 attention for what I think is going to be a fascinating panel on technological change and global governance in health and I'd very much like to invite Sheikh Muhammad bin Hamad al-Fani to the platform here. Christian Brayshaw is already here. Madame Dieu Manier, please, thank you. Is Sheikh Muhammad here? Please, Fatah Sayyaf. Our three panelists are going to wax eloquent on on the subject but it does occur to me that when I look at you in the audience and I look at our panelists here, our distinguished panelists, most of you, most of us I hope, include myself, will live into our 80s and plenty of you will make it past the 100 mark. So this means that modern technology has actually improved our health. However, we have ailments, epidemics that cross frontiers, AIDS, SARS, Ebola, Zika, I mean these are maladies which actually demand collaboration between governments and between health systems. They also demand big improvements, big inventions in the field of medical research. So what I would first like to do is ask Sheikh Dr. Muhammad bin Hamad al-Fani, who is the Director of Public Health, Ministry of Public Health, Qata to take the floor. Yes, from there. Thank you very much for your kind invitation. We are very glad here to be here with you and in what policy conference. We believe that this is important dialogue for all the countries that work together and it's always a chance for us to learn from each other. As my experience as Director of Public Health in the last 10 years and how we move westward in Qatar and many people ask us, what's the reason that Qatar grow very quickly? Either there many countries have oil and gas before. One of the main things that is mentioned here and interesting me is governance and technology. These things are the future of the 21st century. In every century, before the industrial revolution, now it's the technology revolution and maybe mainly starting by internet. I want to start first from governance that we learned as Qatar before we don't have a medical college. So all our people travel around the world, study in USA, UK, Canada, Arab world, even Egypt, Syria, Pakistan. Then we come back with different knowledge and this different countries have given us a lot of richness in our health sector. Then we move forward to understand more how to governance of the work and the value of governance internationally. Of course, all the world think that the last 60 years we have less deaths and grow in population due only for peaceful, 90% to 80% peaceful work than before. But it's mainly they forget about the effect of medical technology and the innovation that happened that follow this to grow by vaccinations, antibiotics and other intervention that happened mainly in public health. Here we would like to think always about governance. Now I saw today in the morning a lot of worries that in change of the leadership, it will make a risk for the world improvement. And this is something is not acceptable. If you read the history always, you will find that in history, nobody can stop humanity from growing up. Anybody will try to stop that. He will not win in the end. So we understand well that to lead the world, you should think about the humanity and the growth of humankind. So this was happening before between one leading country or empire that grow the world, but now there's not any more. Now it's working more for global governance. And we need to put stress on this word global governance. It's not acceptable to put all the world risk on one decision or one person or one country is the world is grown enough. The Internet has traveled quickly between countries. I want to assure that if even there's something wrong happening in country, it doesn't affect all the world. This is something we have learned in Qatar. We even I'm here with you in a very political issue because we're having working in intersection collaboration. And this many people from foreign affairs come to Mr. Health to support us with some leading issues in health and we come to support them in this issue. This is going to give us solidarity and to move forward. The second thing Qatar is known for long time to invest. Thanks guys. We don't have any taxes on the technology. So always we invest in technology in early stages between the West and the East Far East. And we get always the technology would help us sometimes that without having much sophisticated people or program systems, the technology will help us to cope and to excel quicker by this technology. Now I think everyone know not is too much to know about dictation grammar. The computer is fixing everything in health. Now we are having a systems of said electronic surveillance system and in Hamid Hospital and our system. We have now Surner program, which is connecting all the world and monitoring the system properly and easy way than before. We believe this practice should be grown around the world. And we have different structures that been achieving a lot of effects. One of these very simple things is car accidents. Before in Qatar it was 26 per 100,000 deaths. And now have moved forward with the decision of the country and technology. It moved to less than one third, eight per 100,000. This means that speed limit cameras, all these technology have supported us not only by the culture, by monitoring the system properly. If you tell me what you want, I want from this as a health person. I want to tell you that we respect the world. The doctors respect each other, you know, around the world. And we work together without race, nationality, and this will help the world to give magical issues in health. Like now we have treatment for hepatitis C. Nobody believe like Egypt and Pakistan having 20 percent of their population with that C. And now they have a chance to survive this. People were divorced and now we have Viagra and Seyalis and we get a lot of things moving forward to keep the families connected more and and we have promoted life that you can study enough and still have just to enjoy the life because of longer liberty of life and better productivity in your giving hope for people. We want this to transfer even in politics. We want to do a plan like we have the brave sustainable development goals that happen to 2030 putting the world together on the same target and the same track. So whatever who is from the right party, from the left party, everybody should be responsible to deliver this sustainable development goals. And this gives us a positive that if we achieve maybe 80 or 90 percent of this into 2030 the world will be in different place. What is something that it's our responsibility for history if we check very well that we need every time to move the world into the future. This was happening all the time by different reasons. Of course there is some catastrophes happening in the world, some disasters. But if you look very well like any movie the evil start but at the end the good people wins. And this is what we want to do here and we are hoping from this to find a declaration to to may have a better governance that whatever it's like insurance for the world. Whatever something mistake happen the system will keep going on because the good people wrote it long time and agreed on before having the wrong people in power. The second thing is advancing technology and try to market it as soon as possible to the other countries because some of the countries they can make a leap frog jump like some kind didn't use ATM they directly use their phone to take cash from the machines in Africa. And this is because they they didn't get need this middle part they jump directly to the future. We hope that this will help the world even to go to finish the goal of poverty goal number one no poverty which is a challenging one but I believe with good humans we'll always find a better generation for our children's and grandson. Thank you. Thank you very much. Just one question actually on Qatar and one of the great problems it seems to me in the medical world now is that antibiotics are becoming disease resistant and in a lot of countries especially in the Middle East you can simply go to a pharmacy and buy antibiotics over the counter without a prescription. What happens in Qatar? Yeah I'll tell you we are in the Middle East but of course we'll find many things in Qatar will be really exceptional. Of course we have a law for eight to ten years not to prescribe antibiotics without without a subscribe from the doctor this is working very well but always the challenge and this is something worries that we are starting to invest in but Qatar in the end is a small country and the challenge comes usually from the massive countries you know strategically fix the big countries automatically the small country will be fixed so this should be starting from the bigger countries and maybe the technology will help us to track every pill you know like for the for the addiction things like morphine other you can track every pill and by the technology you can make it easier for antibiotics to say who took this pill and where this package was sent to and to get it the only challenge now the world is becoming smaller and smaller traveling is easy so when you fix it in Qatar and you don't fix it in a neighbor country you'll always have some smuggling here and there so it should be having a innovative idea to to tackle where did this antibiotic used and more awareness in the medical field. Thank you very much and now it's my pleasure to ask Cristian Breschel from the Institute Pasteur and Cristian I know you have a presentation to make so. Thank you very much Mr. Andrews and thank you to Thierry de Montbriade for the invitation and for setting up this session. I will start with a quote from a Nobel Prize in Nebrennere and he stated that progress in science depends on new techniques new discoveries and new ideas probably in that order this may be a too strong statement but it really illustrates that technology is really at the heart of the progress in biomedical research. Now before moving forward it's important to emphasize that scientists do need in the field of biomedical research infrastructures, equipment, technological platform and this at several levels sequencing for example and Mrs. Dr. Drew will present this for the Beijing Genome Institute is now a bench side equipment and in fact a lot of it is outsourced in centers such as the Beijing Genome Institute. The key is bioinformatics and integrative biology but life science and biomedical research has moved to a status which was previously devoted to physics or to chemistry which is the need to large equipment such for example as this cryo electron microscopy at the national level to the synchrotron and it's interesting to see that about 35 percent of the activity of the synchrotron solar in France is devoted to life science so it's a complete redistribution of the need this in the context obviously of connectivity sharing information and the major point of automatization and the blend between individual creativity of the scientists and automatization. It is very relevant for our for the Pasteur Institute I will not go into detail which is a large research institute in France multidisciplinary 2,500 people also involved very much in public health in teaching and in public private partnerships and this in the context of an international network and in addition to this and it is really my pleasure we have initiated with very interesting collaborations so in this context this is an example of the what we call the titan cryo electron microscopy this is a new generation of electron microscopy it costs 10 million euros it needs a special building it cannot be decentralized and it can lead to some informations which are invaluable this is a picture of in red blue and yellow of antibodies which bind to the Ebola viral protein and this image really allowed to design new treatments new diagnostic tests and new vaccines and Felix Ray in our institute has recently shown that antibodies to the dengue virus cross-react with antibodies to the Zika virus and this opens very interesting perspective for prevention and treatment another example you can directly visualize the viral particle of HIV as we never have been able before to do so so regarding the governance we really come to a point where each of the research institute worldwide cannot have all the large infrastructures and that we need to have networks and of distributed infrastructures this is the example of the european molecular biology laboratory with facilities in heidelberg many platforms in grown-ups structural biology in the uk with bioinformatics and in italy with murine biology and there are other examples and there will be an increasing number now coming to the sequencing we know all of us that it's a revolution that the cost has very much declined and that this has allowed a new appraisal actually of the human genome and the implication of disorders of the human genome but it's always important to remind that you have other technologies i'm not going to detail this is what we call microfluidic at the institute pastor and it's really allows to set up new immuno assays which are hundred to thousand times more sensitive than the current assays so all this progress has led really to the concretization over the past 15 years of what we call personalized medicine precision medicine where we are really able to identify the parameters of an individual of a single individual among the population and to design biomarkers for prediction of treatment efficacy of treatment side effects and the we many analysis show that this can only increase in the future already 42 percent of the new drugs from the companies are can be a minimum to be personalized to be targeted on a personal basis and it comes to 73 percent for cancer and we foresee a very significant increase in the future and it's a topic of large investment for the companies so we we need to put this in the context of the global and one health perspective and this slide illustrates a very important move in the UK with genomic england in the US with the precision medicine initiative there is a move to have hundred of thousand of individuals hundred of thousand individuals who are followed up on a prospective basis with all their genome analysis being determined and this will allow to really have a new insight into global health the resilience project is particularly interesting the idea is you follow up a cohort of individuals who have mutations they should have the disease they don't have the disease and so the question is the reverse is wire and which are the components which modulate the impact on the genome of mutations this is a major turn this is very demanding but we need to have these large cohorts so obviously we need to share this information worldwide and clearly we have entered via our technology allows us and this has been shown in other sessions to really be beyond i would say the goodwill and the the talkings really to mind electronic health records for better research application and clinical care and where as we are all of us aware of it's about really coming from the data obtained in the individuals to data which are obtained in the laboratory then integrate the data and this is the keyword in database and then transfer this to a number of institutions and doctors and now we have entered the era of large network which gather for example in the US but we also have this in Europe and in Asia different hospitals research institutions which can share this data obviously this raise a number of questions which can be addressed before later now we have entered also the era where large companies are becoming new players and they provide new software frameworks which have now helped to empower people to take a more active role in their health this is for an example with apple this is with microsoft for respiratoriness this is with i cannot read but in oncology but i could have cited obviously other companies but this is a major move that the patient is a much more active partner of his or her health through these technologies we are entered the era of artificial intelligence deep learning facebook is an example i could cite others and again it's about the individual being part of the whole process finally rapid diagnostic test is a key point point of care there are now disposable which will completely overhaul the way we regulate our tests and the health system and it goes beyond the diagnostic test i like this slide which shows the evolution of the status cop over the years since the first discovery by setting up by lynec and we have so sophisticated disposal that again we can use them in a very different way so it's about what leroy hood calls predictive personalize preventive and participate participatory approach to medicine the famous before but we have to be realistic it's also about personalized problematic and promising because we know that we have several challenges reproducibility of the data this is a key point if we share if we transfer data which are not reproducible this obviously has no value economics questions with regulatory agencies and affix confidentiality of the data and so on so the question and especially for an institute such as the pastor institute is how really again to integrate all this progress in the global and one health perspective and it is clear that the institute pastor is very much focused on its international network thirty three institutes now in 26 countries and we are setting up presently the one in guinea in konakri so again rapid diagnostic tests are very important for many countries where we are working and they are completely changing the pattern of diagnostics it's really allows this connection test onsite communicate and then act at pastor we have been working very hard on next generation diagnostic test this is an example of a task force that we have set up following the ebola crisis obviously i don't want to go into detail where you have several examples of immuno assay and molecular biology based assay they share the same concept they can be performed very rapidly and again and again they can be performed onsite i'm very proud of this this is what our students had just recently won at pastor the gold medal at what is called the international the international genetically engineering competition ijim in boston engineering competition in boston and they have designed a tool to both on the same apparatus trap a mosquito test for the presence of a virus and share the result throughout the world and this is how it will stand in the field so we have a bulk of technologies which allow to work on a centralized organization and also to work on a decentralized organization so i will skip this up but just to illustrate again that we provide infrastructure teaching onsite capacities in all these in all these countries but the point i want to make is that the new technologies the capacity both onsite to generate the data and to share the data allow to design worldwide a regional and global approach again i don't want to go into detail these are several scientific consortia which are run globally beyond malaria and resistant to antibiotics on a number of pathogens and clinical conditions and this we have really entered the era of molecular epidemiologic map of a disease this is a new england journal medicine paper which has been published by 10 pastor institutes working with several partners in many countries and they provide the first molecular map of resistance to treatment of malaria by what we call artemisemine this would not have been feasible only five years ago the institute pastor is obviously at the heart of the reaction to a sanitary crisis and again all the technologies before sequencing before sharing the information are at the heart of the coordination we can set up to meet with all of these sanitary emergencies and crisis which are listed here we we need to have networks we need to have networks between different countries and this is an example of a network which is has been supported by the european commission which is really about one health that means merging the efforts of clinical medicine veterinary medicine to really provide a survey of infections and emerging infections in different countries and this is a good example because you want to establish this network but then you need the correct technologies to do so this is another example performed in partnership with the united states with the assistant secretary for preparedness and reaction which is really again on the setting up of networks to prevent and react against a sanitary crisis for example for avian flu for the influenzae so we have set up now within the international network this is an example in cameroon of novel system architectures and features of platforms platform to generate the data platform to share the data and provide early warning systems so again it's always the same organization which is very easy to describe on a slide very very difficult to set up actually where from left to right you generate the data on site you merge the data you integrate the data and this is really where it comes as difficult and then you are able to transfer the data the point i want to make with these slides is that what has been perceived initially only a few years ago as something really which would be only focused only possible for say so-called developed countries is now absolutely amenable to emerging and developing countries finally this is an important action which again illustrates the potential of this evolution this is what we call the pastor global health genomic center it means in selected institute of the network provides the bio banking capacities meeting with the regulatory constraints the ethics and the economics and then provide to the selected institute the capacity to generate data on site instead of transferring the samples to friends to the us to other countries but then to share the data with a computer biology based information system and obviously we cannot do this by ourselves we are in the era of partnerships this is a clear example of the need for governing rules we are interacting with the gate foundation on this with the sage bio networks also with industrial partners and this is a case where we have to share the information but also to meet with constraints obviously again with confidentiality with intellectual property with overall security so to close i would like to shift the the topic just for very few slides on the i have nearly finished but because i believe we need to remain very humble with regard to technologies there is a very interesting topic which is the intestinal microbiota that means we have actually two genomes our human genome and what we call the bacteria genome about 1.5 kilogram of bacteria in our intestine and the interplay between these two genomes these two genomes is really shaping actually our personality our features and is very important for a number of disease including so-called non communicable disease diabetes obesity cancer neurological disorders sequencing of the intestinal bacteria was impossible about 10 years ago the progress in technology in sequencing has led to analyze in detail these populations and it has contributed to a medical revolution which is ongoing which is a capacity to transfer the gut microbiota from here one animal to the other and to transfer a given phenotype but now this is possible in humans and this is a new england journal of medicine paper very impressive which shows i as a pointer is not working on this screen but when you have patients with claustridium difficile which is a very difficult infection to treat if you compare in the center those who have received a fecal transplantation a microbiota transplantation from patients who have recovered from claustridium difficile and you compared on the right part those only treated by regular antibiotics there is a huge difference and those who receive fecal microbiota from recovered patients recover themselves so the point i want to make is that this is excellent but if you look at this this is really an old concept which has been revisited it was well known in veterinary medicine it was well known by the chinese and during several chinese dynasty and so the point is that in some cases what really technology allows us to do is a reappraisal of old concept but this is not a problem this is at the benefit of the patients so to close again when we speak of technology we speak of automatization but we should never forget that individuals will be at the heart of creativity and this is what this slide illustrates when we recruit young scientists we want them to be modern but we want them to keep the image of the founder of louis pastor so this is a painting from my great which name is la clairvoyance and i like it because it really shows that technology has made huge progress huge progress it is a real revolution and obviously i have only shown a part of it we see the applications well however we are still we are painting the bird but we are still looking at the egg and what we hope for the next years is really to be able to have this transition from the egg to the bird and this is really what free institute pastor with the partners is very much committed to thank you very much thank you dr bristow and i'm sure we will come back to ethics and personalized medicine later when we have the questions for the audience and now it's my pleasure to ask dr zhamanye from the genomics institute in beijing yes i think you brought sequencing down to a very cheap yes affordable level right right yeah actually we we created the trend of the sequencing so i have a quick presentation yes actually they will not cause the beijing genomic institute because seven seven years before they moved from beijing to shenzhen now we are a totally private organization so the dawn of life area that's my topic why seven years before when i first visited a Nobel museum museum in sweden i saw this long ruler it's the two meters ruler and a one size that is 200 big event the other one is in the 200th science and technology breakthrough so it surprised me in the last year 2000 it's a human genome project almost completely deciphered actually it's not completely deciphered because that project spent 13 years and this thousand scientists joined the project so it takes 3.8 billion u.s dollar to sequence one human genome but you see now and of course everybody will ask gene what's the relationship between gene and the disease actually it's very closely related to us including birth defect also the infectious disease and also the cancer of the chronic disease so every kind of disease related very closely related to you genes of course not not only the gene from parents also from your gut bacteria so that's the the right light is the morsel everybody knows morsel how revolution revolution the the it the it area the the green one is the cost of per genome actually the at the end as the beginning of the 2000 bji funded in 1999 and then we moved to shenzhen in 2007 so you see the the first the point the second point and and in 2010 we bought 128 sequences so actually we we create a market for sequencing and at that time they occupied a 40 percent market global globally and in last year we launched our own sequencer and thus we reduced the cost of genome to 1000 so from in last 30 years from 3.8 billion dollar to 1000 dollar in we are very confident in the next three years we will reduce the cost to 100 dollars and this picture from the singularity university the chairman of balding informatics uh roman mcowley uh gave a lesson to the mba emb students so you see the the bji in the middle actually bji opened a new the door for a new world why what's the new world it's we just the transformation from from from industrial area to the life uh area and uh I would like to to say what's the secret of the world the changing the world we know the world is changing so what's the secret like look look back the uh 200 years history these three can a kind of product or uh invisible product like service uh change the world the first one is uh uh private car and for the model t uh make everybody every family have a car because of chi uh I I think we still remember the slogan of of fort is every family have a car and the and the second the information is now no pc like the windhouse system uh and uh google a smartphone change the world totally so that's morse law uh in credit credit that and uh in the next stage that that's why I mentioned the the rule of the novice law because that's my milestone for the next for this century so I think genome sequencing we call it a super super morse law will will will totally change as a radical change it's a paradigm shift so what's the sequence is a low cost high production also the high throughput we call in sequencing and access accessible for everybody so we just that's our target we will make the genome sequencing affordable and accessible to everybody and uh that's the bji triangle it's bji is very unique organization we have a research institute uh actually we published the top journal uh papers over 40 over 40 uh papers on the top journal like cell new england nature and science act uh up to now we already published the 250 papers on this four kind of journals and we also have the industrial side we have our own clinical uh service uh company now is already uh it will be listed on the um uh in public it already uh 10 yeah 10 billion US dollars is valued and the other side we we uh benefit the society we just uh cut the the cost and the the price of the sequence genome and so we pay pay more attention about the society but at the core you know our advantage is a big data large sample and the full coverage uh populations we believe the high quality data full coverage data will be much greater than AI and deep learning of course we need but first you have you have needed the high quality data so one person I have to mention is the former president of imperial college of london you say bji is not only innovating you you are changing the way of innovation so actually we integrated uh basic research and the industry and the popular livelihood so we we we call it the bji triangle uh they already sequencing uh five million peoples uh so I don't because of time limited I don't want to mention too much uh the the first one the nipt is the non in the invasive prenatal um testing it's a disruptive technology so we we already finished uh 1.6 million people and uh now the global healthcare challenge is uh is a three of the big challenges aging population and younger cancer patient the the last one is a serious birth defect especially in in a developing country so how we can face the challenge what we can do for that I have to mention the story of the sepulos in in in 1973 sepulos uh initiated the national program they collaborated fun uh with the fund is with the church with the government government they they just reduced the of the uh um of the sepulos so of course as a as a developing country it's uh do much better than UK than in Italy so I think it's a time to be cooperated with each other between developing country and developed country so that's a paradigm shift as I mentioned many changes in the in the in this area so we need a new discovery so fund is should uh should pay a lot of effort and the technologies should be developed and management even should be changed that's why we we build a very unique organization it's not like uh uh not like a company and the ethics of of course need to change um policy of and culture so I think so many changes not only one country can face they should collaborate each other so that's a photo from the elevator you see the three most important age is health happiness and hope so I think it's it's time to initiate a war on disease so Biden or already needs uh the cancer uh moonshot initiated by Obama and uh but not only in in the developed country I think we we should work together and that's the the most brilliant things in BGI not the secrecy not the cost and the speed but I think the vision we the vision is all mixed for all for better life so I think despite of challenging and difficult we should work together we we should don't forget don't be not only don't be evil we should always for good thank you so much thank you very much indeed Dr. Ju um we'll have we have about 18 minutes so not a lot of time um but let me just get on to this question of ethics um we are making well we you are making such advances in science and medicine at some point there must be there must already be ethical boundaries um I mean if I put it in journalistic phrase are you worried about designer babies Dr. Prashu I mean this gets into the territory of eugenics almost excuse me this almost gets into the uh into the the realm of eugenics yes yes well I mean there are really several tears to be considered because uh so yes we are very much worried and I believe that we should be worried I mean as soon as you start even you see again you have for example technology such as the famous CRISPR cast technology which is very popular and where you have the possibility to have say reprogrammation of some embryonic sets these are some fundamental questions that we must address that's one point but from what I presented we already have the major concern of for me this is a key issue on how are we going to secure all this data and the access to this data and this is a general question obviously nothing new nothing special to the institute pastor or to other institutes but now that it comes to the um now that we have really easier way uh to generate this data to transmit this data and we know that we must transmit this data I believe that we have really to to sit uh with several uh parts of the society and really decide how we want to uh to determine for example some data should remain the property of individual some data might be the property of the state uh some data might be shared so now the good point is that my understanding although I'm not an expert is that you have technologies which should allow to do so so this is a general answer because I believe that we are at the dawn of this but yes it's a very important concern let me put almost the same question to Sheikh Mohammed uh I mean in Britain for example there is quite um a serious body I can't remember the name of it to deal with ethical issues or medicine especially medical research and I wonder if Qatar has the same thing let's thank you for the question it's very important and always debatable in our region about ethical and usually sometimes our region is conservative things doesn't start usually in our region it need more open region to start the bold decisions but in Qatar we have a research uh a committee and we have a international research fund that take care about every research the human rights and the ethics before we start anything this is something that we it's known in Qatar nobody can do something against ethics and humans in Qatar as the signature before you do that but what I'm saying about discussing about the ethics of these issues always we are worried from the future but the future always give us good things too you know because we were worried about the internet about our privacy okay it's hurting us but give us a big value we're worried about IVF some people were saying forbidding IVF now it's a big value for many people to keep living and make them more happy so of course you can do IVF in the wrong way like there is a knife a gun many other things you know you can use the internet in the wrong things too but but things are as a whole moving the world to the future of humanity and giving them and and many things that we couldn't believe that they can achieve I don't think anyone can stop the the wheel from going on but we need always to work only on directing it to the right decisions together thank you madam you are really the same question I mean you you are the genome is no mystery now you're talking about the internet of life where do we go eventually I mean when you if you are going faster than Moore's law we are really into something absolutely unknown territory which may or may not be terrifying it may be wonderful every kind of technology is a double sided war right but the human genome project actually is a start to digitalize life it's make the ATCG it's translate the ATCG to one one zero one zero so it's a life is digital 20 years before no they believe that but now it's time so I think I would like to give a comment for your for the geo editing and in this year a case of children in the United States kill the serocinia completely with the with the gene editing so you see if we can we we're talking about the Isis but I think Isis is a kind of production relationship it's a should decide is a product productivity right so I think thousand years before the marriage cannot happen outside the one tribe but but now it's you know it's forbidden to marry with three generation right yeah so that's that's a good example for the ISIC need to be changed so I I think that's a it's a good it's good time because health and longevity is everybody's dream you they we love innovation but innovation for what right so I think it's a time to to to to water on disease to reduce disease and collaborate the Qatar and other in Middle East country and so I think I believe it I think it's it's much better than industrial time okay any questions please from the audience if if you have any burning issue that you'd like to bring up if you want to design your own population let me in that case turn to Dr Brachel you use the the phrase personalized medicine doesn't that in the end mean that the wealthy will get the medicine they need and the poor will not because the pharmaceutical companies if they are if the medicine is personalized then presumably the market will be smaller and therefore the price will be higher this is also an interesting question for this I'm not so anxious because you see before taking the position of president at pastor I was the vice president of a company involved on in vitro diagnostics and we had this discussion between diagnostics and pharma in principle the pharma would not like to reduce the market because you decrease the number of patients susceptible to receive the drugs and so it is so that then there might be a tendency to have an increase in the price but on the other hand you really target those patients who who need the drug and there is a very important point when you speak of precision medicine which is also to determine those who will have side effects so you see in the balance you have ready to take in account all the results I mean that's my first part of the question it's not only about determining the efficacy but also the tolerance and so this is really worth taking in charge by the health systems the cost the second point is that the progress in point of care in rapid diagnostic tests the capacity to have really everywhere in the world communication about the results will allow many more patients to benefit of this of this personalized medicine for me the main problem of precision medicine or personalized medicine whatever are really the quality of the results which are generated you see when you have Beijing Genome Institute you know you have reproducible results but we will have worldwide a bulk of information and if they are not correct then you come to a precision medicine which is absolutely unprecise a question from the audience I can't see any bomb in that case I'm going to ask one last question really to I think Sheikh Mohammed but actually no all of you we talk here of governance and the implication is that this is collaboration between states on a global level but if you look at the headlines then I think one might argue at the most effective body in medicine for the masses at the moment is perhaps the Gates Foundation or the Clinton global initiative is this a failure of governments that the space is actually being taken by private individuals you touch very important thing that we are sometimes we are not happy about is that if you check about the biggest and the oldest institute of World Health Organization which we haven't mentioned once so far yes and and the challenge that World Health Organization have big made a big value through history and they are aligning the efforts between countries and make them have the chance to meet every year in Geneva to discuss the issues but surprisingly that you know the budget of World Health Organization only four billion for maybe 10 years with the any any ministry of health in the world maybe most of them have more than four billion so they have a trillion so they have trillions they have have three hundred billion dollar and not sharing to put some money in governance more and we have a failure that happened like Ebola they didn't want to pay for Ebola enough and all of a sudden they are ready to pay billions for Ebola if you started in the prevention early stage you will not go there but some they were not hearing what is the threats are happening like in Ebola so Bill Gates Organization is now work alone but could work or it work with WHO again there is Rockefeller there is a Clinton Foundation many of them they but what happened between these people they focused on some issues so they focused on their success but they don't work comprehensively so what we are missing we are having successful story in one subject but we are losing the time to put more seeds in the in the ground and see the trees growing up so we want to be more smart in the future be comprehensive and scale the work for different types of subjects to prevent and treat in health this what we call the real innovation that started in 20th century and we want to keep this in the 21st century in more smarter way by arranging our our goals together thank you thank you very much that's fascinating you have 25 24 seconds and counting down to agree or disagree that pressure what will you well i agree basically Bill and Melinda Gates are extraordinary people when you discuss with them they have done a fantastic job we really have to recognize but on the principle if we speak of governance this is a problem um gene is the the code of life the language of life the nature maybe the god told us the language so we should use that that's my that's my dream