enrichment. that's binding international law. and china and russia voted for it. that is the standard that we have to restore, and if you look at secretary pompeo's list of 12 demands, there at the top is no enrichment. it's going to get us out of this debate of how close iran is. iran does use nuclear blackmail in order to win concessions, and so, we're out of the deal. they are regularly threatening the europeans with-- they've now broken their nuclear commitments, no fewer than five times. we would like to-- we've now put in place, i think, the leverage necessary in terms of pressure and isolation, and all of that, in order to get the kind of deal that will be necessary. it's going to take a lot of leverage to get a comprehensive deal, but we've got to get no enrichment. >> we're going to leave this program to take you to a live event. you can watch the rest on c-span.org. we take you to a discussion on development and distribution

after covid-19 vaccine. >> we are going to be talking in particular of an innovative new model to try to address the issues around how to encourage accelerated research and development of important vaccine candidates, but also, how they can produced and distributed in ways that take an international perspective and a perspective of equity and a public health-driven distribution approach. so, we're going to be talking a lot about the covax and there's a slide for the audience to get more grounded in what is covax. it's the vaccine pillar of something called the act accelerator to speed up access to diagnostics, therapeutics

and vaccines. there are three elements of the necessary tools for an effective medical and public health response. this was launched in april and it was really launched as a collaboration of both government, importantly including the european union and their president, but also philanthropy and not for profit organizations coming together, recognizing this critical need as this global pandemic was unfolding. as i said, covax helps the vax seep of this accelerator and the coalition for preparedness and innovation which was started after the ebola

outbreak in order to try to do research and vaccine against pathogens and pandemic potential, the foresight of that is quite appreciated and guy ga vchvgavi. >> global access for vaccine innovation. and to provide vaccines for children in the poorest countries through market shaping. reducing cost of vaccine and helping to support countries with vaccination programs working with critical partners in an alliance. and administered by gavi which works in terms of procurement and distribution of vaccines, and it will be-- the covax facility is seen as a

marketplace through which many countries, rich and poor have access to a diversified and actively managed portfolio >> the poorest countries need that, and others can procure covax vaccines, why that may bely desirable. and there's the gavi commitment of this exercise and that's important in terms of the ability through donor financing to secure covid-19 doses, make the commitment for purchase ahead of time and that will help to ensure the access for a

very large number of low and middle income countries and the goal is to deliver two billion doses of covid-19 vaccine by the end of 2021. this, of course, depends on the successf successful development, approval and development of vaccines, another huge challenge we're facing previously of a recognized virus and disease. we'll talk more about that as well. and just lastly, i want to mission before we turn to the panel, you know, the issues of funding because all of this sounds good, but it requires the resources, importantly dollar resources, although human resources and political commitment as well, to really realize the important goals and estimated 18.1 million is needed for covax to deliver on these goals and the advanced manufacturing commitment needs two billion through 2021 and to

date has raised $600 million and cepi needs two billion for initial field trials and raised two-thirds. but clearly this is absolutely fundamental for the ability of all of this work to move forward. we have to do those studies and as more and more vaccine candidates are moving and taking in clinical trials, this is a critical gap in funding, and it was mentioned as they began this session, we do need to see broader commitment of country, so far, there are a large number of countries, i think 76, that have indicated interest in committing, but we need those countries to truly step up to the plate and make those commitments firm and sadly, the united states has not participated in any of the initial launch meetings, planning meetings or made any

active commitment. currently on the hill there is consideration of monies to support international programs, including money for gavi and potentially money for cepi. and this is a critical time to distance those efforts to ensure that the united states plays a critical role in this very innovative and, you know, really essential international activity to help develop and equitably distribute vaccines. that's what we want to talk about today. so i will now turn to the panelists. i don't think we need the slide. thank you. i'll start with nicole lurie to really start the discussion. she, as you've heard, has a long history of working in the realm of public health

preparedness and responding to epidemics and pandemics, including h1n1, ebola, zika and now covid-19. and you know, also an american citizen, has worked for the u.s. government and i was hoping, nicky, you could sort of layout for us a little bit why this initiative is so important and why it is, in fact, in the u.s. national interest despite all of the investments the u.s. is currently making in its own vaccine development programs for covid. so-called operation warp speed. but why is it also of value for the u.s. to invest and commit to a program like covax? >> sure, and thanks for the question. i think what's important to remember and i think we hear this a lot, that nobody wins

this race unless everybody wins. that we are not safe until everyone is safe. but i think from the u.s. perspective there are a couple of really important components. it is obviously in our own interest to be sure, not only that there are safe and effective vaccines for americans, but that there are safe and effective vaccines for the rest of the world so that we can end this pandemic. we're seeing right now what we call a lot of vaccine nationalism, understanding lots of countries are taking care of their own needs which they need to and we're seeing countries make all kinds of bilateral deals to get vaccines. that's only going to drive up the price of vaccines for everyone. the u.s. has invested in a number of candidates. we're optimistic. we don't know if they're going to be successful. we don't know if they're going to generate enough doses and so this idea of the u.s. supporting and buying into a

larger pool of candidates so that it hedges its bets, it sees covid vaccines as an insurance policy for itself. makes sense. and secondly thinking of our own recovery. our economy can recover just by vaccinating americans. our economy is going to need markets around the world to be strong and functional for our own economy to recover and that means vaccinating people around the world, probably starting with the first tier of frontline workers that they're likely to do in the u.s. >> thank you, nicky. i'll turn now to kendall hoyt who has been working to serve study on some of the issues around models of collaboration, but also, thinking about when the market doesn't always work

to address the critical public health or global need and why would a model like this be necessary? why can't the free market just recognize these needs? why do we need to-- nicky just laid out a critical set of reasons why it's in the u.s. national interests, but why more broadly do we need to proceed in ways that might be different than we might normal normally expect in a global marketplace? >> yeah, that's a very good question. you know, this is -- the demand is high. the market does work. this is not a market failure. but you know, it's what competition, sort of a time

honored way to generate innovation, but in this case it might actually hinder efforts to develop a covid vaccine and to make it equitably available. in a free market, vaccines are going to the highest bidder and there's limited supply early on. and we did a model of the market and it shows that if you allow free market forces to operate, it's going to cost 13 times more than if we were to do a collective procurement under a global mechanism such as covax. so the cost. it's the going to reduce access to the vaccines available if you do it through these bilateral deals. covax will allow equitable distribution on the basis of need and vulnerability, as opposed to nationality and ability to pay.

and as nicky said, we all have an interest in ending chains of transmission as quickly as possible. so, it would get in the way of that. and furthermore, allowing the free market to operate through the bilateral deals is going to create incentives for protectionist measures, expert controls, things that will snarl supply chains which will then hinder development and extend the amount of time that it takes for us to effectively rule out vaccines. so those are some reasons to consider. >> thank you, thank you. and now turning to our european colleague. let me welcome nicolai to his new leadership role at path. and i understand as we're speaking, he is this morning here in washington d.c. where i

am, he has movers at his home in denmark and copenhagen to help prepare him to make the journey to seattle where path is located. and it has a long history of forging partnerships across sectors and across borders with government, with philanthropy, with not for profit organizations and the private sector. so that perspective clearly is important as we're thinking about how to shape and hopefully support the success of a novel entity like covax. so i was hoping you might be able to speak a bit to the seven issues about how do you make partnerships work, why is this partnership so critical now, and potentially, you know,

provide a little non-u.s. perspective on vaccines nationalism versus globalism. >> thank you so much, peggy. it's a pleasure to be with you all today. those are big questions that you raise and i would say there has been good news and this is obviously a great timing for having a discussion on this topic, i mean, since we became aware of covid-19, there have been an unprecedented global collaboration, that's great, that means that the they have been able to be accelerated on unprecedented scale so that's really great news. this is why it's probably realistic that we'll have a vaccine available in a short time frame. also, what we have seen in terms of partnerships and

global cooperation is the way of breaking down the barriers between public and private sectors. and we talked about the covax. we talked about the accelerator and all of these view and novelty approaches between the public and private partnerships. economic institutions, universities, pharmaceutical companies and so forth. this is how we at path have been operating for the past 40 years and we've seen how this is actually extremely effective and can help accelerate developments and now, in a way, this needs to be proven that it's a completely unprecedented scale and with so many actors. so, actually, we're seeing new models and i think this covax is a unique approach which is actually trying to also pull in

all the countries around the world, no matter if they are low income countries. high income countries. everyone has a role to play in this global effort to get a vaccine out that works. to become available to all. but obviously, it's not only the science piece, it's also the manufacturing piece and i think you mentioned this in your introduction that for all of these candidates for vaccines, for those to be produced and manufactured upfront, we need to start that work now. that means that we need to use all the resources and all of the approaches to prepare that and provide the funding that is needed for that effort. and for the european perspective, i know we talk about nationalism and the u.s. conflicts cod. what i would say as a danish citizen and sitting from here

in europe, that national has also been a part of the response here in europe. obviously, starting on equipment, who has the access to that, and then it went on. i mean, how do you make sure who should get access to the vaccines first. now the european commissioner, the head of the commission is actually pushing hard and has been very helpful at conferences-- and giving the support from the european union side. and the latest is that to counter act nationalism, that eu is now negotiating on behalf of all member states with manufacturers and producers, which is a new approach, and they would have to deliver on that approach, otherwise probably the governments and national governments are also

going to maybe turn towards a more nationalistic plan which i don't hope. covid, a great response from the world. >> thank you, i almost wonder is nationalism even possible when it comes to vaccines or other areas of bioscience, product, innovation and development? for one thing, science is a global enterprise now and the underlying work behind all of these vaccines has been, you know, i think very collaborative and very international. also, so many of the companies are multinational, how they do their work, labs in one place and manufacturing facilities somewhere else, critical supplies coming from different countries, et cetera. and of course, studies have to

be done where there are cases and the u.s. is not proud of its number of cases at the moment. it does mean that we have a lot of opportunity to do clinical trials, but in china, for example, because they have more successfully controlled the spread of this novel coronavirus, they're actually having to go to other countries to do their clinical trials. so there's just a lot of -- in the real world, there's a lot of crossing of borders and requirements for collaboration, or benefits from collaboration no matter what. so, i'm sort of curious, you know, maybe i'll go back to nicky first on this, do you really think it would be possible for the u.s. to just try to go it alone? and you've watched how this has unfolded in other instances and

i should say in framing the question, also, you know, would we be where we are if china hadn't posted the genome in early january in terms of our ability to develop important medical count are measures? obviously, the science has unfolded quickly and as it's spread, people have gotten access to-- without a problem, but that's another issue with vaccine development and collaboration in the past. so i'm just curious, nicky, from the years of experience that you now have had thinking about and working on these issues? >> it's such a good question, peggy. i'll reflect when i first got into this whole field, the world looked pretty different. there were lots of efforts at collaboration, particularly on the public health side. on the surveillance side between the u.s. and other

countries around the world, but from a scientific perspective, you know, the u.s. scientific enterprise, particularly-- it was really the envy of the world. what i feel like we've seen over the time i've been doing this work, is that a lot of the world has caught up in so many ways. as you said, we've got lots of vaccine development in china, vaccine development and manufacturing going on in europe. we have lots and lots of interdependencies. but for those interdependencies to function, i think the relationship has to be built on a relationship of collaboration and trust. and the u.s. has been a sort of precarious position right now because it's been choosing, by and large, to go it alone. in a lot of different ways. and so my perspective as an american now working with a

number of global organizations, is that we're viewed with increasing amounts of skepticism about whether we can be trusted. i hope that we can and certainly the scientific advancements that have been made, both in the united states and across the world, come from this whole area of global collaboration and science. but you also know when push comes to shove, sovereign leaders are under a lot of pressure to protect their own populations first and it takes an enormous amount of leadership and skill and explaining to explain to one's citizens around the world that taking care of my citizens also involves taking care of citizens around the world. if this hasn't shown us that infectious diseases know no borders, none have. so on the one hand we're all dependent on this collaboration to an incredible degree.

on another hand, just as we've seen the lockdowns and export controls and import bans, we have personal protective equipment and all kind of supplies and we've seen lots of border closures around the world, this kind of nationalism is still alive and well and i think it's going to really inhibit our ability to deal with this pandemic and frankly for the u.s. to sort of continue to regain trust as a trusted international partner of going forward and that's an initiative. >> and kendall, i know that you've done work on sort of trying to think about and frame vaccines as a global public good, and that is, i think, from my perspective as a public health professional certainly true, but that's a hard thing to communicate in many instances, especially in the context of a crisis like this,

where every country is trying to look after their own. what, can you tell us a little about the work you've done in that domain? >> sure. but just refer back to the first question about nationalism, i would say that, you know, our political instincts are not in sync. and that's part of the problem. and one of the things that i would like to see are creating some. institutions and the frameworks that would make collaboration more easier, an easier political sell, and sort of reduce some of the disincentives. you know, tom boike and chad brown sort of had this idea for sort of an investment fund or a pandemic agreement and i sort of enqvist --

envision a treaty that would come into force with a code of conduct that nations would agree to, whether it's sharing samples and data in a timely fashion, coordinating on clinical trials, harmonizing protocols or agreeing not to have export controls or price gouging, you could think of a whole range of things that we would all agree to upfront, that would allow for a much more streamlined response, a much more rational response in the moment. but you know, in addition to that, you know, i'd like to see -- you know, there are other things we can do. sort of these viral spillover events are like greenhouse gas, you need the tools and strategies to solve them collectively so there's the

political side you can do, but covax is an important economic piece. it's this tool that allows us to collaborate effectively and efficiently to pool our risk. and you know, a lot of the building blocks of what we need are already there, whether it's cepi, whether it's gavi, whether it's the who and how they've all come together to create something like covax. so recognizing the value and the power of these institutions to create the institutional fra framework that we need and investing them as part of this larger project, i think, is where we need to go. >> well, certainly, treaties are not easy to undertake, but one could imagine in the process of thinking about what might be in a treaty, you could make a lot of important progress forward instead of

laying out the different issues, many of which you could touch on, that can become barriers to effective collaboration and i think that it would be unlikely that in the current state of politics in this country, and probably many others, that we could forge such a treaty. >> right. >> but as an exercise, i could see it would have real value in getting and way, also, from this either/or mentality, that's false dichotomies, because the u.s. can pursue efforts to get vaccines for use in our own country, but also, participate in international collaborative efforts like covax and in fact, it's a sensible strategy that's touched on already because it allows you to distribute your risk and it allows you to diversify your portfolio, so to

speak, because we don't know, you know, which vaccine is going to make it over the finish line, hopefully more than one. but it is really a critical time. >> and i would agree. i think contracts are a step back from a treaty and yet, enforceable, right? and it's sort of the more incremental way to-- a lever for social change of this nature and i think that cepi has been very forward-thinking in this way. >> yeah. i want to turn to-- and come back unless nicolaj has a comment on this point? >> yeah, so just, to just build on kendall's comment for just a minute. part of the reason we're in this conundrum is because in all of our global pandemic preparedness there are a number of things that we didn't necessarily anticipate. and again, as an american, you

know, we-- i appreciate very much the fact that the u.s. government has this end to end financing system. it can pay for the basic science, it can pay for vaccine development. it can pay for the manufacturing, it can pay to buy doses and distribute it to us citizens, but the rest of the world isn't organized that way, right? and as we got into vaccine development we realized there was no pay for this scale of manufacturing that needed to happen. there was no entity that could make an advanced market commitment to purchase doses so that the manufacturers would actually manufacture doses. and so, that's really why covax and the facility came into being, we're sort of making that up as we go, but in the next pandemic, the chemical plant, we can't be pacing the tin cup raising money for these activities. we have to have sort of a global system that lets it happen much more with predictability.

>> i want to let you make any comments you'd like to make. also, you've been watching this from the perspective of what's happening in europe, but anticipating joining an organization based in the u.s., but the european commission, the european union, as you noted, you know, really has stepped up to the plate in terms of leadership for shaping the act accelerator and importantly, the covax vaccine pillar of that effort. and very generous in terms of the pledging and fund raising. on the other hand, we're seeing some of the countries in europe advancing bilateral agreements and the eu creating its own vaccine initiative as well. so lots of these different tensions coming out, so you know, how important do you

think it is to find the right balance, as these efforts go forward? do you think that as -- after the idea of the accelerator was launched, the sort of vaccine nammism, energy began to take hold and maybe pulling away from support for covax? what's the perspective and how important is that adherence of the european commission behind this effort? >> thanks, peggy. before i dive into the european situation, just a comment on the nationalism question that you raised. so, and the vaccine trends that we have seen over the last couple of years. so, there is decreasing interest overall in vaccine before covid-19 hit us. actually supply of vaccines to

many around the world that are affecting maybe africa, southeast asia and others, there's been a declining trend in terms of interest and that's obviously due to profitability as well for many private sector companies. so we were already on a declining interest in terms of vaccine capacity. then covid-19 obviously hit us all and now we need to, you know, pick that up around the world. and my point of this is that the u.s. markets from a pharmaceutical, biotechnology perspective, is the most profitable in the world, right? so it's a very interesting market for all major pharmaceutical companies in the world. so it's very difficult when, obviously, the u.s. administration approaching you to, you know, get access to your products. in this case, a vaccine.

or it could also be their product which is also something that we've seen. so that i just think that the pharmaceutical, the biotech industry also has a role to play in this whole thing and we're seeing this a bit with the accelerator that is coming along, until things that we need that collaboration, that collective mindset also coming more firmly out, so that other-- so governments around the world can see that it actually doesn't pay off to do these bilateral deals, because if they see other countries start to do that, there will be a pressure from the citizens of that country to actually, you know, pursue those deals and na can be hard for any politician to try to contract that. on the european question, i think we -- as we talked about,

there's a solidarity now in terms of let's try to do this togeth together. there is a big difference, i don't know if it's the same in the u.s., but in europe, the money that is being provided for development assistance, which could, for example, finance the covax facility and the market commitment for the low income countries, that is part of some money in the european commission and also in the national budget. so, that money can be allocated, solidarity in terms of, you know, development from european countries. and then there are the national, you know, health ministries, who are actually responsible for purchasing medicine and so on. and that's what is making this more complicated because you have two streams of, you could say funding, but i think the covax facility is signed well for that.

so you have availability for your own citizens, but then you can contribute via your development assistance to this facility. and i could imagine that this model could also work for the united states. so, i think it's quite a great model, as i said, and europe has shown that you can actually protect your citizens, but be part of the international efforts. >> thank you. >> steven, you've been quiet, but you look like maybe you wanted to comment. >> thank you. i've been listening intensely, an interesting discussion. and i have two points, first on parties and treaties. the dominant fact today in between the united states and china, it's worsening. every day there's another set of provisions enacted into that. that clash which is escalating has paralyzed the u.n. security council and it has nominated to

such an extent that we see a-- with the exception of the pledging conferences organized in may and june, we see a void of high level diplomatic activity in this period, which is shocking, and astonishing that you have a planetary crisis of health and economics and stability and you do not have high level diplomacy at the level of state leadership looking at this with any kind of, okay, how are we going to work collaboratively towards this. so, that's just a very cautionary remark about the dominance of this clash and the way it's shaping responses. the united states, you can make the case that it has a legacy of leadership that it can pull back, that it can reembrace, that it's going to be surplus capacity in terms of production agreements. it's in its own interest to

hedge its bets as kendall and nicky pointed out. and gavi is a known partner, and the opinion of cepi is very high. the problem is how do you crack through and get some initial action that reaches outside of the nationalist approach? i remain optimistic that some pathway will be found. i think with the $3 billion in the senate bill put forward to support go. avi is one of those. and the second point i want to make. let's not forget what's going on between middle income. they witnessed this winter and spring, they had witnessed the free for all market for test kits, for ventilators, for remdesvir and the like and we've spoken with folks like

salim abdul kareem, and they know they cannot deal with this broken response because of the marketplace dominated by the high income countries. and africa, much of the surge has come late. there were effective lockdowns in march and they were delayed and they were untenable and now there's ma-- a massive surge. and now look u.n. secretary-general put forth a 10.3 billion dollar appeal, the largest in u.n. history on emergency humanitarian and health response. and they are seeing multiple crisis right around the corner in low and middle income countries. extreme poverty, food scarcity, economic stress, health infrastructure, damage, rebound epidemics, immunization programs. that's the context on which people are making the case know that we have to begin to think

ahead and act on a very urgent basis and gavi and cepi have the institutional capacity to move this forward. we have a problem of trying to move forward in time. thank you. >> well, thank you. very insightful comments, very sobering comments as well. and a powerful reminder of just what challenging times we live in and a powerful reminder about the importance of leadership within a nation and among nations to achieve so many critical goals. you know, coming back, you ended your comments, steve, you know, talking about the capacity of gavi and cepi realizing the goals of covax, it's a much broader collation than that necessary to make

this possible, but it is a new idea, a very fragile organization in very early stages and you know, i know nicky is working night and day on trying to make it work. you know, what do you think are the key challenges right now and the biggest concerns? obviously, getting the money needed to do trials is going to be key, but there are many other issues as well and of course, all overlaid on the uncertainty of the science, of course. >> sure. well, you know, i think first as you've said, i would come back and say there's so much of this that relates to money and the financial situation. so as you started out by noting, cepi estimated that it needed about two billion basically to deliver vaccine candidates that were viable to the world. part of that delivery of the vaccine candidates is the final

r & d and a lot of that is in clinical trials, right. which still need to be funded, and we still need to raise about $700 million or so to get that work done. in addition, as i think we've sort of alluded to, we've talked about manufacturing, but you know, one of the strategies for cepi and for covax is to ensure that there's capacity distributed around the world. in part is the counter some of the nationalism so if any one country wants to lock down the dosage. you've got to manufacture in other places and also because of the considerations about equity and access and ultimately capacity building. so, all of that involves fran france-- transfer of technology to facilities around the world and there are good manufacturing facilities around the world and that's a great thing, but the ability to scale them up, and to manufacture those doses and at the end of the day, as you

know, there's a global race to get the files and syringes, and a global gas shortage. just like we are arguing about the ppe. we've had this in the background, you know, a global glass supply just as one of those many examples. and then you've got to be sure that you can get the regulatory agencies around the world together to be coordinated-- and they've been great so far -- to make sure that the vaccines are safe and pure and all of those things before they're used to populations. so, those are some other things. and then finally, i would say even after vaccines are authorized for use, different countries have really different abilities to monitor vaccine

safety. post licensure, that's another place where global collaboration is going to be really essential. >> yeah. well, and that's going to be very, very important and also, if there are multiple vaccine candidates out there, vaccines that are in use making-- and they require multiple doses, making sure that we actually know who's getting which vaccine and that they get the right vaccine as their second dose and you know, certainly would be nice if we could begin to understand, also, which vaccines work better for which sub populations, so there's a lot of interesting and important work to be done on the r & d side, as well as on the safety monitoring and it all argues, also, for a lot of transparency and exchange of information. you know, both within a country, making sure we're collecting, but also, collaboration with others as

we're learning more about these vaccines and also about the human immune response to this virus and this-- the nature of the virus. so we don't have too much time left. let me turn to the nicolaj who is just coming into his role at path. i think he said he began in early january, just as we were learning about this novel coronavirus and thinking about all of its implications, but given that the experience of path in spearheading critical partnerships and working across sectors and across countries and looking now at covax, what do you think are the sort of critical issues, the time urgent challenges that have to be addressed, the things that we cannot let pass if we want

to see success? >> so, thanks a lot. we have many, many vaccine candidates in our -- and obviously when covid-19 hit the world in january, we put all of this aside and now are working with cepi, gavi and others to actually try to help how to get some of these candidates forward and through clinical programs. at the same time as we talked about the manufacturing capacity for vaccine, it's there, but it's in the very clustered way. a lot in south asia. so how do we make sure that more manufacturings are upscaled and you know, security of production, quality, and all of this, so we're actually

helping some of these potential manufacturers to actually uplift their skills and to be ready to actually be producing billions of doses of potential vaccines. >> when you talk about the production, cepi with the production and supply chain. there's something we haven't discussed so much which is the distribution of the vaccine, i mean, how do we get it out there when it's available and at the right price and so forth? and that's really difficult. we have seen now with other immunization programs that they have really gone down, which is measles, polio and other things that we are vaccinating for. so how do we get that infrastructure up and running again and actually putting that into use for the potential coronavirus vaccination? that's the piece we also need to make sure that we get ready

urgently. >> yes, thank you. so kendall, turning to you now i'd like you to have an opportunity to comment on the set of questions and also as we're moving towards closure, you know, maybe offer a few thoughts, are you optimistic or pessimistic about whether or not we will be an i believe to find a path through this current scramble towards a vaccine that will enable and support the ipped coo of global -- kind of global that we've been talking about and i'll ask the other palm the ending question before we conclude. kendall. >> i think the most hopeful thing i could say in a world where diplomacy is not always a option is that i think the work

that path is doing to produce production, that cepi is working on distributing manufacturing capacity, that's diplomacy by other means. that is one way to be effective in this environment and covax will be a very interesting demonstration. this is going to be a test of nationalism versus collective efforts and you know, i would put my money on covax just from a pure risk probability perspective. so operation warp speed, one of the largest well-financed nation based approaches, i think we have maybe six and research says once you're in human trials, 17%, if you've got six, maybe a 67% chance whereas it has 10 candidates.

the chances of them having a successful candidate are good, probably better, and interesting rationale is some vaccines for my most vulnerable population is better than no vaccines. in a lot of countries they're going to get locked into agreements with no vax seep ap covax is going to look at a viable alternative. rega regardless of how many countries sign up and what their budget is right now, i think over time the logics will play in its favor and i'm hopeful we'll have a chance to build on these students. >> i'm glad, heartened much -- and too bad don't have a couple million to spare. are you optimistic or pessimistic? >> i tell you, for me one of

the most inspirational calls i've been on recently have been calls of countries who had expressions of interest to join covax. you know, in addition to the traditional countries, there were maybe 95 countries who got on a call for two days and these are countries who are often adversaries in many other different areas of politics and competition and all the other sorts of reasons that people can think of to fight one another. there they were all on the phone together thinking through and learning about how they might join forces to procure a vaccine. so that actually made me incredibly optimistic that we could find a way forward through this. they also seemed to recognize, maybe i want to end with this point, that if we want to do this and we want to be successful, especially without getting doses early and enough

doses so we don't devolve into a food fight over doses, we have to get money to put down on raw materials and manufacturing of all of those other things. and that is a really, really urgent need. the amount of money needed is something like the amount of four or five days of global gdp loss that we are facing now. so while it seems like a big number, in the big scheme of things, it's really not. if you spread that across the countries that cannot do it it's not such a terrible problem. it's solvable. >> nikolaj, optimistic or pessimistic? >> the world has a common vision, a common purposes

against covid-19. we have seen unprecedented cooperation, political collaboration and it's almost like a moon landing that we're going to do together so i am an optimist. i think we have proven that we can break down barriers between us and i think with the leadership together we can move this forward. ...

>> my feeling, , i agree with mh of what's been said, that gavi and cepi had been impressive. they have been fast, visionary, they've taken risk, they have emboldened their thinking and the numbers required look like big numbers, but they are not. if we can find come if we can get over this hurdle and secure the baseline that is required, they will be able to do great things and have enormous impact, and we need to keep our eye on the ball and urgency of getting to that point under very difficult circumstances. i think we need to be very realistic now. we're heading into this next phase. it's going to be a very, very difficult next couple of years and we need to brace ourselves for that. we're going to need to be fairly rugged in the way we go about putting displays forward and where that's going to be a

turbulent and very difficult environment in many of these low income and lower middle income countries. but there's no choice and i think all of you have shown just how much ingenuity and intellectual capacity and commitment has been brought to the table and i thank all of our speakers have been with us today probably have been intellectual and institutional leaders in this field. so thank you. >> thank you all. thank the panel is. thank you to you, steve, for your tremendous leadership at csis, and clifton jones and hope csis team. i think this is it. it's a close. thank you all. >> thank you. ♪ ♪ >> at 11 a.m. eastern the senate will gavel in and we'll have live coverage here on c-span2. c-span2. no deal has yet been reached on the next cov9'