eastern on c-span, online at c-span.org, or listen on the free c-span radio app. up next, discussion on the pandemic and global vaccination efforts from the center for strategic and international studies. this is just over an hour. >> good afternoon, and welcome to the center for strategic and international studies. i am the chief communications officer, and it is great to be with you today. first i want to thank our great sponsor for making this all possible. this has been several years that the foundation has sponsored us and they stuck with us through the pandemic and this has been incredible. i also want to thank the bob schieffer college of communication and i want a special message out to bob

schieffer, who is the inspiration for this series, my mentor, and somebody who we have learned so much from over the years. i/o so much my career to bob, so thank you to bob. before we get into it, and we have got a lot to talk about today, we have a short video that our lab produced -- our ideas lab produced this video. if we could roll the video. ♪ >> >> for weeks now, the world has watched in horror as covid-19 swept across india like a tsunami, shattering previous records. understand the rapidly evolving situation. as the covid-19 pandemic comes into its second year dominating headlines, in the event that both an ongoing tragedy and a

warning of what might be to come for other nations, the biden administration, the u.n., and the world health organization are developing strategies to tackle the pandemic. if we have learned anything in the past year that is finding viable solutions to a problem of this scale requires a multifaceted approach. in this episode, our panel of experts will unpack, answer questions about the administration strategy for dealing with covid-19 globally. the future of the vaccine count, and how we can prepare and protect other vulnerable countries so that we never see numbers like this again. let's dive in. ♪ [end of video clip] >> before we get our panel today, we have with us a very special guest to will stay with us through the panel. jeremy is the executive director

of usaid's covid task force. he is one of the united states most talented emergency response professionals that is out there, and he previously served in the obama administration from 2013 to 2017. he is director of office u.s. staff of assistance where he led u.s. government response to international disasters. he led humanitarian responses to things like the ebola outbreak in west africa. jeremy, thank you for being with us today. we really want to hear what you have to say. jeremy: that's a very generous introduction. i want to talk today about how u.s. aid are seeing the outlook. the intro highlighted the challenges we are seeing in india and south asia. i think it underscores the challenges that we are going through.

it's the reality of our large-scale vaccinations that are still somewhat distant for the world at large. so it has been almost a year and a half the world has been experience a globe will health crisis unlike anything we have seen in our lifetime. in the u.s. government is absolutely committed to doing our part in playing a leadership role that the world is accustomed to seeing for the united states to help lead the world out of this pandemic. and to do that in a way that we can do in a better way to detect biological responses. the work that i am leading will be central to this effort, and i just want to talk through some of our plans for tackling this next page -- phase of the pandemic and the challenges it holds. i last spoke to them for months ago, in that time the number of fully vaccinated americans has grown from 10 million to 124 million and rising thanks to the

ministrations robust focus on accelerating vaccine availability. so we are making significant progress, but we also recognize that no matter how many people we vaccinate at home, the united states will not be fully safe as long as the virus rages on and continues to replicate and generate new and more dangerous variants the current surge underscores the devastating consequences and risks for the continued global transmission and the urgency to end the pandemic. u.s. aids work will be central and build on what the agency has in leading this complex global health response, including some of the help i work on in 2014 and 2015 on the west african ebola outbreak. >> we are currently experiencing technical difficulties, programming will resume momentarily.

>> don't worry, jeremy, this is the beauty of live streaming. jeremy: my apologies for that. it would not be the pandemic era if we were not having some technical difficulties. i'm not quite sure where my connection drops, so i will just pick up on the transition that we are broadening with the administration and some of our focus. what i last spoke to them four months ago, the number of fully vaccinated americans was 10 million. today it's over 124 million and growing due to the biden administration's robust focus on exceeding vaccine availability. we still have many millions left to vaccinate in the country, we are making substantial progress and we recognize as well that the united states will not be fully safe as long as the virus rages on in other countries and continues to replicate and

generate dangerous new variance. in the one in southeast asia shows the risk and consequences of uncontrollable variant. the work on covid-19 will be central and it will be building on decades of experience the agency has in the global health responses, including the response that i helped to lead in 2014 and 2015 in my previous tenure on the u.s. africa ebola outbreak. the complexity of that challenge really pales in comparison to what we are seeing in the present moment, which is an overlapping of health, humanitarian and development crises, each of which are global in scope and his dog in scale. that's why the administration is moving rapidly to expand our global response efforts using the resources and the american rescue plan. so it has been working closely with the cdc, the department of

state, department of defense, department of treasury, and other partner agencies to begin rolling out the more than $11 billion provided under the american rescue plan to the administration for the international response. and as my colleague gail smith and i outlined in our senate hearing a few weeks ago, we are doing this through a comprehensive plan to both tackle the virus itself, it also to address the human and systemic challenges and impact it is causing beyond the health sector. all while working to build stronger global readiness for the future. we are pursuing five major objectives. the first is to focus on saving lives from the virus itself. the first objective is to accelerate equitable global access to vaccines. but we also recognize that we can't wait on the vaccines to arrive, we need to do work in the immediate term to save lives, that's why the second

objective focuses on saving lives and the more immediate term and preventing transmission through a support to clinical interventions and strengthening public health measures that will both mitigate the number of new cases generated and save more of the lives that can be saved from the cases that emerge. of course this virus is not only causing human suffering through the disease itself, it's also threatening lives in other ways, and that's why the third objective of the plan focuses on the acute human impacts that are emerging in other areas. we are seeing significant food insecurity and risk of famine and humanitarian settings. we are seeing severe disruptions to education and household livelihood. the first net increases in global extreme policy cynthia joe financial crisis of the late 1990's. so the human level impact jan the virus itself are in urgent

priority for the administration, particularly on the humanitarian front. in the fourth, and related, is the systemic level. so the virus is causing systemic rift that we have to manage in order to preserve global freedom and prosperity, and we are seeing threats of further deterioration of human rights in some countries that has the governance risk of enhanced conflict, and so concerned that those ripple effects in the pandemic could cause future instability, so we are going to work on tackling that. finally, the last objective is to build back a better global health security architecture. and i will talk a bit about that at the end of my remarks. but, with the world in the grips of this new wave of covert transition, driven by deteriorating conditions in

south asia and across latin america, i want to focus today, primarily on the first two objectives and how we will try to bring to get control of the virus itself through our vaccination efforts and through our life-saving clinical and public health interventions. on the vaccine front, we know that the vaccines is the best tool available to bring the pandemic under control. see the urgency of doing so. as was said a week ago, now that the u.s. has made tremendous strides on vaccinations at home, we are in a stronger position to vaccinate the world at large, that's why the president said the u.s. will become the arsenal of vaccines, just as we were the arsenal in earlier generations. we see priorities for delivering on that. we want to approach this in a way that leads with our values and leads with science. so in accelerating global access to vaccines, we are going to demonstrate the innovation and

ingenuity of people and taking a science driven approach to tackling vaccine availability and expanding vaccine availability. so when it comes to doing that, we are not, as the president said, going to use our vaccine to secure favors from other countries. we will use them to accelerate the end to the pandemic and to be driven by the best public health strategies for doing so. we also recognize that when it comes to vaccine availability, scarcity is the enemy of equity. and so the only real path to vaccine equity in finding ways to ramp up global vaccine production is not going to be easy, the world needs to produce up to an additional 14 billion doses of vaccine in order to cover their global population and we have to do that on a global vaccine infrastructure that is built to produce only about 4 billion doses per year. so we are taking steps to expand

global supply, such as our commitment through the partnership to invest, to make development finance corporation investment in vaccine production in india. we are actively pursuing other deals to expand supplies and other parts of the world. and we will have more to say about that in the near future. we recognize as well that expanding supply is on securing and optimizing the use of vaccine production outlooks. there is more global production capacity available on the world that we are able to make use of because of a lack of manufacturing. and so our inter-agency partners are working with international partners to explore options to both expand the production and availability of those input but to make better more optimal use of them around a strategy for vaccinating as many as possible.

the global financing landscape is also an important focus of ours. it striking when you look at how the world collectively as financing vaccines and it looked a little how the u.s. was preparing pp at national level year ago. but just as devolving ppe procurement led to inefficient competition and a lot of uncertainty being signaled to the ppe market, so too does the fragmented nature of vaccine procurement signal uncertainty to manufacture to industry and result in inefficient market outcome. we think regional partnerships like the au vaccine platform are really, really critical to finding ways to aggregate and consolidate demands, to send clear and certain signals to market so vaccine producers can have certainty of financing and certainty of demand to scale up production on that basis. in the u.s. is doing a very

important part of that with our historic $2 billion announcement for the covax initiative in another 2 billion over the coming year. there are other pieces of this equation as well. and what we see right now is financing through multi-development banks that have put forward tend to billions in vaccine financing that is having trouble translating it into deals. so we are working with covax to find some ways to aggregate that mdb in a more coherent way so that it's not every country pursuing its own deals but rather partnering and consolidating around the larger scale procurement mechanism. ideally through regional level efforts. and finally, this will be an

important part of the equation. we see the announcement to share 80 million u.s. doses as a really important step. we have a significant share going through covax. that will be an important means of bridging critical supply gaps that covax is facing now caused by the disruption of indian vaccine exports. but regardless of how much vaccine gets produced and how many vaccines the u.s. and other countries are able to send, ultimately, the impacts depends on getting shots into arms. that's why we are investing resources in country readiness and deployment. so u.s. aides have already provided $75 million of new funding to support vaccine readiness and more than 40 countries and with the new arp resources we will be expanding that dramatically to cover every country where we work.

and so this process over the next year of expanding country readiness in sync with expanding supply is how we will hopefully bring an end to the acute phase of the pandemic. but of course, we've got a long way to go and a lot of work before that begins to really bring down cases. so we can't let that light at the end of the tunnel that is provided by vaccines to distract us from the immediate task at hand. so approximately 80% of total global cases have occurred in the last six months and we are seeing a dire surge right now in south asia that may provide a sneak preview of what the coming year will look like for much of the developing world. the latin american region is facing dire conditions and represents 20% of the death toll with mortalities continuing to climb in the region. we are seeing troubling signs of new waves of cases emerging in parts of africa.

numerous countries there have reported new upticks in cases in the past few weeks. usaid is taking a range of measures to support countries to fight the virus in the immediate public health measures while we simultaneously work to scale up vaccine availability. it's going to be really critical in the months ahead that all countries double down on ways to mitigate transmission, this means protecting health workers, reinforcing risk medication investment, promoting basque wearing and ventilation measures. supporting diagnostic and contact tracing, and we are working to ensure that the countries have the tools, supplies and capabilities to save lives and avoid high death tolls. we are also focused on ensuring communities have quick, accurate and actionable information about covid-19 and how it spreads. our partners have reached more than 2 million people -- 200

million people with critical health information in more than 85 countries. these critical interventions of slow transmission will be really critical to preventing as many hotspots from emerging as possible. at the same time, we know that hotspots will still emerge. especially as the proliferating variance of the virus develop more dangerous characteristics. we will be providing enhanced support health systems to ensure they have the tools they need to manage those surges in transmission when they occur. that means things like ensuring adequate availability of ppe, critical medicine for equipment, diagnostics and oxygen. over the past 15 months we have sent millions of units of ppe around the world, and just in the past few weeks have deployed numerous flights throughout asia with shipments of ppe and other critical materials. we have sent seven to india,

another three to nepal and are preparing additional flights that will leave to the wider region. another critical priority will be helping countries manage the burden on their health care system and save more of the severe cases. in africa, mortality among critical covid patients was found to be 48% in a recent article compared to the global average of 31%. it's clear that more can be done to save savable lives. we will expand our support for clinical services, for training and for supply of critical items. oxygen will be a priority for u.s. aid in the months ahead. any severe cases of covid-19 can be saved with timely oxygen therapy, but facilities in the developing world have a very uneven capacity to provide this kind of treatment, so we will be working to scale that up. finally, i want to say a few words on goods, emergency. when i travel to west africa at

the height of the ebola outbreak, our first recommendation was not to build more treatment units or send more ppe, it was to install a structure in the country. in many countries covid-19 takes advantage where national responses are frack showed -- fractured, siloed or fully coordinated between ministries in the national levels of government. just as we have done here with our own white house task force for the united states, it will be critical for all countries to ensure they have a unified management team, with clear authority and unified accountability. in a critically important element of that must be enhanced diagnostic testing and surveillance. if we cannot see what's happening in the country can see what's happening in their own country, it's hard to manage a crisis when you are blind. we are seeing widespread gaps in testing continuing across many of the countries. nepal is reporting positivity rates of over 50% in some areas.

we are seeing positivity in sub-saharan african countries allocated -- elevated to alarming countries as detection remains low, which suggests lower case numbers and artifacts of load testing rather than low transmission. there is an and norma's amount of work to do to bring this virus under control over the next several years. in the united states is committed to not only ending the pandemic, the present pandemic, but also building back a better world. one that is prepared to defend the response. with the world health assembly meeting, it's important to reinforce that even as we focus on continuing the fight with the pandemic, we must keep attention focused on building back a stronger global architecture. the past year has reinforce the importance of the global health agenda and the importance of the reform who made following the outbreak of ebola. but has revealed critical dabs

and global readiness. much of our work over the months ahead will focus on building global consensus around how to address those gaps. in several areas of emphasis for the u.s. are going to include stronger pandemic alert and early warning systems, enhancing transparency of national reporting with emerging health risks in shielding risk assessment and response guidance from political pressure. we are having a global mechanism for preparedness as a major gap. but we can do any of this alone. the biden administration realizes that we will only achieve these goals if we work in partnership. and that's why we return to who and join the covax initiative. and we are expanding with regional and multilateral partners. and we are doing this by mobilizing the full force of the u.s. government. we will do so driven by our humanitarian values and mr. president said, we will do so

not as a means to gain political favorites, but rather as a means to fight and in the pandemic, driven by the knowledge that benefits and protects the world ultimately protects us here at home. thank you. >> great, thank you very much for that, jeremy. with that, i would like to introduce our panel. today we have with us dr. julie, who cochairs the csis commission of strengthening america's health. during both terms of president george w. bush she was director of the cdc where she led the agency through sars and over for emergency responses. she is currently executive vice president and chief patient officer at merck. a bunch of people make that mistake i bet. gary is president and founder of the covid collaborative and a principal of civic enterprises.

during his long and distinguished service in government he served as deputy national security advisor and economic adviser to president george w. bush. he established the groundbreaking minute lineal challenge to fight global poverty. he co-led the launch of the president's emergency plan for aids relief. we also have with us dr. steve morris, my colleague, who is senior vice president and is also the director of our global health policy center. during his time, he has directed several high-level commissions and has had more impact on policies then just about anyone i know. panel, we just heard from jeremy and i want to get your collective reaction to what he just said. can we go to you first? >> it will take me a long time to present all of my collective reactions, because there was a lot there, which is the consequence of the complexities

that we are tackling on a global basis. a couple of overarching things. i think you have laid out what really is very comprehensive and complex agenda and it's pretty clear that its functions under the umbrella of a strategic national doctrine that needs a little polish. we all know that the takes a whole of government response and we have some track records of success. it is a slower moving emergency, but nevertheless the pandemic that is still with us. we saw this broad government engagement in the malaria initiative, global health security agenda is another example. so we have a growing confidence that when our government is operating from a strategic

platform and brings together the capacities of various government components, including usaid and cdc nih and other components of the state department commerce, etc., we can really do amazing things. that's the financing gap of mobile health security agenda so i think we need to come back to that point. i would like to be optimistic that with a strategic doctrine that is refresh in the context of what we have learned in the last 16 months, and then a working mechanism to bring the best of what our various agencies can do and should be doing, i think we can really move much faster than we have for the first year of this pandemic.

>> thank you jeremy for laying out what i think is the to do list. good job. >> gary, can we get your thoughts? >> i was very glad to hear about the focus on inputs and financing country readiness, clinical services in the global architecture and readiness for the future. i think where jeremy laid out our promising steps in the right direction and as julie mentioned, they reflect the complexity of the problem we are confronting. but i still get the sense of tapestry of actions rather than the straight line of a strategy. they still lack, i think, the magnitude and urgency that the current crisis demands, as jeremy noted, the next three to six months will be critical to try to limit deaths in india and

brazil and prevent covid elsewhere. but instead of a bold and comprehensive strategy, i think what i heard was a series of largely tactical steps signaling support that the administration has done for a patent waiver here, donating 80 million doses there, that kind of thing. i think if president biden wants, as jeremy noted, the united states to become the world arsenal of vaccines, he needs to take exponential, not incremental, action immediately and on four fronts. first, donate much greater numbers of access doses immediately and continue to donate as they become available. it has been estimated that the united states will have some 300 million access doses come july, and the eu and the other g7 can

add significantly to that. and in fact, we propose that the u.s. leverage its own leadership to secure a pledge of the upcoming g7 to collectively share at least one billion doses by the end of the year. second, jeremy noted we need to expand additional short-term manufacturing capacity for u.s. authorized vaccine to extend the regional capacity. he said that the investment of in india and under contemplation with south korea, which would be fabulous, and the extent that the finance corporation can fund similar arrangements in south africa and elsewhere, that would be all to the benefit. in this is in our interest -- interest to ensure we can produce boosters and new vaccines while the excess production could serve local needs. third, as jeremy noted, we need

to support distribution delivery infrastructures, especially in low income countries for emissions for u.s. id working with other agencies, building on it literally and figuratively. and finally, we need to invest and accelerate the development of a sustainable, global distributing network of new manufacturing capacity and low and middle income countries, africa and elsewhere. not only to combat this pandemic, but to ensure we are prepared to fight the next one. i think that prioritizing those activities in the next six months is going to be critical to our success in ensuring that the globe does not split into vaccine haves and vaccine have-nots. which would really imperil not only the ability of those countries to cut back with the

pandemic, but our ability to end the pandemic here. >> steve? can we get your reaction, steve? >> thank you, so much. we stand by those key points that terry just made, which relate out in the open letter that we issued 10 or 12 days ago. the co-collaborative that we lead with our friends, i think we stand by those points and i think those are very, very clear. i will add a few remarks. jeremy, i think we need to commend you for the leadership that you have demonstrated over the last six months, which has moved us very far forward. you have assembled a strong team at usaid and you have been working collaboratively across the agency to try to drive towards where we are today and

beyond and you have really made a major contribution and we are grateful to you for that. and in the sweep of what you have laid out is very compelling. of course the gravity and force and urgency of what we face today, which makes it very difficult to think beyond today, so you carefully laid out that spectrum of things that we have to somehow be able to move forward simultaneously. we cannot lose sight of those things, so we are very indebted to you. you have moved us forward. we still are short of having a true national strategy. i know you are working hard on that and we will see that national strategy. we do have a strategy that has targets, as numbers, that is bold, that puts money against these things. we do have quite a significant amount of money that has already been committed, which is a great advantage that we face today

that we have, that we can come forward with bold ideas and ask for more. and we need to do that rapidly, very rapidly. the second point i make is we do not yet have a coherent leadership team in place. we have different people that are leading in different spots within our government. we have just signed who has been appointed by the president to preside over both the domestic and the international. but on the international site we do not yet have what you could say is so coherent and cohesive leadership team. we have something that is much more fractured than that. in terms of who's in charge, yes jeff is in charge. beneath that level it becomes murky on which set of issues are people in charge, and who will carry this mission forward? the president plays the absolutely pivotal role in

staking out where we want to carry this forward, making the case to the american people in a dramatic way in bringing that across very rapidly. we are in the season with the advent of the world health assembly followed by the june 7 coming up june 11 to june 13. those moments when presidential leadership can be voiced in the g7, but we can do a lot to get forward where we are going. the g20 eu summit from last friday offered a few promising commitments, but basically was a disappointing. it did not bring forward much evidence of high-level statesmanship and states woman ship committed to this issue. this has been a chronic problem since the pandemic began in china get states leaders mobilized around a common vision of moving heads and making serious grant commitments.

and that is still absent. and i think that we took away from last friday, another sobering indicator of the world that we live in, which is one where money is short, people are consumed with their own internal crises, and the world is very fractured in terms of the division that exists among the major collars, particularly between the u.s. and china. there are a number of issues i would like to explore in the course of our conversation around special assets and contributions. aldo sighs up again cdc, and also what muscle can be brought to bear by a id and others and try to get firms like moderna to come forward more proactively in terms of voluntary licensing and tech transfer, which is going to be fundamental to that sort of vision that gary laid out. thank you so much. >> panel, let me ask you, if we don't have someone seeing that is completely in charge, when needs to happen to get some

single person in charge? and who would be charged with pulling together a national strategy and when would it be released? >> we could probably turn to gary to answer this because he has been there and done that. i can address this from experience that i had in the bush administration. i don't think that out of the starting day we had it all worked out on 911 or when the first crises of that administration appeared. the very quickly it became obvious that we needed a coordinating mechanism that was built to support the presidential directive in the presidential strategy that had unfolded. and that got easier as time went on. the homeland security council worked fairly well in that regard, at least in my experience. having a designated white house official responsible for these activities. in the obama administration we saw the old bola -- ebola one.

that was an important role that held the power of the president but also the accountability for articulating the strategy and then holding the feed to the fire of the people who had to execute it. when we were preparing for the influenza pandemic during the bush, i think the cdc was given 128 requirements that we needed to fulfill, with timelines to liberal bowl and budgets attached to them. so we had to sit down and figure out how are we going to fulfill our critical requirements as we try to prepare our nation for an influenza pandemic, and every other agency was doing the same thing. so we would come together around the table and share experiences. sometimes learning in vigorous debate about who should be doing what, but we eventually, in my opinion, did not approach nevada but became a hole that was greater than the sum of the parts and we did move the needle

of the dial during that time. we were fortunate because we also had investment from our congress that allowed us to sustain that level of engagement and progressive preparedness over an amount of time. and when those investments aren't sustained, it's very easy to understand why that mechanism would fall apart. you were there when a similar mechanism was established. maybe your experience can complement or contrast with what my experience was. >> you are muted. >> i think what julie says is exactly right. but, at the end of the day, in my experience, there is no substitute for presidential leadership. it wasn't called the presidents

emergency plan by accident. i was there. it was intentional. it was meant to be owned by whomever occupied the oval office. in the presidential ownership of an issue is critical. the global aids coordinator may have sat at the state department, but the president owned it. and there is no substitute for that kind of presidential leadership and direction. in this case, the global pandemic response has to be owned by the white house and directed out of the white house, and it doesn't have either the perception or the reality of the authority to act on the president's behalf and to show that the white house owns that issue, then something needs to be done about it. but the direction has to come

from the white house and has to come forcefully from the white house to make sure that all the agencies are working together, and that one plus one equals three because that, at the end of the day, is the way that we are going to succeed. >> steve? >> i think the president's hat, up to this point, to deal with the cascading crises domestically internally, and those were profound, and we have made astonishing progress in the last 120 days, and it's a real tribute, and we are crossing a pivot point right now, as jeremy laid out in his opening remarks, we are crossing a pivot point where americans can have more

confidence that the gains that have been made are going this day, and that our lives are going to be on a trajectory towards normality with all of the caveats that we know. we have to be vigilant and careful looking ahead. we are dealing with variants, waning immunity, still lots of ground cover and immunizing children and those that are resistant and the likes. but nonetheless, approaching this moment or we have much more confidence on the domestic side and the president is able to think and engage more broadly. and over the previous six or eight weeks, there have been multiple signals along those lines. it's not like there hasn't been plenty of >> the arsenal statement is the most recent with is a dramatic term. i am hopeful. i am optimistic. i think we have a lot of the

pieces put in place by the good work that jeremy is doing with his team in concert with what is happening elsewhere at the state department, at hhs and elsewhere. it will require something more. we know there is a certain resistance and reluctance to do anything that might risk what is happening on the domestic side. we need to move beyond that resistance and create a very solid and coherent team centered out of the white house. thank you. >> jeremy, i know we are putting you at an awkward spot with these great opinions that we can make, because we are not in a position of responsibility. but still -- having said that i would like to hear your thoughts. >> i think, at least from the vantage point i have, i'm not

quite sure where some of this perception comes from, that the white house is less than fully engaged. one of the first things, the very first national security memorandum the president issued was on this topic. was on global bio security and defeating the pandemic. the decision to rejoin the who was signed on the afternoon of june 20 -- excuse me, january 20, the day the president, the day one action of the president. the day of the inauguration. the announcement of the 2 billion dollar conservation to covax was made by the president personally in february. likewise, the announcements on dose sharing were made personally by the president. i can tell you, the arsenal of vaccines, is his very much -- is very much his own formulation of what he wants to achieve.

i would not oversell it. i think you guys might slightly to the degree to which the international is being overlooked. i think in terms of the relative amount the white house has talked about, the domestic of course, they are talking about it more. that was core to what -- courts of the commitments the president made -- core to the commitments the president made before he was elected and he takes that priority extraordinary -- extraordinarily seriously. he has given us clear marching orders starting with national security memorandum one and his ongoing engagement by the senior team at the white house to go out and beat the pandemic. that is the marching orders we have taken and we are rolling out on. to the question of the organizational structure within the administration, these things

are always somewhat fluid. as you get into the problem, you begin to, you begin to build what -- you didn't it -- you begin to build against what you need. what we found in terms of the trajectory of the pandemic, we are making adjustments. we brought in gayle smith to the state department, my old and a friend and former boss, to help corral the overall international efforts. she will work closely with the white house task force. i think we are getting that architecture into place. i would not oversell the degree to which we somehow are short of the mark on that. i think the administration requested $11.5 billion and they fought for and got it. that is a dramatic increase in resources relative to what was available and was sought by the prior administration last year. that is on top of the $4 billion

we are giving to covax, as well as investments by the dst. we are rolling out a robust response and we will adapt and iterate as you do to what we find as we see where the pandemic goes. >> steve daca -- steve? >> just one thought on that. i think of what we are seeing is not an underestimation of the important things you've mentioned, but rather a sense that business as usual across-the-board by all governments is not working. we have had the independent panel come forward which sketches a myriad of cascade of failures in 2020. it crosses the board. now a world on fire, except for

a few places that have the advantage like the u.s., the u.k., israel, seychelles, a few places that are building their way out of this. the rest of the world is on fire. the writing is on the wall. a monumental set of crises and we have not come up with scaled responses, any of us, u.s. or others, and only the u.s. has the capacity, it seems, to me, to begin to shape the political and economic marketplaces, to break some other level of response -- to bring some other level of response. if you look at the g20 and you see the g20 comes together and, guess what? not much comes out of this moment in time. the history books will say this is let -- this is yet another signal of failed leadership. very mediocre responses to a

crisis that is raging around these members of the g20. i think part of the impatiens people are feeling is the sense that, yes, the u.s. is an exceptional entity, it has exceptional capacity if you're talking about the vaccine marketplace, it is the biggest player in terms of our into d, production, consumption, we build up our production base with our private sector partners that is unparalleled. we are in the midst of this. stepping forward at a higher level to shape the global marketplace, politically and economically, is an essential moment. i think that is what many of us are trying to express. >> i hate to bring this terminology into this conversation, but i think we are in agreement that this is an issue of national and global security. it is not a health crisis alone.

it is a security issue. if there were battles going on in these countries, we would be behaving very differently as a united states, our level of engagement, asserting our global is so -- our global authority power and influence would happen at a different scale. we are imagining this is something we can do in a series, like, let's take care of the u.s., and then as we bring that fire under control, then we can begin to think about how we can be more helpful to people elsewhere. i think that is where the sense of inpatients comes in. -- impatience comes in. when i look at india it is like a nuclear bomb went off in the continent and we need to be responding like the threat was that serious, because in some senses it is existential. we need to have urgency and boulder planning. i know i am talking about -- talking from both sides of my mouth, because on one hand i'm

seeing many good things are happening and sciences on our side in terms of things we can do with our countermeasures, but on the other hand we cannot be complacent because we might have tipped into a safer place in the u.s., we are not safe and we will not be for a long time. i share with you this sense of trying to amplify the urgency but not disrespecting what has happened in the last few months, because it is extraordinary and everyone understands that change has occurred we are thinking more multilaterally of the g7. maybe the world health assembly. these are mechanisms and opportunities to assert ourselves and commit to that. it will not be politically easy. we know that. but we are in positions of influence where we can at least try to bring more people with us and try to understand what is at stake care as we have in other global crises in the past. >> let me just add, picking up on that, that places where the

rubber meets the road next is the g7. we know that the g7 and the g20 have not stepped up to play a leadership role in the pandemic yet. they have been largely leaderless and almost leader proof and allowed to lay fallow under president trump and are much maligned talk shops -- as talk shops and indeed the recent g20 summit was relatively true to form, delivering mostly platitudinous with some -- mostly platitudes with some limited action. there was a sign -- there was a time when the g7 was a platform for decisive action. it took decisive steps after 9/11 to enhance global security. in the midst of the aids pandemic, it was the g7 that launched the global fund,

putting itself in the forefront of the fight against hiv-aids, malaria, and tuberculosis. the common aspect of all those actions was that it was u.s. leadership that turned rhetoric into action. right now the u.s. should be hammering out a robust action plan for the g7 that calls for a collective commitment to sharing the maximum amount of doses possible, the calls for partnership mechanisms for cost sharing, does sharing, tech transfer, and coinvestment. the g7 is in an opportunity and we ought to seize that opportunity. >> jeremy, along those lines, you have been asked in congress, isn't this the time for the u.s. to reassert its leadership role in the world, the way the administration has responded is that it is time for the u.s. to help end the pandemic, not

necessarily a time for us to reassert our leadership in terms of politics. can we be in a position to do both? >> i am not quite sure i see the distinction you are drawing there. the president said very clearly last week that with our approach to global vaccinations coming in the months ahead that we will use that as a reflection of our leadership and values. you will see a very strong contrast in now the u.s. is approaching global vaccination and how some of our -- some other countries are approaching it. the president has said we will not trade vaccines for favors. the president will use our vaccines in support to accelerate the end of the pandemic. we will not -- we're not going to try to beat china and russia at their game because we will not play the same game. this is not about using vaccines

as leverage for small-scale geopolitical tactical winds. -- wins. it is about using an aggressive approach to global vaccination as a geostrategic victory for the world at large. i think the way that we tackle the pandemic is a signal of how the u.s. and this administration seeks to operate in the world. we will do so in partnership. we will do so working with others. we will do so in a way driven by our values and by science and evidence. i would not try distinction and i think you may be dead between showing strategic leadership -- and i think you may be did between showing strategic leadership and global health leadership. we are intentionally reflecting

the way we are trying to engage in the world more generally. >> but are we to test but are we treating it as much of an existential crisis as truly wended out before? >> i think we are putting an unprecedented volume of money on the table, far more than any donor ever has. we are working together on pulling all the capabilities of the u.s. government. the work we have been doing in south asia over the past few weeks, that was a combined effort between usa, the department of defense, the cdc pulling in some of the capabilities from health and human services, as well. coordinated by the state department. i feel like we are rolling out a very robust -- we are ruling -- we are rolling out a very robust response. certainly the most robust in terms of funding and country coverage probably the u.s. government has ever rolled out globally.

there will be more to come in the months ahead. we are very focused right now on taking the resources made available through the american rescue plan, mobilizing the full force that we have available as the u.s. government to support countries. at the same time, take a case like india or some of the other countries really struggling, ultimately the u.s. cannot solve every country's problem on their behalf. it is a partnership. the indians have made very clear to us that they are -- they welcome our support but also this is they are challenged to lead. the u.s. is not leading the response on behalf of the indian government. the indian people are leading that and we are supporting wherever we can. that is the posture we are trying to adopt. >> we have time just for a few final thoughts. let's go around the horn real quick. julie, can we get final thoughts from you?

>> this is a situation where, again, we want to be, may be grateful is the right word for the change in our posture and the progress that has been made. we are in a race. we have a virus and variance and vulnerability and vaccine and vigilance on the other hand. it's too soon to sell when the race will be -- it is too soon to tell when the race will be will one. the strength of the commitment our government is making has been welcome. we have not talked about the role of the private sector in all this because i do not think we can ever think of this as a government only response. we need the private sector engagement. not just for countermeasures but for a whole host of other issues. strengthening the mechanisms by which that part of the equation is integrated into the planning, not to be called upon for our intellectual property or our

resources, but rather, how can we bring what we know how to do well, and i'm not just talking about the pharmaceutical industry -- we have a lot of capabilities and capacities that could be highly relevant. many of us are and some of the countries already that we are most interested in. that is an opportunity that we should probably scale and speed up, as well. the good news is, good direction and much more confidence that we can do it. my concern remains the sense of urgency is not going to get us as far as we need to go, as fast as we need to get there, in the context of the variance in the faltering vigilance. india's extreme case. we are seeing the story repeat itself in country after country. it is very worrisome. >> gary? thoughts from you? >> i really want to thank jeremy for the tremendous work