booktv.org, used the ux at the top of the page to look for the author or the title of her book. >> c-spanshop.org to c-spans online store with a collection of c-span products and every purchase helps support our nonprofit operations. .. . now here's the vaccine confidence project heidi larson. suspected morning someone who you are familiar with. she is a science journalist and award-winning author. his book is on global during a pandemic. her book, the coming plate newly emerging diseases >> and her new book the coming plague is disasters in a world out of balance will be published in august.

so you can get onto amazon and preorder that. heidi larson is a professor of anthropology at school of tropical medicine and founding director of the vaccine confident project headquartered at the one school of hygiene and tropical medicine and she's an author and wrote about how vaccine rumors start and why they don't go away. to moderate the discussion we have scott rosenstein. he and i have worked together for many, many years. he's also the special adviser of global health to the erasure

group. they will engage in conversation about 30, 35 minutes and we you can use q&a. you can use the raise the hand icon or type in the chat box. please ask a question. don't make a speech and with that i'm going to hand it over to scott. thank you so much for joining us scott. >> super, thanks so much, it's really an honor to host two incredibly accomplished voices in global health to really help us process all of this happened over the last year but also talk about where it's goingll and wht that means for the field of global public health in the coming years. so i know many of the students on the call have probably heard me talk more than enough and our time is limited to i'm going the try to speak as little as possible because i have a lot of ground to cover. i just want to get right into it. there are a lot of students on the call. there's a lot of interest in the field of global public health and international development,

so where i want to start is i want to get a sense from both of our speakers today. where were you when this all started, what were you working on, what were you thinking about, tell us how that changed practically and substantively once the pandemic overtook all of our lives? >> i was where i am right now and i was pulling 24 hours shifts because most of the news out of china was breaking at 2:00, 3:00, 4:00 in the morning and starting every day i become aware that there was a strange outbreak in wuhan and only passed through wuhan and i understood that it was a major

nex us for china and has all the super fast trains go through wuhan. it has one ofo the most importat asdomestic airports and, you kn, 13 million people, it's massive. we don't have a city that large. it's a city that most americans have never heard of and i was monitoring and getting increasingly anxious. by new year's eve, i was reallye freaked out. this is it, this is the big one. at the very least the sars come back, it might be something worse. but when i would tweet about it and send out any e-mails about it to keep people, i was getting really, really smashed out, told shut up, one person sent a series of death threats and one

person posted on twitter, we should skin her alike and torture her and which i said redundant. i mean, the mountains of threats that i received from scientists and random who the heck are they, i don't know, from alleged public health experts were huge and yet by the 30th of december i was aware of leon young's postings and other chinese scientists or m ds and i was dumbfounded that i wasn't seeing anything from w.h.o. as we go in january 2020, my life is completely consumed with this. there is really nothing else i'm doing and it is 24/7 and i am

absolutely convinced that we are looking at a nightmare and i'm just not seeing it reflected at the same level anywhere else. i'm not seeing, you know, people i usually really respect shouting from the raptors and i'm being told to shut up. the turning point comes january 19th when xi jinping himself personally steps into the situation, we don't know that publicly, but chewing out the state council in beijing telling the leadership aye had it. there's something clearly goingh on in wuhan. we are not getting correct reports from our own people, you know, i don't want to hear anymore more cover-ups. and the following day, we go from every day they are saying

there's somewhere 30 to 40 cases in all of china. they even have a day when they report fewer cases total than the previous day so if like somehow deaths didn't happen. we made a mistake and then suddenly on the 20th, boom, we have dozens of cases and we know now that's the point where the big small stops or phases to a lie and w.h.o. is acting like there'sri a crisis. >> great. heidi, how about you, where were you and how has that changed? >> well, i was here in london and i'm in school of tropical medicine and there was conversations about this emerging. it was sidelined. it was very much like laurie was

wsaying, bits and pieces of information and the discussion started to, well, you know, something is going on and -- and without really but i totally agree, there was no -- the level of concern really didn't get going until -- in january and i remember larurie i was at davo at the end of january and he was saying, this is big, this is big. this is big andnd was basically- was in his room most of the time on it and some -- it was -- and then it just -- it was like a flood at some point and then back in london and the last thing that i did that is not where i'm sitting now where i've

been since then was the talk in boston on the first week of march and i was actually a bit surprised it was going to be in person but it was and it was the next week and that same conference center became the hot spot for boston and it was one of the things that you get home and go, you know, but, yeah, i've been here since and then got plunged into it pretty deeply. >> great. i want to transition to what we have seen over the last year. we are in march tenth, for a lot theeople early march is one-year anniversary. we've obviously seen a number of character ins the saga. i think one of the questions that i get a lot is where are we in the story?

are we in the first inning, or in the sixth inning, where do vaccines fit into that? i was wondering, heidi, just to start, where do you think we are, where are we in terms of vaccination and vaccine development and can you talk a little bit of sort of what the last year has been like in terms of that kind of trajectory? >> well, i think the last year we've been following, i mean, my group has been following vaccine concern issues sentiments for the last decade and we just shifted all of our list social media listening and survey work to be focused on covid but it wasn't on the vaccine to be honest from last spring we were trying to get the pulse in howom people were dealing with lockdown and masking and then there was the mask on and mask off, 1 meter, 2-meter, i mean, the confusion in the informatioi

environment was just -- was just nuts and then, yeah. what -- i think the vaccine discussions just started to come into the conversation more in the summer but last year was really about control. this year is about the vaccine. and it's really, and this is just kindergarten. i mean, i've -- i mean, i've been working closely with africa cdc and seeing here are the numbers going up in the uk, the numbers going up every day with who is vaccinated, but you don't see the headlines who is not getting vaccinated. and -- and that's a real issue, but i think globally we have a long way to go. i think we are understating the complexity of the -- of the issue.st there are a lot of bilateral deals going on with india and china and russia and covax,

global entity getting a lot ofin attention. that's just about 20% of what some of the low and middle-income countries need. we have a long haul ahead and who knows how this virus is going to evolve and the variants are no small thing. >> lauri inch, same question to you. you talked about the information ecosystem, how do you see that evolved over the last year, how it gets information and how it gets distributed by different people and some of the challenges that we face and so really making, getting our -- getting our heads around all of the credibly fast moving information and all of the uncertainty on how that gets us to where we are now and sort of transitional moment around vaccination and around sort of thinking about what this next

chapter looks like? >> okay. so you have four questions to me, i think. end of january and into february, i'm on the record at that time saying i felt this was a 31-months battle. so we are out of this 13-month, out of 36 and i would still think that's about right. we -- yes. those of us that are fortunate enough to have been fully vaccinated may be feeling the lights at the end of the tunnel but as heidi just said, the lights are not nearly at the end of the tunnel but the vast majority of people on planet vearth. we still don't really have a plan for getting vaccines to, you know, 90% of the population of this planet. meanwhile, we have variants emerging as heidi alluded to at the end of her comment and it's no surprise that there are

emerging out of places that have a lot of virus because that's the whole point. when you have a lot of virus in circulation, you're creating all the proper circumstances requester evolutionary selection of vaccine or immune system resistant strains and so right now the biggest panic, concern for me is brazil which is completely out of control, has at least two tough variants, one of which clearly resists about half of the already approved vaccines. and if we don't get this under control and understand that this is a global crisis, then we are going to see a constant flow of variant emerging that force us so develop new fancy boosters that can outdo the variant straints for rich countries. in the meanwhile, nobody is dealing with the poor countries. they are not getting their first

dose and that goes to a second part of your question about where do i think we stand right now with the epidemic. my view is the wealthy world, primarily europe, east asia, japan, north america is going to experience robust economic recovery and we will see some particular profit sectors start skyrocketing really soon. the tech sector is coming back and we will see the construction sectors, infrastructure development sectors, financial sectors, they're all going to start soaring and they'll be this sense offi euphoria as a result. goldman sachss is predicting unemployment in the united states by the end of this year, down to 4%. you know, that's like

unbelievable and with all the blockades on immigration it actually means that we are going to have whole sectors of the economy desperate for workers. you know, begging for employees after a period when we hit unemployment as high as 20% here in the city of new york. we are going to go flip all the way. i think we will see, therefore, a lot of, oh, let's just forget the epidemic, it's in the past now, but it won't be in the past and i hope that you'll ask heidi because jest really the expert on this but we will have a stubborn roughly 20% of americans that refuse to get vaccinated and some will refuse of legitimate concerns of historic achial abuse of key population groups by the medical sector in america such as the tuskegee experimental, look, we

faced abuse, why should we trust you? a lot would be off-wall conspiracy. excuse my french. it's hard to remember that you're in a formal setting, excuse me. we are seeing qanon. that's continuing to play out. to your information question, my friend john cohen, writer for science magazine, many months ago when we were in a group called said you know what, i'm sick of the fire hoes and that's exactly what it is. we are working at home so there's no separation between home and office in our lives.

i roll out of bed and i hook the fire hoes up to my mouth and then comes information and the goal until i finally collapse and go to sleep and repeat the next day. you can't keep up with it and what is unique in this epidemic that we have never ever seen before with an outbreak is on the plus side an enormous amount of sharing of information that scientists aren't holding back info to await prestigious publication. there's an understanding that in a crisis you must release information and onn the downside that means that a lot of what is pouring on the fire hose has never been peer reviewed and help us assess is this accurate, is this crap, are there fundamental flaws in the statistics in the paper or the

methodology or what have you, all of it contributes to the things that heidi will talk about in terms of conspiracy thinking. if you put out a paper that says we are absolutely sure that this particularly group is getting benefit from hydroxychloriine. here comes thoroughly debunked paper and we now have a legacy that's built up after a year of a mountain thoroughly debunked science that rests in the

ethernet in cyberspace and never completely purge them out. if you're a conspiracy-inclined individual or if you're just a malevolent jerk and you're in st. petersburg russia, there's a mountain of bs out there for you to pluck from all over cyberspace to weave together this elegant conspiracy about how dangerous the vaccines are or how masks don't work or how social distancing is actually population control or go on and on and on. >> great, heidi, let's get into the vaccine hesitancy question. this is a question that i get a lot. obviously lots of polls are out there. something that you have been working on astst lot.

one of the features of the polls sends to be distinction, will you get vaccinated immediately versus will you get vaccinated eventually and i wonder how movable you think that is. i see the polls move a lot and also to lauire's question, what is your feeling on that, how many people do we think in the u.s. or in general are movable and what does that mean for the vaccination going forward? >> we have kind of polling on and off in different ways overfe the past year and it's really -- it's really up and down. and we are doing it in multiple countries and i don't see any two countries that are the same and when you look more sub nationally it's even more varied and it changes. daniel had written an article around the h1n1 pandemic as it

was and she talked about .emotional epidemiology and i think it's really a perfect term rmbecause in last june there was more enthusiasm for the vaccine than it is now. it kind of went further down in september or october and seems to be a waning pandemic and people -- all they heard was information, there was a lot of information about vaccines. we got a lot of misinformation. there was a bit of increase in confidence around november, december. i think that was a bit with the pfizer announcement. 95%. that's w a really high efficacy and i think that was a confidence booster for people who were uncertain. i mean, the flu vaccine can be

50, 60% sometimes. and we were going into a second very serious wave. so i do think that sometimes we do underestimate kind of people's -- putting a bit of reason in here because their ups and downs are constantly heweighing their risk and has never been weighed like this before. this new virus that keeps changing and we keep getting new information and looking at that am i really at risk, is it worth taking the risk for what became an emergency authorization? w i think a lot more people now are ready to take that risk than they were. but as laurie said a solid group. i think it depends where you live and who you are and -- and it's a whole mix of reasons

globally. thankfully we did 15 country perception studies and listening in africa. i tell you, almost every single one of the top reasons for refusing a vaccine could come out of ohio. they could have come out of berlin, they were really, you know, don't trust it. stmade too fast. the speed thing is really -- i think as a medical and scientific community. we really failed to talk about why it's all fast. instead, we are going to be the first to get there as a vaccine or scientific community or, you know, the warp speed narrative, but there wasn't discussion about why it's so fast and it's fast for good reasons. we have some great technologies. there was a budget there for it. there was a a fund that was only there because of ebola and a lot of great -- we unpacked a linear

process to work in parallel. there was great innovation. people haven't talked about that enough to get less anxiety and a little more understanding. >> if i could just add to that. about this time last year, we had roughly 200 prototypes for vaccines in some stage of development around the world and so far only two, so far have dropped out and said it doesn't work. everything else is still in the pipeline or an emergency approval and the safety profile is a phenomenal, if you looked at any other vaccine that we've rolled out in recent years, including the ones that took ten years to roll out and went through mountain of safety trials. we have neveret seen anything le the success of this.

>> yeah. >> other than a very small handful of people suffering, none of which was life-threatening, all was was reversed and all people with responses to other insults in their environment. other than that, we -- we are seeing people have is that some people on second dose of vaccine are down with what feels like the flu for a couple of days. that's the worst. now, i can't really remember a vaccine. rolled out for emergency approval that proved that safe and on the efficacy side, even the j&j vaccine which is single dose and which people have tended to downplay and say it's not as good as the moderna or the pfizer or what have you, well, you know, it's also the only one that was tested in south africa and brazil amid

circulating variant strains of virus that could reduce neutralizing antibodies and still perform at 65 to 70% efficacy. that's amazing. we have childhood vaccines that we use that aren't that efficacious right now. >> just to build on that and final yes before i move on, moving forward, is there a case to be made of vaccine optimism that many people who didn't appreciate the value of vaccines before this pandemic now will appreciate it and that will have effect for broader levels of acceptance of enthusiasm of support for vaccines that in many countries aren't on the top of people's mind? [laughter] >> let me just say one quick thing on that and i think heidi should answer it but, you know, you all remember back a year ago when we had a toilet paper

fanatic response. i don't understand why. all over the world people freaked out about covid and the response was to go by toilet paper and paper towels until stores all over were empty. they had no toilet paper or paper towels. okay, i think what we are seeing to see in americato is a toilet paper-like response to vaccine. all of a sudden are hearing, seeing a difference in their neighbor, they're more relaxed. they seem to feel better about life all of a sudden because they are protected against the deadly virus and we are seeing younger adults clambering, can't i get on a list, why do i have to be 65 and i actually think it could reverse completely like even that 20% stubborn group could begin to erode just because it's like a fad effect. it's, gee, i don't feel hip

unless i'm vaccinated. i don't know, heidi, you chime in. i think there really is a power to what's going on. it's -- they are talking about it as the kind of social proof so that when people start seeing really how it can change their life, i don't think we've ever had such a huge opportunity, society wide to see the power of a vaccine. you could have cost effectiveness studies of the vaccine up the wazoo and that's going to have zero impact on public acceptance but when you see, it's going to let you go back to school and let you go back to work and let you hug your grandmother or whoever else you want to w hug or whatever, it's -- it's a whole different ball game and i think there is a real potential for changing the landscape around it if we get it right. >> all right.

how about we take some questions? are there questions -- >> yeah. so if you want to -- great. use the raise your hand icon or type in a question in the chat box and we can read that off. >> can you talk louder? i can't hear you. >> sorry, you can use the raise-hand icon and -- or you can type in your question into the chat box. .. .. >> we are allll witnessing of

global basis and what you gals can enter this, if it were up to you how would we set up a global organization that would clearly have the truth, the right science and right distribution of ideas, that's probably also a very political question, i would like to hear what you're saying. >> all-star and handed off to you, first of all this is been anticipated and attempted over and over again and we actually have a plethora of multinational organizations in the global health space the overlap into different parts of vaccine in pandemic and epidemic responses in general global health, the problem some perform very well such as hiv drug distribution in developing countries a really outstanding success of global

health. the problem in terms of truth, the organizations that have the greatest acceptance are those in our essentially united nations institutionss but by virtue of being the united nation institution they have a voting lobby that backs them up in the body is the national government. so in the end, if you are the president of the united states and all the people that are going to implement your policies are the governors of 50 states and half of them will pose you 100% politically and in your opposition party and determined to sabotage you, there is a limit to what you caner accomplh by issuing a fiat are putting out truth at the top, if you're

going to be undercut every step of the way by the governors, and a very real way that is w.h.o.'s problem, it's got 194 member states and a percentage of those states are more than happy to accept services and information from w.h.o. but don'tce you dare demand that they provide truth back to the institution. fortunately this all started in china which from the get-go was not providing accurate information to w.h.o. >> heidi. >> i totally agree with lori that is part of the complication right now, there are corners of the world that don't trust global entities who they see as counting and controlling basically, i think also in this

arrow that were in we see an absolutely change public than a decade or two decades ago. they don't want one universal truth, they wouldn't trust it, they want something that is locally evidenced that they feel is more tangible and they feel like the truth has become far too remote from them and they don't have a say or ownership, i do think we need credible sources but it also needs to be endorsed locally because if it's not it's not worth the wait and whatever. >> i'm doing a shout out to heidi one big learning experience for me, this is like 15 or 20 years ago when heidi worked for unicef as an anthropologist, she taught me about why some parents would refuse to vaccinate their children in places like india or

fiji or the middle of indonesia and it was so much vaccination was campaigns, correct me if i misunderstood, and learn from you that so many of the vaccines were campaigns and the parents would say only time you come to the village is when you win an stick needles in our children's arms but what about when they have a feverut or malaria, where are you when they're sick with something else, all you care about is these needles why should we trust within the needles. >> you got it, what i was saying about 400 before about vaccinations, if we get it right, were in a point in society now where everybody is fragile at some level and if we only get out there, we've gottee

to the highest risk groups but now as we start to get more vaccines in the pipeline and start to reach to broader societies, we gotta drop to get vaccinated part and if you're in marketing, you're not just marketing in the airline industry, the flight, you advertise the beach, you advertise the destination and i think we need to think about the destination as also as a society getting faxed. when were engaging people to get vaccinated, remember to not to say here's your vaccine, thank you very much for how are you doing, how are things going and particularly for the hardest most resistant groups, they want to know thatt your motive is not just to get the vaccine in the

arm but you actually really care about their well-being and a simple way that we can do that better and i think we have to make really sure that were going to be doing. >> we have to counter them thinking it's all about bill gates putting a microchip in them. >> nevermind the fact that that 3030 going on. >> authority there, verity know everything you're doing, who needs to put a microchip in you. >> more broadly from the global architecture perspective, i think historically people in the pandemic in this world are familiar with panic and don't think cycle this is a really big global for test or fee, do you think that cycle around investment into long-term public healthnt and pajama preparedness into all the issues around trust in truth and understanding

tabetween the systems and the large entities and large public health entities in the communities on the ground, do l you think will be breaking the cycle or are we still at risk a few years from now still looking at underwhelming funding environment and a lot of people distracted by whatever the next crisis is, where are we in that story. >> the technology is pushing us to a dramatic change and if all the promises are actually realized of things that i know are in development already propelled by covid from positions they were probably in before but would've lumbered through the pipeline for many years otherwise, we should

sometime 2022 or 2023 have the following technological capacity. number one multiplatform surveillance tools that will allow you to take o a sample frm frany container, put it on a microchip and have a breakdown of what isn't it rapidly in real time. that will allow us to say, people are sick in the village and it's a new antivirus. it's a new that virus, what have you. and that will also allow more rapid integration between the animal host, the one health approach the audience may not all know about one health but the concept humans don't exist in isolation on this planet, we are part of an animal kingdom in many of the viruses that we

suffer from including the current pandemic come from animals. we can do a lot better for focusing on the animal host before we have an epidemic in humans. the toolkit to do that will not only be realized and it'll be a crisper based technology but it will be affordable, it will be rapid and available, i do think it becomes onus is on the wealthy countries to subsidize distribution around the world so it's equitably distributed. in the capacity to use the technology and the knowledge base is equitably distribute it. this is clearly happening mrna vaccines, pfizer and the moderna have revolutionized the whole concept of how you make aze vaccine. it is already being openly discussed and there's no reason whatsoever that we can't have. a window nearly 100 days between

identification of aay new outbrk in the actual putting into people's arms and yourct vaccin. because we now have the technological genome sequence it, make the rna piece that are appropriate as antigens, develop the antigen, package it, the vaccine is done, to adopt. if the platform is uniquely used repeatedly the same way as the platform is approved by the fda or its equivalent agencies overseas. the platform then becomes a streamlining of the whole regulatory process so now some scientist talking about a seven day window, one week a new microbe to a new vaccine. so that could shift everything

sometime in 2025, 2026 to a modality that could actually mean, i believe i'm saying this somebody who's spent my whole life screaming about emerging diseases, plagues and outbreaks but it could meet us to a place where the only o stumbling block to blocking pandemic as we experience now will be about money resources and social organizations and there will no longer be any technological peace that is in the way. >> heidi, do you think the commitment from the international community will stay strong over thet coming years or a repeat of 2003, 2009, that kind of thing. >> this is big, we haven't seen anything like this since 1918 in

terms of pandemic and vaccines were not part of the equation, nevermind multiple vaccines. this is going to change things, maybe in different ways than we expect but i think this has shaken up the planet in different ways and one reason it'll provoke change, is not just about health and if there is one big failing of the un response is it's too health centric they should sit in the secretary-general's office, this is knocked out every single sector of society, this should involve labor, transport, education, travel, economics and business, this is everyone and i

think not to underestimate the importance of the health sector which is crucial but this is way bigger and for that reason i think things will change, how theyoi change were yet to see tt story unfold. >> other questions i see a few in the chat. >> joyce asks variance in new york city and then anthony is asking about thoughts on increasing information in the press about high body mass index with serious: hospitalizations and deaths. >> it is very hard to hear you, i didn't hear your second question at all but i think i vaguely heard you were asking

about variance in new york inn the first partier, if there's any way you can i boost your volume or speak closer to them i can be very helpful. all talk about the variance in new york because that's what i heard. so far we haven't seene the new york variance or the california variance spread widely out of narrow locations, that's a good thing. the new york variance is something to worry about because it showing two key features of the virus that we probably underplayed, the first how did it arrive it was in an hiv patient. so we have large numbers of people immunosuppressed out there for one reason or another, cancer treatment, hiv and they can under certain circumstances. virus in their body for a very

long time, this gives the virus a chance to keep trying, your putting selection pressure on a walking petri dish, that is a big lesson, we have to pay attention and think carefully about what were doing that is promoting evolution of sars cob to and as far as a california variance it plays a big role in los angeles but not much beyond their so far, i'm not sure why you has a spread further, it may have to do a social mobility issues on lockdowns. if so then that is good news and it tells us one more reason that the social measures are effective in important and must continue. the last thing i would say they will be more variance and more evolution this virus has not finished by any means pulling tricks out of its bag and were just at the beginning of our

coexistence with sars cob to. >> the other question was a growing evidence around the linkage between obesity and severe covid outcomes, what do you think of that, what does it mean more broadly in obesity epidemic, pandemic that were dealing with. >> i'll start with that, the evidence is very solid there is three things that are really solidly linked to risk of a dire itoutcome if you get infected wh covid, hypertension without a doubt, solidly linked, obesity solidly linked, diabetes and high blood sugar, those three overlap obviously people who are obese have hypertension and diabetes and if you look for

diabetes you find it more in obese individuals etse cetera. what we haven't seen good studies that separate them. so we can really see what the lead factors are. i have said repeatedly for a year, a great disappointment to me and a failure of public health and something i have condemned repeatedly that we are notre taking advantage of widespread testing for covid infection as an opportunity to provide a direct intervention in the form to the cheapest thing imaginable, cuffing individual this either blood pressure and offering, before we give you your covid test we would like you to go to tent to where you get an intervention regarding hypertension and free cardiology

work and free access to anti-hypertension drugs and counseling about nutrition and similarly we should have been pinprick keen people as they go in for covid test to see if they have diabetes or pre-hyperglycemic so they canere diverted to interventions and in that way we could erratically address the two big epidemics that have been in the background all along, high blood pressure and diabetes. >> do you think diet and lifestyle are a big indicator around different countries and different outcomes that were seen? >> for sure but also age, worst case scenario is to be 100 pounds overweight, 75 years old with a history of cardiac problems, that individual infected is very likely to end up in an icu.

>> great, any other questions, comments. >> there was one question that i got an a direct message and i'm not sure who sent it but it has to do with kovacs, i'm curious about this as well how does kovacs work in second the question the country of georgia was commenting their membership means they can't buy vaccines independently but there also not low-income to get a vaccines eay so there stuck in a gray middle, can lori and heidi can you talk about global access the managed or prioritized. >> heidi, you take it. >> let's see, it couldn't be

true that you can get your vaccines somewhere else because right now they're only giving up to 20% and that is not feasible, africa right now is developing their own approach to meet the 20 - 60, 65% gap because they know there's not enough to go around in there trying to extend that limit, i don't know, i'm not exactly sure what that references to but there is different wide arrangements in kovacs but the principal and sure is a lotot of countries hae put funds into a facility to bring down and procure at scale which brings cost down and apply for the vaccine as they become

available. it's been off to a slow start to say the least, people put funds in there for a mix of vaccines because it was a gamble. a lot of countries it's like gambling you put your money on cards and hope that one wins and that's why some countries like canada and the u.s. and is different with the arrangement, you don't know which ones going to get to the finish line, now that is starting to come up, lori if you want away in oso please stick version of what the principle is but it's playing out slowly. >> a step back in 2009 when we had the h1n1 flu pandemic and in the beginning it was thought to be a dangerous influenza and it turned out to be a pretty

routine flu that was far more contagious than usual and did indeed spread to every i single country in six months, what we found the vast majority of the planet either neither got vaccines or got it after their flu had come through and passed on. this led to tremendous resentment against the countries that were perceived as hoarding flu vaccine early on. so the idea can we come up with a mechanism that allows us to widely dispersed in vaccine and equitable fashion around the world in kovacs really came out the handful of individuals at the world economic forum, including seth berkley who runs the global vaccine alliance, doctor who runs w.h.o., the

folks from the world bank, the global fund to find tuberculosis, aids and malaria, can we come up with a mechanism that can ensure some kind of equity, that was the intent behind kovacs, 194 nations have signed on to the mechanism either committing to abide and provide funding and vaccines or committing to receiving vaccines, the problem of course as soon as they heard johnson & johnson has a vaccine, novavax has a vaccine, moderna, whoever everybody started placing orders in the orders at the front of the line but the most money up front, canada put in enough orders to vaccinate every single canadian four times over, the united states put in enough to

vaccinateri every american two times over. the uk is up around three times over in theory and someone in this means that chad has none, molly had 0 in vietnam struggles so where we are now is first of all as long as donald trump was president of the united states the u.s. was not part of it absolutely refused to participate in any way shape or form, one of the first things biden did in his first week was to commit $4 billion of u.s. money to.ov kovacs effort and i assume that money will process in the next threeil or four mons that will certainly help but kovacs, the last i looked it was 38 million short of its necessary funding that funding

is essential to outbidding the rich countries to get actual vaccines in the facility for distribution to poor, middle income countries. >> i take a quick stab at georgia questions, one of the challenges for countries that are classified in uppered middle income, they don't qualify for discounted vaccine through kovacs and they're not at the front ofhe the line or procuredt separately, other sort of getting her in both directions, that is one of the challenges that they are facing with these country stuck in the middle and more generally for people that have been talking about this for a long time i feel like kovacs is an incredible success in a disappointment at the same time and doing much better than a lot of people predicted but has a long way to go and that's where we are now, that is the open question moving forward how t do these countries make up this gap, make up the shortfall in

access to vaccines and roll it out in a timely fashion. >> just to add to that, were seen a lot of things playing out as heidi said that don't fit prior pattern who would've thought the country with the worst epidemic will be the wealthiest country in t the word but it's also the third richest country on the planet has almost no vaccine and can't get any and that is japan. this is not a straight arrow phenomenon that fits into meat narratives either left-wing or right-wing it is a complicated picture. >> the only prediction in the beginning of this i would guarantee we would continue to be surprised throughout the course of the pandemic and that still the case, were of cleo minutes over, are there any questions or anything you would like to add. >> i want to thank you scott for moderating what was an

interesting discussion, i think lori you got it right when you said were overwhelmed with information and i certainly read a lot about covid-19 and i was very surprised and learn to turn this amount. a big thank you lori and heidi for joining us. >> here's a look at books being published this week bloomberg senior editor profiles amazon founder and ceo jeff bezos and amazon unbound. in university of chicago professor looks at sexual harassment and assault in the field of sports, entertainment and judiciary in citadel and independence, his story recounts a tactical decision that secure the army victory in the revolutionary war, also being published as weak best-selling author daniel james brown explores the struggles of japanese american families on u.s. soil and japanese american soldiers in europe and world war ii and facing them on, brent

jones looks at the lives of the men of the uss astoria during the final year of world war ii, find these titles is coming weeks wherever books are sold and watch for the authors in the near future on book tv on c-span2. >> listen to c-span podcasts, book note post meet jason founder of david's tent d.c. where christians come together to worship through music and prayer. book notes plus, new episodes are available every tuesday morning subscriber you get your podcast and more about the c-span podcasts@c-span.org/podcast. >> here's a look at the nonfiction books according to quail ridge books in raleigh, north carolina topping the list

amanda gorman's the hill we climbed a printed edition of the poem and they are not a ration of president joe biden after that the mafia an account of the development of provision bombing during world war ii the collection of stories and essays by author the best of me that is followed by wilmington davis aquino's history of 1898 wilmington north carolina race riots which resulted in the death of 60 black men and the displacement of hundreds of black families and wrapping up our look at the best-selling books according to quail ridge books is michelle's memoir, some of these authors has appeared on book tv and you can watch your programs of booktv.org. >> book tv on c-span2 every weekend with the latest nonfiction books and authors

funding from book tv comes from these television companies and more including wow. >> the world has changed the fast reliable internet connection is something no one can live without, wow is there for our customers with speed, reliability, value and choice now more than ever it all starts with great internet. >> wow along with these television companies that support book tv on c-span2 as a public service. >> next on book tv "after words" program cindy mccain desk discusses family, country in her life with her late husband john mccain of arizona, she's interviewed by joseph lieberman armor u.s. senator on 2000 democratic vice presidential nominee. >> welcome everybody it's a great pleasure for me to have asked to have this