in a major reset of us foreign policy, president biden promises to rebuild america's neglected alliances and re—engage with the world. he also said he would stop support for saudi arabia's offensive military campaign in yemen. the us house of representatives has voted to punish republican congresswoman marjorie taylor—greene over her incendiary remarks including support for violence against democrats. 11 republicans during the entire democratic caucus in the vote. serious consequences are called for china after report shows uighur muslim women were raped in camps. china has accused the bbc of making a false report. now on bbc news, it's hardtalk.

welcome to hardtalk, i'm stephen sackur. the roll—out of covid—19 vaccines has boosted hopes the virus can be tamed, but it will have to be a worldwide effort if it's to be effective, and right now the signs are not so good. while tens of millions have already been vaccinated in the rich west, the world's poor are facing a very long wait — the phrase "vaccine apartheid" has already been coined. my guest is the chief scientist at the world health organization, dr soumya swaminathan. is vaccine inequity undermining the fight against covid?

dr soumya swaminathan in geneva, welcome to hardtalk. hello, stephen. thank you for having me. it's a pleasure to have you on the show. let's start with an overview. is there any reason to believe that we are getting on top of this global pandemic? well, one year ago, the director general of the who announced that this covid—19 was a public health emergency of international concern. that was on 30 january, 2020. and he said that there was a window of opportunity that countries had, that we all had, to get on top of the virus and to stop it from becoming a huge pandemic. one year later, we're

in a situation where we have crossed 100 million cases, more than 2.2 million people have died, and these are just recorded deaths — there are probably many more uncounted deaths and deaths due to collateral effects, impact on health systems. but at the same time, we have new tools that we didn't have a year ago. most importantly, we have vaccines, but we also have a lot of diagnostics and some therapeutics, some drugs. and if we use them wisely and equitably, we have another window of opportunity now to get ahead of this virus. at this point, it looks like the virus is winning because it's transmitting, it's growing explosively in many parts of the world, it's mutating, it's changing to adapt itself, to be able to transmit itself better from person to person. but i think, you know, it's been unprecedented, the speed at which people have come together, scientists particularly, and have developed the new tools.

right now, it's a question of how we use those tools fairly, equitably, based on moral, ethical, and scientific principles to get ahead. so a lot depends on what we do in the coming weeks and months. but if you say that right now the virus is winning, it suggests to me that we are not using the tools we have developed wisely. yes, ithink, you know, very early on we started learning about how this virus spreads and we also know that you have to do a combination of things to stop this virus from spreading from person to person. so, for example, you have to put in place measures that, you know, physically distance people, you have to avoid people gathering together in crowds, everyone needs to wear a mask whenever they are in contact with people where they cannot maintain physical distancing. universal masking, the models show, can do more to reduce mortality in the short term

than even vaccines. we need to, of course, maintain hygiene and wash our hands. we need to be in places that are well—ventilated, avoid crowded and closed settings. and then the governments need to put in place systems for early detection of cases so that you can isolate them, and this isolation needs to be supported, because many people don't have the capacity, you know, to be able to isolate themselves — they may not even have a separate room in the house where they live. so supportive isolation, quarantining of contacts, tracking and tracing contacts. so, essential public health measures, which, by the way, have worked in many countries that have adopted them. yeah, we know of those measures and, frankly, we've known about them for many months. the difference, and what many people hope will be the game—changer, is the roll—out of a host of different vaccines now. but in mid—january, your boss, dr tedros, the chief of the who, spoke of, quote,

"a catastrophic moral failure" in the way vaccines were being distributed. he pointed out that 39 million doses had already been administered when he spoke in the high—income countries, whereas he said just 25 — not 25,000 or 25 million, but 25 individual doses — had been delivered in sub—saharan africa. now, if that was a moral failure of catastrophic proportions a couple of weeks ago, has anything been done to rectify it? yes, and that's what we've been working on for the last several months. you know, from history, we know that there's always been delays between access to products in high—income and low—income countries. if you take hiv, it took more than a decade, 12 million africans had died, before anti—retroviral treatments were made available to them. and now, of course, many of them are living long lives.

it's the same thing happened with him — by the time vaccines were made available to the developing countries, the pandemic was over. luckily, it was not a pandemic that actually caused high mortality and so we got away with it. and this is why in april of 2020, the who got together with several countries, with foundations and with other global health agencies, gavi and cepi particularly for vaccines, to launch the act accelerator and the covax pillar. so there are pillars that focus on drugs, diagnostics and vaccines, but the covax pillar, which is gavi, cepi, the coalition for epidemic preparedness innovation, and who jointly addressing the issue, both of accelerating the development of vaccines and promoting that and facilitating that, but even more importantly, ensuring equitable access. and the covax facility... yeah, but it's not working... it's not working, dr swaminathan. i mean, the covax programme says that, if it's lucky,

it may get 3% of people in the poorest countries vaccinated by the end of the first half of this year — just 3%. we already, in the uk, have a figure of around 15% of the uk population vaccinated. in israel, they're up at 33—34% of their people vaccinated. this idea that there is a fundamental inequity between the rich world and the poor, it is profound and it's utterly damaging to any notion that the world is acting together to conquer coronavirus. yes. i mean, you know, we knew that there would be a gap between supply and demand, particularly in the first months of the year. first of all, i think we should acknowledge the fact that we got to a registered vaccine 314 days after the public announcement of the whole genome sequence of the sars—cov—2 virus — that in itself is completely unexpected, so, you know, our expectations have also become higher.

secondly, the early vaccines had 95% efficacy, again, something that nobody expected — our expectations of all vaccines are higher. we currently have over 200 vaccines, you know, 63 of them in clinical development, so there's a good pipeline of products, manufacturing capacity is being ramped up as we speak and so in the months to come, we are going to see hundreds of millions of doses of vaccines flowing into countries. the covax facility has just sent out an indicative allocation list to all the 190 countries that are members of the covax telling them what they can expect to get in the first few months of the year. it's going to start small, but it's going to be distributed, you know, based on some fair allocation principles... i asked you specifically what the who... in february... but what does the who feel that it can do to hasten a more equitable distribution? for example, one of your colleagues in the who, margaret harris, sent this message to the people

and government of the united kingdom. she said, "once you have completed the vaccination of your vulnerable groups" — that is care workers, health workers, people aged over 70 — she said, "once you have done that, the message given to your population in the uk should be �*you can wait�*, and you should then focus on ensuring equitable global distribution of vaccine that you currently have, because that would," she says, "clearly be the moral thing to do." so is the who message to people in britain that once the most vulnerable have been vaccinated, they should accept that then vaccines should be sent to the poorer parts of the world to protect the most vulnerable in those parts of the world? yes, exactly. i mean, i think when we made this plan of a fair allocation and equitable distribution, we knew there'll be limited

supplies, and so we started prioritising the groups who should get it first. i mean, one group are clearly the health workers and front—line workers. you know, we've seen they were disproportionately affected by this pandemic. they need to be protected so they can take care of the sick and health systems don't collapse and then come, of course, the elderly and others who are at high risk of infection and death. now, this constitutes about 15—20% of a country's population. you know, it varies, but it's in that range. and the 3% you mentioned earlier are the health and front—line workers in most countries. we are saying, let's protect these people around the world first before we start scaling to beyond these priority groups and vaccinating, you know, healthier adults. i mean, that is the endgame, is to vaccinate enough people in the population so you develop the population immunity to break the chain of transmission so the virus then, you know, there's no longer a pandemic. but we need to reduce deaths, we need to prevent preventable

deaths, and that we need to do now as soon as possible, and that can only be done if we are vaccinating these vulnerable people all over the world. but do you recognise the profound political difficulty that comes with your message? because you are saying to taxpayers whose taxes have been used to procure hundreds of millions of doses of vaccine for the uk government or the us, or the canadian or other rich world governments, no, you're not going to get the vaccine, your government is now going to send all of the excess vaccine that it currently has procured to poorer parts of the world to vaccinate them. do you think that's really, seriously, going to fly in the rich world? are citizens going to accept your argument? well, i think there are several things that we can do, countries can do and manufacturers can do. the first is that a lot of the vaccines have been developed through, you know, public funds,

including from philanthropic organisations and private/public partnerships, and these require that there should be some equitable access provisions built in when this happens. it's true that many of the high—income countries have really invested heavily in the development of vaccines, and this has been done over many years, the platforms have been built over many years. one thing we can do is to expand manufacturing, and companies that have successful vaccines can and should partner with others that have the capacity to manufacture, have spare manufacturing capacity in different parts of the world, and we try to use as much of that that's available in the world to really ramp up the production. and the third thing is the messaging. of course, there is a message of global solidarity here. it's a message of humanity. you know, a life in every country is worth the same. but i'll be honest with you... while we're not asking any country not to protect.... yes, forgive the interruption. i have to be honest,

what we see, particularly in europe and in the rich world, isn't so much solidarity. we see vaccine nationalism. we've seen a big fight between the eu and astrazeneca about supplies of the oxford astrazeneca vaccine, which ended up with the eu threatening to block all exportation of vaccine made in the eu to destinations outside the eu because they said it wasn't prepared to see vaccine leave the eu when they weren't getting the supplies that they claimed they'd already ordered and paid for. so in this context of vaccine nationalism, which, frankly, appears to be spreading around the world, what hope do you have for this sentiment of global solidarity? well, you know, we're linked in so many ways that it'll be impossible, really, if countries start closing their borders and so on, because if you look at supply chains, vaccines are not all made and manufactured and packaged in one place. you know, they move

across borders. the raw material is made in some part of the world, it's shipped across, and the finish happens somewhere else. and then, you know, it's packaged and distributed. so countries need to cooperate for this. and i think this is where we really need to come together. and it's notjust the moral and ethical argument. you know, there's also an economic argument to countries helping each other. if you have islands in the world that are well protected, where the entire population is protected, and the rest of the world, the pandemic is raging, new variants are emerging, the virus continues to multiply and spread. and we've seen that these variants cross borders. they don't respect borders, and they're going to come back and infect people all over again, apart from the fact that lots of people are also dying unnecessarily in these countries that don't have access. and a recent economic analysis done by the international chamber of commerce showed that if we do not distribute vaccines equitably, the world could be looking at a loss

of something like $9.2 trillion in 2021, and half of that would be borne by the high—income countries. you're the chief scientific officer for the who, dr swaminathan. just a quick word on a lot of noise and discussion about the efficacy of different vaccines, because, again, public confidence and public trust is really important here. president macron in france, in the middle of this spat with astrazeneca, he then turned his attention to efficacy and he looked at the oxford astrazeneca vaccine and he said, "i'm not even sure it works for the over—65s." he says it may be quasi—ineffective. when you hear political leaders wading into the science debate like that and airing opinions which seem to be more informed by, shall i say, politics than science, are you concerned what it's doing to public trust? yes, i mean, ithink we know that vaccines...

traditionally, there are challenges in vaccine acceptance, more in some countries than in other parts of the world. it's really important that we focus on the science and the data and the evidence and that we let the institutions that have the responsibility to examine that data, the regulatory agencies and countries and the other bodies that have been set up to do that, make these pronouncements. and then we trust that these agencies, including the who, which has the sage, which is the independent expert group that gives policy guidance on immunisation, and then we have our regulatory and prequalification teams. they, of course, work with regulators around the world. but once the pq team has prequalified a vaccine, we can trust that it's efficacious, safe and that it's been manufactured to some quality standards. so i think this is not a question of an individual�*s view. it's really a question of what the data show.

and to me so far, all the results that we've seen — some of them are through press releases and some of them are through publications — are very encouraging. forgive the interruption... we can have safe and efficacious vaccines. right. forgive the interruption again, but would you say, as you look around the world — because we shouldn't just focus on the west here — but as you look at the sinopharm chinese vaccine, you look at sputnik v, the russian vaccine, some in europe now saying, "you know what? we'll sign deals to get these vaccines, because they're easierfor us to procure than some of the ones made in europe and in the west." are you saying the who is entirely happy and confident that all of these different vaccines are both safe and efficacious? so what i said was, once we have examined the data and the committee says that this vaccine can be put on the emergency use list or can be prequalified and the sage gives policy guidance on a vaccine, that

means that we are satisfied with the data we've seen. currently, we've only put on the emergency listing the pfizer vaccine. but we are working with 12 other manufacturers, including the russians, the chinese, the indian and so on, to look at the data. and i'm confident that in the weeks to come, we will be putting on that list more vaccines. i'm not saying that the vaccines out there are going to be useful. with respect, don't you need to hurry up? i mean, the uk authorised its first vaccine for use in early december. here we are at the beginning of february and you're saying that you've still only managed to entirely certify one vaccine and that it may be weeks before you certify some of the others. what's holding you back? so, this is a really good point, and we really encourage manufacturers, even those who are at an early stage, to come to us with their data, because the earlier we can see the data, the earlier we can get prepared. the astrazeneca vaccine, as an example, is being manufactured in at least eight

sites across the world. so it's notjust the uk site which is supplying the uk, and the mhra looked at that. we need to look at the sites that are going to supply vaccine to the covax facility. and so we have to go through dossier by dossier for each of those sites. but the earlier we can start, the better. and as i said, we're engaging with... and they don't always have all the data that we are looking for, so that takes a period of time. but we, of course, are trying to expedite as much as possible. we want those vaccines out there and being used as early as possible. indeed, because, as you said earlier, it is still a race against time and against the ability of this virus to mutate. how alarmed are you by what we are learning day by day, in particular about the south africa mutation of covid—19? because various different vaccine companies are now saying that, yes, there is evidence that their vaccines are significantly less efficacious against this

south africa mutation, which does appear to be alarmingly resilient. in the uk, they'vejust announced that there are now eight locations where the south african variant has been found with no obvious link to travel from south africa. so it seems as though it may be taking hold in countries like the united kingdom. how worried is the who that this particular mutation could present a whole new level of threat going forward? yes, we are concerned but not entirely surprised, because viruses mutate, they change all the time, and we've been tracking these over the last year. in fact, there was a previous mutant virus, 614, which actually became predominant over the early spring months of last year. but of late, we've seen these variants emerge, you know, b117 in the uk, the 501y2 in south africa and the b1 variant in brazil. we're concerned because

the viruses are mutating so that they have an evolutionary advantage, that they can make themselves more transmissible. and the combination of mutations that we're seeing now in the spike protein is, firstly, allowing them to infect other people more, as we've seen with the b117 variant in the uk, you know, one and a half times more transmissible, perhaps a little more severe clinically. we're still waiting for more data on that. as far as the south african variant is concerned, it has a particular mutation which affects the binding of the antibody to the spike protein, and therefore both in lab assays and in people who've been in the vaccine trials, we've seen that the ability of the antibodies to neutralise that particular strain of virus does seem to be weakened. now, it's not completely gone, so these vaccines are still efficacious, but less so when compared to people who got infected with the wild—type virus or even with the uk variant.

so it's worrying, but it tells us two things — one, that we have to step up vaccination quickly before these variants spread too much, and secondly, that we really need to focus on bringing transmission down and suppress transmission as much as possible so we don't give these viruses an opportunity to mutate even more. just a final thought. many of us around the world want to believe that the roll—out of the vaccines — aad you've just pointed out the problems with the way it's happening — but ultimately it will mean that we can talk of a world that has beaten covid—19 and that can return to some sort of normal. the more i listen to you, the more i'm wondering whether that's the wrong way of thinking about this. do you think that we have to change our mind—set, that we will be living with covid—19 for the indefinite future? well, we'll certainly be out of the pandemic, there's no doubt about that, we're not going to be living like this forever. but again, as i said, it depends on things we do now in the coming weeks and months,

the actions we take to suppress transmission, the equitable roll—out of vaccines as well as the other diagnostics and drugs and taking, you know, globally coordinated decisions. and also when we.... the virus may stay on, it may become endemic. we don't know yet if it will, but if it's another coronavirus, we can deal with it as long as it's not causing this kind of devastation all over the place. so we want to get out of this acute phase of the pandemic, but looking ahead, it's clear that we need to invest, of course, in public health and preparedness and resilient health systems, universal health coverage, but also, i think, at a new model of how the world copes with big global public—health challenges. and this is where we need coordination on research and development and manufacturing and access. and this is where i think solidarity really has to play a role in order to ensure that the solutions that come out of science can actually

make a difference to the world as a whole and notjust some people in some parts of the world. indeed. well, dr soumya swaminathan, i thank you very much indeed forjoining me on hardtalk. thank you. hello. cold and snow on the way. for now for many of us, it's just yet more rain with an ongoing risk of flooding. but as you know, in northern scotland, the snow has arrived. heavy snow, at that, where the met office has an amber warning in force throughout friday. still snowing here, and even into the weekend within that amber zone — so significant disruption as a result, as those

snow totals mount. now all the wet weather, snow or rain, is from this area of low pressure only very slowly moving away over the weekend. as it does so, rain turns to snow as an increasingly strong and bitterly cold easterly wind sets in across the uk. and as that continues into next week, we will continue to see some snow coming in, particularly but not exclusively to eastern parts of the uk. this is how we start off on friday morning — most of us are above freezing. most of us seeing rain rather than snow, but the snow very much still there across northern scotland. wet, too, in northern ireland, especially to the eastern parts of northeast england — both areas with the risk of flooding from the persistent rain. showers moving into wales, southwest england, the west midlands as we go through the afternoon. east midlands, east anglia, southeast england, and parts of northern england away from that rain towards the far northeast. drier and brighterfor a time, a few sunny spells, and still that big range of temperatures from north to south across the uk.

now the overall pattern doesn't change very much as we go through friday night into saturday morning. still the showers or bands of rain circulating around an area of low pressure, and still very wet for some of us in northeast england, along the east coast of scotland with that snow further inland, and especially into the hills — stillsnowing, perhaps for some of us, even into the start of the weekend. for all this weekend, it turns much colder and that snow becomes more widespread. plenty of cloud around on saturday, showers or spells of rain especially in the east with the wind starting to pick up, as well. i think deeper on into saturday, more of that rain turning into snow in northern england initially on the hills. looks to be a drier day though in northern ireland. 0vernight and into sunday, the cold air really starts to dig in. rain turning to snow across eastern parts, could be a prolonged spell of snow across parts of east anglia and southeast england, then further snow showers in the east — some may push further west. regardless, though, for all of us, it is much colder by then.

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