challenges lies an unprecedented opportunity the chance to infuse economies with bigger simply by harnessing the untapped potential of female health the equation is simple yet powerful for every dollar invested in women's health three-fold returns in economic growth await it's an investment that transcends monetary value unlocking cycles of prosperity that resonates through every layer of society from education of our young girls to the leadership of women to the highest echelons of power the statistics are more than numbers they are clear a clarion call for urgent action woman out living men but spending 25% of that time in poor health common drugs resulting in adverse side effects due to miscalculated doses for women and the hidden cost of untreated conditions like premenstrual syndrome which are more prevalent than male specific conditions yet significantly under research our panel today is more than a discussion it's a catalyst for real and measurable change the global alliance for women's health in bodies emission to ignite investments spur innovation and shape agendas to bridge the health gap that women disproportionately bear we are not just advocating for equality in health we are strategizing for a future where every woman's well-being is a cornerstone of economic strength and societal well-being join us as we embark on this journey of transformation because when we invest in women's health we invest in the wealth of the world and I am extremely honored to be joined on this session by her excellency Smriti Zubin Irani minister of women and child development of India and it has idea who is the president of gender equality at the Baleen Melinda Gates Foundation who co-chairs the global alliance for women health burnt moon talk the chief executive officer at Siemens health in years and pair fog the president offering pharmaceuticals and allow me to open the discussion with you and so why the alliance now why the alliance first why the alliance now and why was it very important for you to frame the whole issue of women health care as a gender inequality issue yeah thank you for that and so what the opportunity in front of us is actually laid out very clearly in this report where women's health has been a long underinvested neglected area in global health but actually overall in all of the investments that we make and there's so much that we can do and so much potential that there is to make rapid advances in this field that we felt that that moment is right to bring together a multi-stakeholder platform to bring attention to this issue to increase investments in women's R&D there's so many health problems that women have that have been very long understudied under researched lack of data so that we address address the lack of research and science and innovation and women's health that we bring attention to the poor health care that women get and and how do we change that and we also pay attention to the lack of data that exists about women's health and now the of course the added benefit and we are at the World Economic Forum is the tremendous economic return that investing in women's health can can make and that's what this report has outlined and I encourage all of you to read it further we know now that there are actually tools that already exist and innovations that already exist that if we use them widely they would make a huge difference in women's and girls' lives around the world and they would make a huge difference in the economies one example is the HPV vaccine that we can come back to we can come back to that I'd like to move to your excellency do you think that we've been looking at women's health care for too long from very narrow perspectives and missing out on sort of linking the dots I mean what can you tell us after long years of experimenting with very remarkable initiatives in India when it comes to women's health care I think women's health care systems or conversations never were mainstreamed and that has been one of the greatest challenges how do you provide solution to an issue which is never spoken of yeah mostly there is a presumption that women do not want the psychological burden of their own medical challenge to fall upon their family unit or hinder the economic progression of their contribution and that is why they tend to either self-medicate or not medicate at all from the Indian experience let me provide you a big context post 2014 when Prime Minister Modi took office in the year 2010 11 there was a World Bank report which said that if there is a lack of sanitation facilities for women there is a negative 6% burden on the GDP of India that being said there's also the issue of security of women who are violated if they decided to defecate in the open now this information being available was politically and administratively acted upon by Prime Minister Modi who first said that if you want to ensure the health and dignity of women let's start building toilets now so far from a cultural context building toilets has never been politically glamorous but Prime Minister Modi did that and we built under his leadership 110 million individual toilets which means it was an added impetus given to a woman's menstrual health as well under Prime Minister Modi for the first time in the history of our country we had an administrative protocol set up for menstrual hygiene management by governments at the center state including administration at the district or the grassroot village which means that the narrative about women's health was mainstreamed politically and administratively then Prime Minister Modi said let's look at the issue of access to safe cooking fuel a hundred million poor women given cooking fuel clean subsidized directly by Prime Minister Modi we saved because there has been a WHO report which said we saved 400,000 lives per year of women only by providing access to clean cooking fuel then there was the water promise 130 million individual portable water connections given to poor families women who spent half a day either collecting firewood or collecting water for their domestic consumption lessening their burden and then came a program called the Aishman Bharat which is the world's largest health care system let me come back to this program when we talk about access your Excellency I want to move to Burnt here and ask why are you joining the Alliance so VRS is a little bit of a commercial break now we are even if it doesn't sound like it we are a young company as we did we are public companies in six years but what we really want to achieve is the transition from a technology company which is respected for the great equipment to something bigger and we gave ourselves a purpose the pioneer breakthroughs in healthcare for everyone everywhere sustainably and this is not a tag line this is something which is a real responsibility yeah we measure ourselves that we really say what is the impact for 8 billion people and about half of these people are women and we need to be serious about it and that is why we join and that is why I think it is impossible in the long run yeah that women typically take care of the health matters of the families the majority of nurses is female in Germany the majority of medical students is female and since this year the majority of medical doctors is already female yeah but there is this huge gap and whatever we can do to contribute we want to do pair why are you joining and do you think the alliance comes at a critical time perhaps not only for women but for humankind I think it's for everyone we should and I think that's one thing that is very important we should stop looking at this as shall we say solving an issue for women we're actually not we're solving in which an issue for the population of the world because and the report clearly shows that that you know beside the inequity and obvious fairness which of course is very authoritatively described in the report we should remember that reports like that have been generated with regularity for decades and led to nothing we know this very well because we are a solution provided within reproductive medicine and maternal health so we've been in maternal health for five decades and we have seen that no matter the best efforts and how well we try there is no traction or interest from payers or from science in this area so I think it is at a critical time I think it's overdue so let's make it happen now we are so happy to be here and I think the the composition of the alliance board as well as the people up here shows the complexity of the problem we're trying to solve it's not only a problem of drugs or of infrastructure it's a policy issue it's a it's changing hearts and minds of policy makers and decision makers and for that you need this multilateral group of people who can provide different perspectives so for us it's natural to be here and we're really really happy that we can join I want to go back to you Anita so as Per rightly said we've had reports before what's different this time do we have more of an opportunity map and what does what does a report like the McKinsey report with all the figures in it bring to the discussion yeah it was a great question and you know so what so case foundation has been working on gender equality and on maternal health for a for a very long time what's new is that three years ago we we made a new division called the gender equality division which is really looking at what are the we continue the the the work that we've been doing but we're looking at what are the where are we missing impact right and one of the areas that we identified where we thought that we were missing impact and we could do much more was women's health and we had the pleasure and privilege of organizing a convening with the NIH in the United States last year where we brought together NIH hosted this meeting and we brought together 250 women and other interested individuals from around the world representing industry academia science philanthropies venture capital regulatory patients patient advocates like people women suffering from diseases that have no cures very little investment right now to come together and in a meeting and then discuss what is it that we should be doing for women's health right and this group these 250 women over the next year worked to produce a report called the called the opportunity map for women's health r&d for women's health innovation which has eight areas of work that if we fund it would solve so many of the health issues that we see among women and 50 very specific opportunities that could that the that we should all address by investing more in science and innovation as well as in better health delivery and better gender specific and ethnic data because a lot of the burden is right now hidden and it doesn't it does not get attention because nobody's measuring right because measurement is undervalued your excellency I want to go to the Ayushman Bharat program that you have in India you had just started speaking about it so it touches the the lives of 100 million families in India you can tell us more about it but what I am really interested in knowing is after over five years of working on that program what can you tell us about your observations of the outcomes of giving women access access to healthcare so I think first before I just address the issue on hand I would like to reflect a little bit on what pair said all reports are not useless in fact the one that sham comes up with gives not only a cause for action but also a cause for reflection for instance when I talk about Prime Minister Modi looking at what has been said before by experts on issues of women's health he did it at various levels and I've described some of it there were also reports and a plenty of them which spoke about access to healthcare and making it affordable and looking at that challenge which had been documented in many such agencies and many such possible organizational outputs Ayushman Bharat today serves 440 million Indians across 27,000 hospitals for over 1900 diseases the hospital admissions only under that program now stands at a count of 62 million apart from that the prime minister also dedicated his efforts towards preventive healthcare so they are close to over 120,000 health and wellness centers that are operational there when you look at opportunities in women's health it does not only subscribe itself to access to healthcare institutions it's also an economic opportunity for women to come up and become a part of the healthcare workforce the pandemic showed that 6 million women turned up at the front line of delivering vaccine and pharmaceutical support to all Indian families we did it digitally also today in the health and wellness centers that are operational in India 130,000 healthcare workers 66 of them are women but there are segments of healthcare vis-a-vis gender which need direct focus on Anita spoke about this opportunity segregated eight such segments and when as a woman I hear talk about oh healthcare is to be for everybody I agree we're far too long have we said healthcare is for everybody hence everybody will get addressed but they are issues which are culturally contextualized to some parts of the globe where certain aspects of women's health do not get a public exposure for instance Aishwan Bharat Yojana ended up helping 270 million Indian women get screened for cancer of the breast and the cervix now there was a presumption let's say in the global north that cancer of the cervix is a culturally taboo issue will never be spoken about and no government will address it what this success or these numbers tell us is that all women needed was access and affordable care another issue which is not gendered but gives you cause for possible reflection 360 million oral cancer screenings men women everybody alike now these are data sets on which governments like ours are ensuring the privacy of the patient at hand are also ensuring that we have this whole ecosystem where we have over 600,000 data sets which are now available for investors and medical institutions to build on and service the medical community and women at large better my work let's say in the ministry of women and child development we have created something called the potion tracker which is a digital platform where 2.2 million women feed data from 1.4 million nutrition centers it covers a hundred million beneficiaries 25 million are women who are pregnant and lactating 75 million are kids under the age of six we track them monthly and Sofanya would be shocked that WHO standards of measuring nutrition mostly has smaller sample sizes of families that are measured we measured 75 million children every month as per WHO standards we made that data digitally available to local governments but also at the center we red flag each and every child who possibly has had their nutritional status challenged till such time if one child is found to be severely acutely malnourished the medical officer lands up at the door along with weight support for the mother so that we can give them institutional care till such time the child is completely healed we will come back to data and specifically with women's healthcare burned I want to go to you back to access and which you have identified as a strategic growth vector I want to ask where you see the opportunity and if you can illustrate through some examples I mean a little bit where we come from yeah and and I say it don't don't be too negative yeah I mean typically we come from an environment where our business is to cater even better technologies to those who already have it here and we are working with the leading institutions they are our innovation partners and we can rely on the ecosystem existing yes there is the MD Anderson cancer center and they need a better CT scan and whatever and then here we are and we are proud yeah so that is a little bit of a caricature yeah so but in this transition to really be about for everyone everywhere we have clearly understood we cannot wait for the ecosystem to call us yeah we need to help building the the ecosystem we have to transcend our normal way of looking at ourselves and we need to go into new types of partnerships and we need to be inspired not by those not only by those who have it all but by those who don't have it yeah so and that this is an as proud source of innovation as the next level of of whatever cancer care image quality or whatever what it is yeah so this is the transition for that the work we build partnerships with NGOs with governments but also with healthcare providers who have the same target yeah to to solve the access to care issues whether it is in the U.S. even yeah where there is a big difference in in coverage yeah depending on where in the city you live um to emerging countries yeah and one of the topics is similar to what you mentioned um high focus on bringing breast cancer screening to underprivileged communities yeah with mobile deployments as one of the examples yeah whether it's in the U.S. or in Indiana let me pick on some of what burnt said and come to you because he said the word innovation and he said access and you have solved a problem of access through innovation when you came up with a drug that resists a sensitivity of oxytocin I hope I'm saying it correctly to heat and oxytocin is really needed for women who get bleeding after they give a birth how did this invention come about okay how did you come with it and how many lives is it saving well let's start about what happened and how we this and again we could never have done this ourselves burns point is is very valid here we this is thanks to a very constructive public private partnership starting with the WHO and MSD from others so in 2013 the WHO recognizing the heat and climate sensitivity of oxytocin which actually puts women at risk because when you have a profuse bleeding you don't have much time to stop it so if you start using a drug which may not be fully potent you increase the risk of of a fatality significantly so there was a request for proposal for a uterotonic whatever it looked like that could withstand temperature and therefore did not require refrigeration in transport or in storage and and faring had then worked with oxytocin and oxytocin like molecules for a very long time and and simply engineering wise if I allow myself to be a little technical by exchanging one out of nine amino acids to an unnatural amino acid this molecule became heat stable and so when the request for proposal came we had the solution and we started this public private partnership in 2013 now it's now on its 11th year it's moving into its second wave of clinical trials and validation because it's not like we have a molecule we give it to the WHO and they go out and try it we we went together through a 30 000 trial 30 000 women in a prospective controlled clinical trial to validate the safety and efficacy of the product we got it approved in swiss medic first now we have a commitment to the partnership that we will ensure regulatory approval in all low and low middle income countries in the world which is close to 90 and most of them probably countries where we usually do not operate or do business and we're also responsible to to train healthcare providers to do this probably so for us this has been I would say a transforming moment because it sort of puts us on the global healthcare map as an important contributor to a global ecosystem right and and I would just end by saying these partnerships are not necessarily easy I think there have been many times when the people around the table and I can attest to that have sort of wondered why we're actually here because we do see things different I'll come back to you with public private partnerships but I want to go to Anita here and ask her um you've been through from your experience long years of different kinds of collaborations what can you tell us about the type of collaborations that can really push innovation yeah so I'd say three things Zana one is um bring people from different types of backgrounds together you know people who are like improbable partnerships people who've not had a chance to be in the room together and in fact the innovation equity forum that I just talked to you about those 250 women literally many of them were crying because they said they had never been in a room together talking to a venture capitalist or talking to industry uh or talking to scientific uh experts in in a disease that they they they suffered right and so just the operating the convening and the opportunity for improbable partnerships improbable people who have an interest in the area right to come together that's something that um we have to do better and I think it's a real opportunity for women's health area I've had the the privilege of doing it in other parts like typhoid uh was like that you know we didn't have a solution for typhoid and yet we knew that there was a solution possible you just have to bring all of the different people together to make it happen right so that's one thing the other thing is like the commitment right people who are really committed who are not just like talking heads like they really want to get stuff done so if you can do those two things diverse group of individuals and committed individuals you can really make things happen that's my experience your excellency I heard you once say that there's a confidence gap between that needs to be bridged to move from failure to success can you tell me what you mean what you really meant by that when it comes to women health care well I'd set this back home that women have no problems speaking up problem is how much are they hurt and I think that articulates the gap it is not as if the challenge or the opportunity or the capacity to address the challenge did not exist as Anita says there's a need to get convergence there's a need to get money on the table to supplement the cause there was also a need to have policy makers come to the table and collaborate better they are parts of the world Xena where public private partnerships become untouchable in many areas of engagement the health sector is one such area where public private partnerships have done well both for the private sector and for citizens at large and I think women's health is one such arena in which much is to be done but if it can only be done if the public private partnership and the development sector can spearhead it I think that's where the solution lies so for me as far as health and women goes women never had a problem articulating the challenge was hearing now there are many years and that's I think a cause for celebration and this is where I come back to you we were just starting to tell us about what it felt like to sit with the stakeholders at the table the first time each coming from a different world what what level of trust was there in the air I think in there was a long period of feeling each other out and trying to come to grips with what is our actual incentive for sitting at this table and and I think the challenge with the public private partnership runs around economy of course right where we have to respect how we sustain ourselves as organizations and to to find a way to come over that that step right that for me as the president of a pharmaceutical company no one gives me money and and I have responsibilities for sustaining my organization of 8 000 people with salaries their breadwinners and with infrastructure that allows my organization to to exist and grow and thrive and for that I will need the money that I there's left after I sold something pay taxes do some fees and then I can decide what to do then there are other funding agencies that I can't use but but you know we we basically have to overcome that and I think there was a lot of doubts in the beginning there was a lot I wouldn't say conflict I commend everyone who has been at this table people who have come and gone but what kept us together in the end and kept us at the table was that we're all here to solve a vital problem 70 000 women die every year from profuse bleeding after delivery most of those deaths are clearly preventable and and the the consequences of those debts are of course a tragedy and unacceptable is a loss of life but it's a loss of so much more for the family that in the end we found a way and I think now after 11 years we are very comfortable in working with each other and finding good solutions then I'll go to you with this imper just said basically in one of his points that philanthropy cannot solve alone the woman health care issue you have to have real investments now you as semen's health in years okay you take equipment state of the art equipment to underserved communities you can't just leave them and go I mean I'm sure there's a lot to be done capacity building education working with the local community walk me through the cycle and tell me when you think business kicks in so in order to address this challenge yeah we we um we are as part of especially of this access to care um program very actively partnering um with on the one hand local governments local providers um and NGOs yeah so that we build the infrastructure which is which is critical and then we and as you said it only makes sense it is only sustainable um when it's a source of income yeah we cannot I mean as as much it sounds more noble to donate um it's not sustainable yeah so we need to find a way to do this on the other hand yeah when looking at where we historically come from yeah you're not alone yeah I mean you know in the the world didn't have computer tomography and MRI scanners 40 years ago so this there was an effort to build the infrastructure so that this is replacing explorative surgery yeah which was standard of care back then but it also didn't fall from the sky so there was also some ecosystem building and now some maybe overly trivial examples when you look at and I'm I don't know rural India as good as as you do but when you look at how much access to coke Coca Cola Coca Cola is in the world so I don't I don't know the data yeah but when you compare access to coke with access to care it shows that Coca Cola did a good job in you know they are not donating the soft drink yeah so it's possible yeah to to to build the chain yeah it's a trivial example I mean you look at cell phone coverage in LMICs it's pretty amazing so in what is now more important yeah healthcare the cell phone or Coca Cola yeah so I think we have the we have some role models yeah to be careful yeah but I would add to that is that you have to price it right for the people so they can afford it right and so if you and many pharma companies don't don't do that and that then that become but there are also some partnerships that can help in that regard when you guarantee volumes correct exactly that's the public partner public private partnerships or philanthropy can come in and see hey how can we catalyze this market right vaccines Gavi this is a really good example of how we have made vaccines available to children everywhere around the world and the vaccines are made by pharma companies but we've been able to you know make a market for vaccines in developing countries so that everybody can get the vaccine by bringing the prices down and that opportunity is there for women's health right that opportunity is there for taking for all of us to act Anita also from your work I mean we're talking about heavy interventions big inventions capital intensive technology are there sometimes small solutions to big problems absolutely so just like we have vaccines like very powerful public health tools there are so many things that we can do which are very simple tools that can save millions of lives so one example is is is postpartum hemorrhage that per was talking about the most common cause of dying during childbirth is a bleeding after delivery and until very recently the standard of care was that you would do if a woman started bleeding after the baby was born that you would do one thing and then another thing and then another thing gates from the Gates Foundation we funded a very large study to show that if you actually instead of doing one thing and then another thing and another another thing and wasting time if you put it all together as a bundle and you deliver it together you save so many women from developing severe postpartum hemorrhage but there is an added benefit that came out of this study which is just mind blowing which is that so far there was not a good way of measuring how much blood women were actually losing right you just eyeball it and say oh this looks like too much blood to me and so I should I should maybe I should do something so the investigators the people who did this study had the brilliant idea that we should develop a standardized tool which is basically a plastic drape that they put under a woman who's delivering and it has a pocket at the end which captures the blood that as it is coming out and there's measurement like you have on a cylinder or something or a how many ml so they they realize that when they were measuring it they were detecting much more women bleeding more than they thought by which were looking right they yeah so they could see oh oh I should do something now because I can see the that there's 300 ml or there's 500 ml and when they started acting you know the number of postpartum hemorrhage cases that they were diagnosing went up from like three percent four percent to sixteen percent twenty percent right that type of number such a simple tool and say when they acted on that number huge impact on the number of women developing severe postpartum hemorrhage so what's the intervention here it's a plastic sheet with measurement on it right sense not even a dollar that we could get out to every woman out there yeah I have a HPV vaccine can I just say because that's an amazing amazing uh vaccine prevents cervical cancer cervical cancer 600,000 cases every year 340,000 deaths everywhere it takes women in the prime of their lives mothers with young children right we the world had that you need two or three doses to prevent HPV infection which is what leads to cervical cancer now we know through actually data from India that if girls can get one dose of HPV vaccine it protects them from cervical cancer how much did we save so yeah so you save you save so much money you save giving them three doses of vaccine so now you can immunize so many more girls you don't just have to immunize the 9 to 11 year old girls you can go up to AJT in age 20 and save so many girls from getting a disease which is lethal right so I mean and so the cost saving is huge right and the opportunity to have this simple tool like it's a one and done one and done for cervical cancer that's where we are today we can do this I was going to go back to your excellency with the HPV example actually based on the the Indian data uh what can you tell us about all these studies all these findings the the McKenzie report findings today and how they can help health officials in pushing for more strategizing of preventive health care for women I think that on the onset of the response I would like to tell gentlemen to my right that care is available everywhere not Coca-Cola what the Alliance can help do actually is reflect on such reports over the past let's say decade and a half see what are the goals and the proposals that haven't been met thus far if they can put and ascribe a geography to it I think that'll be helpful for thought leaders pharmaceutical companies those who are manufacturing medical devices and also possibly give the Alliance the global expanse which is its ambition targeted benefits that will come to gender and health so that's one I also believe that there is much data which is not available only with policymakers let's say Siemens and the medical instrumentation which is available at their end they have data from the entire globe and the health systems there which without I think usurping any property rights at least that data also can speak to such an alliance which will help inform policy better and I believe lastly that many alliances and the pessimists will say are pronounced but never are implemented in an accelerated fashion so can we have at least 10 such agendas especially on deliverables not only in terms of research because research is a very poignant journey takes time takes effort and takes dollars but they have been known to have we've had frameworks where if you can pinpoint certain diseases or certain medical challenges which within the available medical ecosystem today governed by policymakers and private sectors if such medical challenges from the gender perspective can be as a red flag made available to every country public and private partner I think that this amalgam of some of the best minds can help I really like that idea because it's like what she's what I'm Mr Rani say it's like what are the best buys that exist today that countries can implement right we can do that yeah for instance and I'll take from what Mr Edi said about the plastic sheet yes we all know data exists today where most of the deaths are happening at childbirth due to excessive bleeding yeah we are a country when there was pandemic global supply chains had shut down when there was no movement of goods services machines we built the Indian PPE suit industry in March when the pandemic hit we had zero companies by May we had 1100 companies by June we became the second largest exporters of PPE suits in the world 80 percent of those who are manufacturing were women your excellency I want to move to burn here because we're on TV we have to stick to time what role do you see a company like yours playing in bridging this data gap and AI is coming into the equation now so I think the big opportunity of AI in this context is that when we again switch from the topic of the let's say the established health care systems to the two to emerging healthcare systems the discussion in the established healthcare systems is AI is a productivity tool yeah how can I make the physician more efficient and so on how can I solve the step shortage problem in this challenge AI it's about AI first yeah so like instead of digitalization there was digital first approaches and instead of AI effication of existing topics it's about using AI to bring access to care yeah so and this is you have one example yeah where we bring together with the global fund AI based screening of tuberculosis to Indonesia yeah so this is about bringing diagnosis where it wouldn't have been without it let's continue the discussion outside we run out of time your excellency smirty uh zubin irani minister of woman and child development in india thank you very much annita's id president gender equality at the bilan melinda gates foundation thank you so much bern muntak the chief executive officer at simons ethanes purfa the president of faring pharmaceuticals thank you very much thank you ladies and gentlemen thank you