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tv   Experts Discuss Global COVID-19 Vaccine Gap  CSPAN  June 7, 2021 9:42am-10:54am EDT

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colored troops during the civil war. by the end of the conflict, made up 10% of the union army. in 2015, civil war living historians and re-enactors recreated a may 1865 parade of the grand army of the republic down pennsylvania avenue from the u.s. capitol to freedom plaza near the white house. participants included groups representing the u.s. color troops and descendants of the soldiers who were not permitted to march in the original parade 150 years ago. watch american history tv tonightality 8:00 eastern and every weekend on c-span3. up next, a discussion on the pandemic and global vaccination efforts from the center for strategic and international studies. this is just over an hour. good afternoon. welcome to the center for strategic and international
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studies. i'm andrew schwartz, the csis chief communications officer. it's great to be with you all today. first i want to thank the stavros knee or koes foundation, our great sponsor, for making this all possible. this has been several years that the knee arcos foundation has sponsored us. they've stuck with us through the pandemic and virtual. this has been incredible. we thank them for their support. i want to thank the bob schieffer, i want to than bing bob schieffer, somebody we've learned so much from. i owe so much of my career to bob. thank you to bob. before we get into it, we have a short video that our ideas lab produced. this is our andrea c. ak ideas
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lab. with that, if we can role the video. now, the world has watched in horror as covid-19 for weeks now the world has watched in horror has covid-19 swept across india like a tsunami, shatters previous records. authorities are struggling to address the rapidly evolving situation. as the covid-19 pandemic comes into its second year dominating headlines and our lives, india stands as both an ongoing tragedy and a warning of what might be to come from other nations. the biden administration, the un and the world health organization are currently developing strategies to tackle this next phase of the pandemic. if e we've learned anything in the past year, it's that finding viable solutions to a problem of this scale requires a multifaceted approach. in this ep sed of the schieffer series, our panel of experts will unpack unanswered questions about the administration's
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strategy for dealing with covid-19 globally. the future of the vaccine and how we can prepare and protect other vulnerable countries so we never see numbers like this again. this is the schieffer series. let's dive in. before we get to our panel today, we have with us a very special guest who is going to stay with us for the panel. jeremy konyndyk is the executive direct of usaid's covid task force. he's 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 as director of usaid's office of u.s. foreign disaster assistance where he led the u.s. government's response to international disasters. he led major u.s. government humanitarian responses to things like the ebola outbreak in west
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africa. jeremy, thank you for being here with us today. we really want to hear what you have to say. >> thanks so much, andrew. that's a very generous introduction. so i want to talk today about how usaid and the administration at large are seeing the outlook. the intro there highlighted the challenges we're seeing in india and south asia, and i this it just underscores the challenging point that we are at, kind of caught in this gap for the year ahead with the hope of vaccines on the horizon, but the reality of large-scale vaccinations still distant from the world at large. for almost a year the world has been experiencing a global health crisis unlike anything we've seen in our lifetime. the u.s. is helping lead the world out of this pandemic and
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also to do that in a way that leaves the world better prepared to respond to future biological threats. the work of usaid which i'm leading will be central to this effort. i want to talk through some of our plans for tackling this next phase of the pandemic and the challenges that it holds. i last spoke four months ago and at that time the number of fully vaccinated americans has grown from 10 million to 124 million and rising, thanks to the administration's accelerating vaccine availability. so we're 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 around the rest of the world and continues to replicate and generate new and potentially more dangerous variants. the current surge in south asia really underscores the devastating consequences and
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risks of continued, uncontrolled global transmission and the urgency of accelerating efforts to end the pandemic. so usaid's work will be central to this. and it will build on decades of experience that the agency has in leading these kinds of complex global health responses including some of the work i helped to lead in 2014 and '15 on the west africa ebola outbreak. we're currently experiencing technical difficulties. programming will resume momentarily. >> don't worry, jeremy. this is the beauty of live streaming. >> my apologies for that. it wouldn't be the pandemic era if we weren't having technical difficult it is. so i'm not quite sure where my connection dropped. i'll pick up on the transition that we are -- the broadening that the administration is making now in some of our focus.
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when i last spoke to csis 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 accelerating vaccine availability. while we still have many millions left to vaccinate in this country, we're making substantial progress, and 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 variants. the current surge in south area really underscores the devastating risks and potential consequences of uncontrolled global transmission and the urgency of accelerating efforts to end the pandemic. usaid's work on covid-19 will be central to this and will build on decades of experience that the agency has in leading complex global health responses including the response i helped to lead in 2014 and '15 in my previous tenure at usaid on the
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west africa ebola outbreak. but the complexity of even that challenge really pales in comparison to what we're seeing in the present moment which is an overlapping set of health, humanitarian and and developmen crises that are global in scope and historic in scale. that is why the administration is moving rapidly to expand our global response efforts, using the responses in the american rescue plan. so we've been working closely with the cdc, the department of state, the department of defense, 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 and i outlined in our senate hearing a few weeks ago, we're doing this through a comprehensive plan to both tackle the virus itself, but also to address the acute human and systemic challenges and impacts that it is causing
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beyond the health sector, all while working to build stronger global readiness for the future. so we're pursuing five major objectives. the first is to -- the first two are focused on savings lives from the virus itself. so we want to accelerate global access to vaccines, but we also recognize that we can't wait on the vaccines to arrive, that we need to do work in the immediate term to save lives, and that's why the second objective focuses on saving lives in the more immediate term in preventing transmission through 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.
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that's why the third objective of the plan focuses on the acute human impacts that are emerging in other areas. we're seeing significant food insecurity and risk of famine in many humanitarian settings, we're seeing severe disruption to education, severe disruption to household livelihoods, the first net increases in global extreme poverty since the financial crisis of the late 1990s. so those human level impacts beyond the virus itself are an urgent priority for the administration, particularly on the humanitarian front. and the fourth, and related is the systemic level. so the virus is causing systemic risks that we have to manage in order to preserve global freedom and prosperity. we're seeing threats to further deterioration and accelerating deterioration of human rights in some countries, risks to
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governance, risks of enhanced conflict, and so concern that those ripple effects from the pandemic could cause future instability. so we're going to work on tackling that. and then, finally, the last objective is to build back a better global health security architecture. and i'll talk a bit about that at the end of my remarks. but with the world right now in the grips of this new wave of covid transmission, driven by deteriorating conditions in south asia, i want to focus today primarily on the first two objectives, and how we're going to try 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 vaccines are the best tool available over the median turn to bring the pandemic under control and we see the urgency of doing so. as president biden said a week ago, now that the u.s. has made
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such tremendous strides on vaccination at home, we're in a stronger position to expand our efforts to vaccinate the world at large. that's why the president said the u.s. is going to become the arsenal of vaccines, just as we were the arsenal of democracy in earlier generations. we see several urgent priorities for delivering on that. we want to approach this in a way that leads with values and leads the science. so in accelerating global access to vaccines, we're going to demonstrate innovation and ingenuity of american people and our commitment to taking a science-driven approach to tackling vaccine availability and expanding vaccine availability. so when it comes to doing that, we're not, as the president said, going to use our vaccines to secure favors from other countries. we're going to use them to accelerate the end of the pandemic and to be driven by the best public health strategies for doing so. we also recognize when it comes
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to vaccine availability, scares tee is the enemy of equity. so the only path to equity lies in finding ways to ramp up global vaccine production. it's not going to be easy. the world needs to produce up to an additional 14 billion doses of vaccine in order to cover the global population and we have to do that on a global infrastructure that is built to produce only about 4 billion doses a year. so we are taking steps to expand global supply, such as our commitment through the quad partnership to invest -- to make development finance investments in vaccine production in india and we're pursuing other deals to expand supplies in other parts of the world and we'll have more to say about that in the near future. we recognize as well that expanding supply hinges on securing and optimizing the use of vaccine production outputs.
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there's actually more global production capacity available in the world than we're able to make use of at the moment because of a lack of manufacturing inputs. so we're working with international partners like w.h.o. and cepi to explore options to both expand the production and availability of those inputs, but also to make better and 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's striking, when you look at how the world collectively is financing vaccines, it looks a little bit like how the u.s. was procuring ppe at the national level a year ago. so just as ppe procurement led to inefficient competition and a lot of uncertainty being signaled to the ppe market, so, too, does the fragmented nature
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of vaccine procurement globally today signal uncertainty to industry and result in inefficient market outcomes. and so we think covax, as well as regional partnerships like the au vaccine platform, are really, really critical to finding ways to aggregate and consolidate demand, to send clearer and more certain signals to market so that vaccine producers can have certainty of financing and demand and be able to scale up production on that basis. and so the u.s. is doing an important -- a very important part of that with our historic $2 billion announcement of support to gavi for the covax initiative and another $2 billion to come over the coming year. but, of course, there are other pieces of this equation as well, and one of the big gaps that we see right now is the financing through the multilateral development banks, which have put forward tens of billions in
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vaccine financing, but are having trouble translating that into actual deals. so we're working with them to find some ways to aggregate that mdv financing in a more coherent way so that it's not every country pursuing its own deals, but rather partnering and consolidating around larger-scale procurement mechanisms. ideally through covax, but through potentially regional efforts. and finally, dose sharing, as the president announced last week, will be an important part of the equation as well. we see the announcement to share 80 million u.s.-owned doses as an important step, with a significant share of those going through covax. that's going to be an important means of bridging some of the critical supply gaps that covax is facing right now caused by the disruptions of indian vaccine exports. but regardless of how much vaccine gets reduced and how many vaccines the u.s. and other
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countries are able to send, ultimately the impact depends on getting shots into arms and that's why we're also investing resources in country readiness and deployment. so us aid has already in the last few months provided $75 million of new funding to support vaccine readiness in more than 40 countries and with the new resources we're going to 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
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provided by vaccines distract us from the immediate task at hand. so approximately 85% of total global cases have occurred in the last six months and we're 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 america region is facing dire conditions and represents 28% of the death toll, with mortality continuing to climb in that region. we're seeing troubling signs of new waves of cases emerging in parts of africa and numerous countries there have reported new upticks in cases in the past few weeks. so u.s. aid is also taking a range of measures to support countries to fight the virus in the immediate term through clinical and public health measures, while we simultaneously work to scale up vaccine availability. and it's going to be really critical in the months ahead that all countries double down on measures to prevent and mitigate transmission. and this will mean protecting health workers, reinforcing risk
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communication investments, promoting mask wearing, distancing and ventilation measures, supporting surveillance and contact tracing and we're working to ensure generally that partner countries have the tools, the supplies and the capabilities to save lives and avoid high death tolls. we're also focused on ensuring that communities receive quick, accurate and actionable information about covid-19 and how it spreads. so our partners so far have reached more than 200 million people with critical public health information in more than 85 countries, and these critical interventions to slow transmission are going to be really, really critical to preventing as many hot spots from emerging as possible. at the same time, we know that hot spots will still occur, especially as the proliferating variants of the virus develop more dangerous characteristics. so we will be providing enhanced support to health systems to ensure that they have the tools
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they need to manage those surges in transmission when they occur. and that means things like ensuring adequate availability of ppe, critical medicines and equipment, diagnostics and oxygen. over the past 15 months we've sent millions of units of ppe around the world and just in the past few weeks have deployed numerous flights to south 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 in the weeks ahead to the wider region. another critical priority is going to be helping countries manage the burden on their health systems and save more of the severe cases. so in africa mortality among critical covid patients was found to be 48% in a recent lancet article, compared to a global average of 31%. it makes clear that more can be done, so we'll be expanding our
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support for clinical services, for training and for supply of critical items. oxygen in particular will be a priority for u.s. aid in the months ahead. many of the severe cases of covid-19 can be saved with timely oxygen therapy, but health facilities in the developing world have a very uneven capacity to provide this kind of treatment. so we'll be working to scale that up. and, finally, i want to say a few words on the importance of emergency management. when i traveled to west africa in 2014 at the height of the ebola outbreak there, our first recommendation was not to build more treatment units or send more ppe. i9 was to install coherent, unified incident management structures at the country level. in many countries we've seen covid-19 takes advantage where national responses are fractured or poorly coordinated between ministries and sub-levels of government. so just as we've done on our own
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white house task force for the united states, it's going to be critical for all countries to ensure that we have a unified pandemic management team with clear authority and unified accountability. a critically important element of that must be enhanced diagnostic testing and surveillance. if we can't see what's happening, if countries can't see what's happening in their own countries, it's very hard to manage a crisis when you're blind. so we're seeing widespread gaps in testing continuing across many of the countries. nepal is reporting positivity rates of over 50% in some areas. we're seeing positivity in african countries elevated to alarming levels, even as case detection remains low, which suggests that the low case numbers in many developing countries are an artifact of low testing, rather than an actual reflection of low transmission. so there's an enormous amount of work to do to bring this virus under control over the next several years, and the united states is committed to not only ending the pandemic, the present
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pandemic, but also building back a better world, one that is prepared to prevent, detect and respond to future biological threats. and with the world health assembly meeting, it's important to reinforce as we focus on continuing the fight against the present pandemic, we must keep attention focused on building back a stronger global architecture. the past year has reinforced the importance of the global health security agenda and the importance of the reforms that w.h.o. said following the outbreak of ebola, but it has revealed critical gaps in readiness. so much of our work over the months ahead will focus on building global consensus on how to address those gaps. several areas of emphasis for the u.s. are going to include stronger alert and early warning systems, enhancing the transparency and national reporting of emerging health risks, and shielding w.h.o. from political pressure. and we are addressing the absence of the global mechanism
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for financing health security preparedness, which we see as a major gap. but we can't 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 have returned to w.h.o., we have joined the covax initiative and we are expanding our efforts with regional and multilateral partners. we're doing this by mobilizing the full force of the u.s. government. we will do so driven by scientific knowledge and humanitarian values and do so not as a means to gain political favors, but rather as a means to fight and end a pandemic, driven by knowledge that benefits and protects the world, ultimately benefits and 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 the doctor
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that co-shares on strengthening health security. during the term of george w. bush, she was director of the cdc where she led the agency through sars. the doctor is currently executive vice president and chief patent -- i'm sorry, chief patient officer at merck. i bet a bunch of people make that mistake. gary henson is also with us. gary is president of the -- founder and president of the covid collaborative and a principal of civic enterprises. during his long and distinguished service in government, jerry served as deputy national security adviser and economic adviser to president george w. bush. he established the groundbreaking challenge corporation 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 morrison, my colleague, who is senior vice president of csis.
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he's also the director of our global health policy center. during steve's time at csis, he's directed several high-level commissions and has had more impact on policy than just about anyone that i know. panel, we just heard from jeremy and i want to get your collective reaction to what he just said. doctor, can we go to you first? >> sure. and it would take me a long time to present all of my collective reactions, because there is a lot there, which is a consequence of the complexity of the problems we're tackling on a global basis. a couple of overarching things. i think you laid out what really is a very comprehensive and complex agenda, and it's pretty clear that it functions under the umbrella of a strategic national doctrine that needs a little polish and ongoing updating in a sense as the pandemic refreshes.
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so we all know that this takes a whole of government response, and yet we have some track records of success. we have a slower moving emergency, but nevertheless a pandemic that is still with us. we saw this kind of broad government engagement in the malaria initiative, global health security agenda is another example. so we have, i think, a growing confidence that when our government is operating from a really clearly articulated strategic platform and brings together the capacities of various government components, including u.s. aid, cdc, nih, obviously other components of the state department, commerce, et cetera, we can really do amazing things. there are some gaps in the agenda now, and one of them you ended with, that's the financing gap for the global health security agenda. so i think we need to come back to that point.
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but i would like to be optimistic that with government leadership from the white house with a strategic doctrine that's refreshed in the context of what we've learned in the last 15 months, and then a working mechanism to bring the best of what our various agencies can do or should be doing, i think we can really move much faster than we have for the first year of this pandemic. so that's kind of my optimistic point of view. i'm not underestimating the challenges and perhaps we'll come back to one or two of those. but thank you, jeremy, for laying out what i think is the must-do list. good job. >> gary, could we get your thoughts? >> yeah, i was very glad to hear about the focus on inputs and financing, country readiness, clinical services, and, of course, the global architecture and readiness for the future. i think what jeremy laid out are
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a lot of promising steps all in the right direction, and as julie mentioned, they reflect the complexity of the problem we're confronting. but i still get the sense of a 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 are going to be critical to try and limit sickness and death in india and brazil and prevent explosive growth of covid elsewhere. but instead of a bold and comprehensive strategy, i think what i heard was a series of largely tactical steps signaling support as the administration has done for a patent waver here, donating 80 million doses there, that kind of thing. i think, if president biden
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wants, as jeremy noted, the united states to become the arsenal, the world's arsenal of vaccines, he needs to take exponential, not incremental, action immediately, and on four front. first, donate much greater numbers of excess doses immediately and continue to donate as they become available. it's been estimated that the united states is going to have some 300 million excess doses come july, and the eu and other g7 can add significantly to that. in fact, we proposed that the u.s. leverage its own leadership to secure a pledge at the upcoming g7 to collectively share at least 1 billion doses by the end of the year. second, jeremy noted we need to expand additional short-term manufacturing capacity for u.s. authorized vaccines here and expand the regional capacity. he noted the quad investment in
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biological in india and the partnership apparently under contemplation with south korea, which would be fabulous. to the extent that the development finance corporation can fund similar arrangements in south africa and elsewhere, that would be all to the benefit. and this, of course, is in our interest to ensure that we can speedily produce boosters and new vaccines, while the excess production can serve global needs. third, as jeremy noted, we need to support distribution, delivery infrastructure, especially in low-income countries, to translate vaccines into vaccinations. that's clearly a mission for u.s. aid working with other agencies, building literally and figuratively. finally, we need to invest and accelerate the development of a sustainable global distributing network of new manufacturing capacity in low and
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middle-income countries, africa and elsewhere, not only to combat this pandemic, but to ensure we're 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 doesn't split into vaccine haves and have nots, which will impair not only the ability of those countries to combat the pandemic, but our ability to end the pandemic here. >> steve? >> thank you so much. we stand by those key points that gary just made, which were laid out in the open letter that we issued maybe 10 or 12 days ago, the covid collaborative that gary leads, along with our friends at duke, mark mcclellan
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and dr. kumar and rachel silverman. we stand by those points and i think those are very clear. i'll add a few remarks. first of all, jeremy, i think we need to commend you for the leadership that you have demonstrated over the last six months, which is moved us very far forward. you've assembled a strong team at u.s. aid and you've been working, obviously, collaboratively to try and drive towards where we are today and beyond. you've really made a major contribution and we're grateful to you for that. in the sweep of what you've laid out, it's very compelling, and of course the gravity and force and urgency of what we face today, which makes it very difficult to think much beyond today. and so you've carefully sort of laid out that spectrum of things that we have to somehow be able to move forward simultaneously.
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we cannot lose sight of those things. so we're very indebted to you. you've moved us forward. we still are short of having a true national strategy. i know you're working hard on that and we'll see that national strategy. we do need a national strategy that has targets, that has numbers, that is bold, that puts money against these things. we do have quite a significant amount of money that's already been committed, which is a great advantage that we face today, that we have, that we can come forward with some bold ideas and ask for more. and we need to do that rapidly, very rapidly. the second point i would 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 jeff zients, who has been appointed by the president to preside over the domestic and international.
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but on the international side we do not yet have what you could say is a coherent and cohesive team, leadership team. we have something that is much more fractured than that. in terms of who is in charge, jeff zients is in charge. beneath that level, it becomes a little murkier, on which set of issues are people in charge and who is going to carry this mission forward. the president plays, obviously, 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, and bringing that across very rapidly. we are in the season right now with the advent of the world health assembly, followed by the g7 coming up june 11th to 13th. those moments when presidential leadership can be voiced, certainly in the g7. but we can do a lot to get forward where we're going.
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the g20 eu summit from last friday offered a few promising commitments, but basically was a disappoint. it did not bring forward much evidence of high-level statesmanship and stateswomanship committed to this issue. that has been a chronic problem since this pandemic began in trying to get states' leaders mobilized around a common vision of moving ahead and making serious grand commitments. and that is still absent and i think 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 divisions that exist among the major powers, particularly between the u.s. and china. there are a number of issues i would like to explore in the course of our conversation
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around u.s. aid's special eats and contributions, and how those size up against cdc, and also what muscle can be brought to bear by aid and others in trying 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. >> okay, so, panel, let me ask you, if we don't have someone senior that's completely in charge, what needs to happen to get some single person in charge? and who would be tasked with pulling together a national strategy, and when would it be released? >> we should probably turn to gary to answer this because he's been there and done that. but i can at least address it from erp experiences i had in the bush administration. i don't think out of the
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starting gate we had it worked out when the crisis of the administration appeared. very quickly it became obvious that we needed a coordinating mechanism that was built to support the presidential directives and the presidential strategy as it 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 ebola, and that showed the power of the president and accountability for articulating the strategy and then holding feet to the fire of the people who had to execute it. when we were preparing for influenza pandemic during the bush administration, i think cdc was given 128 requirements that we needed to fulfill, with timelines, deliverables and
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budget attached to them. so we had to sit down and figure out how were we going to fulfill our critical requirements as we tried 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, sometimes vigorous debate about what should be doing what. but we eventually, in my opinion, certainly didn't approach nirvana, but became a whole that was greater than the sum of the parts and moved the dial during that period of 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 a period of time. of course, when those investments aren't sustained it's very easy to understand why that mechanism would fall apart. but i would ask gary, because you were there when a similar mechanism was established, so maybe your experience can compliment or contrast with what
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my experience was. >> gary, i think you're muted. >> i think what julie says is exactly right, but at the end of the day, in my experience, there's no substitute for presidential leadership. pepfar wasn't called the president's emergency plan by accident. i was there. it was intentional. it was meant to be owned by whomever occupied the oval office. and the presidential ownership of an issue is critical. the global aids coordinator may have sat at the state department, but the president
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owned it, and there's 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 if jeff zients doesn't have the perception or 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 it 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 we're going to succeed. >> steve? >> i think that the president
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has had up to this point to deal with the cascading crises domestically, internally, and those were profound and we've made astonishing progress in the last 120 days, and it's a real tribute. and we're crossing a pivot point right now, as jeremy laid out in his opening remarks. we're crossing a pivot point where americans can have more confidence that the gains that have been made are going to stay 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're dealing with variants, waning immunity, lots of ground to cover in immunizing children. nevertheless, we're approaching this moment where we have much
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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's been multiple signals along those lines. it's not like there hasn't been plenty of statements and signals around, yes, we understand this, the arsenal statement is the most recent, which is a dramatic term. and so i'm hopeful, i'm optimistic. i think that we have a lot of the pieces put in place by the good work that jeremy is doing with his team at aid, in concert with what's happening elsewhere at the state department, at hhs, and elsewhere. but it's going to require something more, because we know there's a certain resistance and reluctance to do anything that might risk what's happening on the domestic side. we need to move beyond that
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resistance and create a very solid and coherent team centered out of the white house. thank you. >> jeremy, i know we're putting you in an awkward spot with these great opinions that, of course, we can make because we're not in a position of responsibility. but still, having said that, i would like to hear your thoughts. >> sure, yeah. i think, at least where i am, the vantage point i have inside the administration, i'm not quite sure where some of this perception comes from that the white house has been less than fully engaged. one of the first things, the very first national security memorandum the president issued was on this topic. it was on defeating the global pandemic, the decision to rejoin the world health organization was signed on the afternoon of june 20 -- excuse me, january 20th, the day the president, the
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day of the inauguration. the announcement of the $2 billion contribution to covax was made by the president personally in february, and likewise, the announcements on dose sharing were made personally by the president. i can tell you the arsenal of vaccines comment is his own formulation. that is his vision and what he wants us to achieve. so i wouldn't kind of oversell, as i think you might be slightly, the degree to which somehow the international is being overlooked. i think in terms of the relative amount that the white house has talked about the domestic, of course they're talking about it more, because that was core to what -- core to the commitments that the president made before he was elected. and he takes that priority
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extraordinarily seriously. but he has given us, i think, clear marching orders, starting with national security memorandum one, and with his ongoing engagement, engagement by his senior team at the white house, to go out and national security memorandum one to beat the pandemic. and that is the marching orders that we have taken and we are rolling out on. i think to the question of the organizational structure within the administration, these things are always somewhat fluid. and as you get into the problem you begin to build against what you need. so i think we came in with a theory of the case on day one, and what we've found in terms of the trajectory of the pandemic, we're making adjustments. we brought in gayle smith to the state department, my old and dear friend and former boss, to help corral the overall international efforts.
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she'll be working closely about jeff zients and the white house task force. i think we're getting that architecture into place and i wouldn't oversell the degree to which somehow we're short of the mark on that. i think the administration requested $11.5 billion, fought for it and got it. that's a dramatic increase in resources relative to what was available and was sought by the administration, the prior administration last year, and of course that's on top of another $4 billion that we're giving to covax, as well as then the investments by the dfc and others. so we're rolling out a robust response and we're going to adapt, as you do in good disaster management practice, to what we find as we see where the pandemic is going. >> steve? >> just one thought on that. i think what we're seeing, jeremy, is a sort of -- not an
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underestimation of the importance of all of those things you've mentioned, but rather a sense that business as usual across the board by all governments is not working. we've had the independent panel come forward, which sketches a myriad cascade of failures in 2020, you know, across the board. and now a world on fire, except for a few places that have the advantage like the u.s., the uk, israel, 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 that this is a monumental set of crises, and that we haven't come up with scaled responses, any of us, u.s. or others, and only the
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u.s. has the capacity, it seems to me, to begin the shape the political and economic marketplaces to bring some other level of response. if you look at the g20 and you say, okay, the g20 comes together and, guess what, not much comes out of this moment in time. and i think the history books are going to look back and say this was yet another signal of failed leadership and very mediocre response to a crisis that is raging around these members of the g20. so i think part of the impatience 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's the biggest player in terms of r&d, production, consumption. we've built up a production base with our private sector partners
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that is unparalleled, and we're in the midst of this. and so stepping forward at a higher level to shape the global marketplace, politically and economically, is an essential moment. i think that's what many of us are trying to express. >> steve, 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's not a health crisis alone, it is a security issue. and if these were battles going on in these countries, we would be behaving very differently as the united states. our level of engagement, asserting our global authority power, influence would be happening at a completely different scale. but we're imagining this as something that we can do in series, like, we're supposed to take care of the united states, and then as we kind of bring that fire under control, then we
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can begin to think about how we can be more helpful to people elsewhere. i think that's where the sense of impatience comes in. when i look at india, to me, it's like a nuclear bomb went off in the continent and we need to really be responding as if the threat was really that serious, because in some sense it is existential. we need to have urgency and we need bolder planning. so i know i'm talking out of both sides of my mouth, because on the one hand i'm saying many good things are happening, and certainly science is on our side in terms of what we can do with countermeasures, but on the other hand, we cannot be complacent because we may have tipped into a safer place in the united states. we're not safe and we won't be safe for a long time. so i share with you the sense of trying to amplify the urgency, but disrespecting that's
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happened in the last few months, because it's extraordinary. everyone understands the change has occurred and we are thinking more multi laterally, the g7, world assembly, these are mechanisms for us to assert ourselves and commit to that. it won't be politically easy. we know that. but we're in positions of influence where we can at least try to bring more people with us and understand what's at stake here as we have in other global crises in the past. >> let me just add to that, picking up on that, that the place where the rubber meets the road next is the g7, and we know that both the g20 and the g7 haven't really stepped up to play a leadership role in the pandemic yet. they've been largely leader-less and almost leader-proof under president trump, and we are much
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maligned as talk shops and the recent g20 summit was largely true to form, delivering mostly platitudes and some limited action. but let's remember that there was a time when the g7 was a platform for decisive action. in the wake of 9/11, the g7 took steps to enhance global security from hardened cockpit doors to export controls on surface-to-air missiles. in the midst of the aids pandemic, it was the g7 that launched the global fund, putting itself at the forefront of the fight against hiv/aids, malaria and tuberculosis. but the common aspect of all of those actions was that it was u.s. leadership that turned rhetoric into action. so right now the united states should be hammering out a robust action plan for the g7 that calls for a collective
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commitment to sharing the maximum amount of doses possible, that calls for partnership mechanisms, for cost sharing, dose sharing, tech transfer and co-investment. the g7 is an opportunity and we ought to seize that opportunity. >> jeremy, along those lines, you've been asked in congress, isn't this a time for the united states to reassert its leadership role in the world, and the way the administration has responded is that it's a time for the united states to try to help end the pandemic, not necessarily a time for us to reassert our leadership in terms of politics. can't we be in a position to do both? >> i'm not quite sure i see the distinction you're drawing there. the president said very clearly last week that with our approach to global vaccination, the support that's coming in the months ahead, that we're going to use that as a reflection of our leadership and our values. i think you'll see a very strong
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contrast in how the u.s. is approaching global vaccination and how some other countries are approaching it. as the president said, we're not going to trade vaccines for favors. we're going to use our vaccines to accelerate the end of the pandemic. and i think that is -- we're not going to try to beat china and russia at their game because we're not going to play the same game. this is not about using vaccines as leverage for geopolitical, small-scale geopolitical tactical wins. it's about using an aggressive approach to global vaccination as a geostrategic victory for the world at large. so i think the way that we tackle the pandemic is a signal of how the u.s. and how this
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administration seeks to operate in the world. we're going to do so in partnership, we're going to do so working with others, we're going to do so in a way that's driven by values and evidence and science. so i think that i wouldn't draw a distinction, as i think you maybe did, between showing kind of strategic leadership and showing global health leadership. i think the way we are engaging the global health challenge is intentionally reflective of the way we're trying to engage in the world more generally. >> but are we treating it as enough of an existential crisis as julie pointed out before? >> i mean, i think we are putting an unprecedented volume of money on the table, far more than any other donor has. we're working on pulling together all of the different capabilities of the uts u.s. government. the work in south asia over the past few weeks, that was a
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combined effort between u.s. aid, the department of defense, the cdc, pulling in some of the capabilities, other capabilities from health and human services as well, obviously coordinated by our embassy in the state department. so, yeah, i feel like we are rolling out a very robust response. certainly the most robust in terms of funding and in terms of country coverage, probably the u.s. government has ever rolled out globally. and there will be more to come in the months ahead. i think we are very focused right now on taking the resources made available both through the american rescue plan, mobilizing the full force that we have available at the u.s. government, to support countries. but at the same time this is not something -- to take a case like india or some of the other countries that are really struggling, ultimately the u.s.
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can't solve every country's problem on their behalf. it's a partnership. and so the indians have made it very clear to us that they welcome our support, but also this is their challenge to lead. so the u.s. is not leading the response on behalf of india. the indian government and people are leading that and we are supporting wherever we can. that's the posture we're trying to adopt. >> we've got time just for a few final thoughts. let's go around the horn real quick. julie, can we get some final thoughts from you? >> you know, this is a situation where, again, we want to be maybe grateful is the right word for the change in our posture and the progress that's been made. we are in a race, we've got virus and variants and vulnerability on one hand, and we've got vaccine and vigilance on the other. it's too soon to tell how and when that race is going to be won. so the strengthening of the
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leadership and the strengthening of the commitments that our government is making is just really very welcome. we haven't really talked about the role of the private sector in this because i don't 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. so strengthening the mechanisms by which that part of the owe equation is integrated into the planning, not to be called on for our intellectual property or 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 in some of the countries already that we are most interested in, and i think that's an opportunity that we should probably scale and speed up as well. so good news is good direction and much more confidence that we
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can do it. my concern remains that 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 variants that we're seeing. india is an extreme case in point, but i think we're beginning to see the story repeat itself in country after country, and it's very worrisome. >> gary, thoughts from you? >> i just really wanted to thank jeremy for the tremendous work that he's doing during the pandemic. obviously his hands are full and he's got a grasp on all the issues and i wanted to thank steve and julie as well for all they're doing during the pandemic. and as julie just noted, what is required isn't just a whole of government approach, but a whole of nation approach. that's why we formed the covid collaborative, to bring people together reflecting the expertise and diversity of america to turn the tide on the
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pandemic. i think we've seen part of some of that reflected in this panel. government, non-governmental actors coming together at this critical moment. and let's make no mistake about it, it is a critical moment. what we do or don't do today will affect our lives for years to come. as i said before, we need to act boldly and urgently now with hard targets and goals set to prevent the world from splitting into vaccine haves and have not . i think we can show the world, as jeremy was just saying, that what u.s. leadership is about is giving relief to people, not extracting gains from people. thanks so much for having me. >> you're very welcome. steve, final thoughts from you? >> thank you. we have a few extra minutes, i believe, here on our program. what i would like to ask jeremy
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to comment on are two issues where he has particular knowledge and expertise. this week, today starts the world health assembly, and there's going to be, among the multitude of issues that will be debated over the course of the next week, will of course be reform of w.h.o. jeremy has served for many years and contributed substantially to the independent oversight and advisory committee which advises the program. we've seen the speed of response in declaring a public health emergency of international concern. what kind of authority to inspect and to publish results without reference to sovereign oversight. how to move to a digital system that's faster and more reliable data system. how do we move w.h.o. to some
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kind of budgetary stability where it has true capacity and it's not 30% dependent on annual contributions versus 70% on earmarked money. these are a lot of issues to mull over. many of them are old issues we've struggled with. i just wanted to hear, jeremy, what might we bring to the table in the course of this week, and what can we expect in terms of trying to get meaningful changes right now in the middle of a continued emergency, but it's a great moment to think about this? the other issue is cepi, which the coalition epidemic preparedness innovation is a very important institution and it's played a critical role in covax. it's now moving toward a multi-year approach. it wants to not just accelerate the development of vaccines for dangerous pathogens that the
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marketplace is not attending to, but also to look at therapies, diagnostics, and wants to look at innovations in manufacturing. it wants to look at variants, vaccine variant, preparing for vaccine variants. it's looking for the u.s. to support it and become a strong partner. there's a $300 million slot in the american rescue plan, which there was some expectation that that would be going to cepi. there's a proposal for a multi-year contribution, over five years, $200 million per year. there are questions around it, and i would like anything you can tell us in terms of how the administration is looking at this moment in time where this institution created with julie's input and others, scarcely four years ago, it was launched four years ago, and it has a record of achievement. but we're at another one of those moments of creating new things in the midst of all of this and how do we move forward.
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so those are big questions, jeremy, but if you could offer some short answers and give us some insight. we could talk all day about all of these. >> let me run through it in 30 seconds. >> just a few small questions. >> so on cepi, look, i'm not going to get into specifics of potential awards in an open panel, but i will just say i think we see a lot of value in the work cepi has been doing, we've had useful and important conversations with them as we are looking to better understand the landscape for scaling up global vaccine production, particularly some of these issues around how to optimize available supplies and inputs for the production of vaccines, an area where they've been doing important work and we're looking to provide more support. so, yeah, i would absolutely agree on the important role that cepi is playing. on some of the -- just on a few of the other points you raised, on the world health assembly, this is going to be an important
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moment to take stock of several of these important reports that have come out, obviously the report that i helped to contribute to, and the other report has put forth bold and interesting ideas, some of the most forward-leaning that we've seen. but there's going to be a lot -- most of the hard work still lies ahead. this is the moment where member states are going to be hearing those inputs, beginning to deliberate on those inputs and over the coming months hashing through and negotiating through what that all adds up to as we take those proposals and how best to translate those into the reforms that we want to see to the system. and as i mentioned in my prepared remarks, some of the issues we see are the questions of early warning, transparency and shielding all of those decisions as much as we can from some of the political pressures
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that w.h.o. is so often under. the last thing i want to pick up on, and i didn't say enough about this in my earlier remarks, but i do want to emphasize what julie said about the importance of private sector engagement. so i come out of the disaster response background and i'm accustomed when there's a hurricane or earthquake somewhere, the u.s. getting calls from companies saying we want to help, and they'll give a few hundred thousand here or there. i think what we're seeing on the south asia response, is just of an entirely different character. we're seeing the private sector step up and take ownership of the need to end the pandemic in ways that are unprecedented, certainly in my career. and so we've been working closely with the u.s. chamber and with numerous companies now to figure out how do we best take advantage of that. how can the u.s. government and the u.s. and global private
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sectors really partner in a way where we're working together? this is not just the u.s. sort of giving tips to companies on how to effectively donate. this is of a different scale and character where they are taking ownership character and scale where they're really taking ownership and investing in this not as a social responsibility thing but as a business investment. they see the business value -- more than value, the imperative where their business is of epd -- ending this pandemic. we're kind of in uncharted territory of how we leverage that together, but we're in a position to take advantage of it. >> jeremy, thank you so much for all your time. i know you're busy, to say the least. i want to say this has been an incredible panel. being that csis is the biggest
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bipartisan panel in the world, we've seen different administrations take place across the aisle, so it's really nice to see a bipartisan interest in all this. thank you, panel, for your insights today. thank you, audience, for tuning in. today this presentation will be available ondemand and there will be a transcript as well. you can see all that at csis.org. thank you very much. >> thank you, andrew. thanks, everyone. >> thanks, everyone. >> thank you. weeknights we're featuring american history tv programs as a preview of what's available every weekend on c-span3. about 180,000 african-americans, both free and formerly enslaved served in the united states color troops during the civil war. by the end of the conflict made up 10% of the union army. in 2015, civil war living historians and reenactors
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recreated a may 1969 parade of the republic from fifth avenue to freedom plaza near the white house. citizens represented groups of the soldiers who were not allowed to march in the parade 150 years ago. watch american history tv tonight beginning at 8:00 p.m. eastern and every weekend on c-span3. presidential historian doug brinkley has talked with our listeners for the past number of years. he has taught at austin, tulane and university of new orleans. in addition to that, he has spent his past 17 years at rice university in houston. author of some 20 books focusing on subjects from secretary of state dean atchison to jimmy
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carter. >> on this episode of booknotes+, we talked to douglas brinkley. there is a collection of c-span products. browse to see what's new. your purchase will support our nonprofit operations and you still have time to order the congressional directory with contact information for members of congress and the biden administration. go to c-spanshop.org. up next, lawmakers and energy experts talk about ways to expand renewable energy development on public lands during a house subcommittee hearing. good morning, everyone.

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