Compelling Priorities for Global Health, at the Columbia University World Leaders Forum

PLEASE SILENCER CELL PHONES THANK YOU

>>> LADIES AND GENTLEMEN PLEASE SILENCE YOUR CELL PHONES THANK YOU >>> GOOD AFTERNOON AS MANY OF YOU KNOW THIS IS THE WEEK OF COLUMBIA AND WE ARE PRIVILEGED TO WELCOME PRESIDENTS, PRIME MINISTERS AND GLOBAL POLICYMAKERS TO CAMPUS EACH OF THEM A WORLD LEADER WHO COMSAR TO EXPRESS HIS/HER VIEWS AND TO ENGAGE OUR STUDENTS DIRECTLY ON THE MOST PRESSING ISSUES FACING SOCIETIES

FOR SEVERAL REASONS THIS PARTICULAR COLUMBIA WORLD LEADERS FORUM STANDS OUT ON THE CALENDAR AND CARRIES VERY SPECIAL SIGNIFICANCE FOR OUR UNIVERSITY COMMUNITY FIRST AND FOREMOST WE ARE VERY HAPPY TO HAVE THE OPPORTUNITY TO HEAR FROM DRTEDROS WHO BECAME THE DIRECTOR GENERAL OF THE WORLD HEALTH ORGANIZATION IN JULY IN ADDITION TO WELCOMING YOU TO COLUMBIA DRTEDROS , WE OFFER YOU OUR CONGRATULATIONS AND BEST WISHES FOR YOU AS YOU BEGIN YOUR TERM AS DIRECTOR GENERAL

WORLD HEALTH ORGANIZATION IS RESPONSIBLE FOR ADDRESSING THE MOST SERIOUS PUBLIC HEALTH CHALLENGES FACING HUMANITY FROM EMERGING PANDEMICS, ANTIBIOTIC RESISTANT INFECTIONS TO THE HEALTH EFFECTS OF CLIMATE CHANGE INDEED, THESE MATTERS HAVE FOR SOME TIME OCCUPIED FOCUS, AND ATTENTION OF A LARGE NUMBER OF THIS UNIVERSITY'S SCHOLARS ACROSS OUR CAMPUSES AND AT OUR GLOBAL CENTERS WE HAVE BEEN HONORED THAT THE WHO DESIGNATED COLUMBIA'S INTERNATIONAL RESEARCH INSTITUTE IS A PARTNER IN PREDICTING DISEASE OUTBREAKS RESULTING FROM CLIMATE CHANGE DR

TEDROS IS ESPECIALLY WELL- SUITED TO SHOULDER THIS RESPONSIBILITY DURING HIS TENURE AS ETHIOPIA'S MINISTER OF HEALTH HE VASTLY EXPANDED ACCESS TO QUALITY MEDICAL CARE BITE INSTITUTING — BY INSTITUTING FUNDAMENTAL REFORMS IN THE HEALTHCARE SYSTEM HE SERVED AS ETHIOPIA'S MINISTER OF FOREIGN AFFAIRS I KNOW WE ARE ALL LOOKING FORWARD TO HEARING ABOUT HIS PLANS FOR THE WORLD HEALTH ORGANIZATION SECOND, TODAY MARKS THE LAUNCH OF THE NEW COLUMBIA PROGRAM ON GLOBAL HEALTH SECURITY AND DIPLOMACY

THIS IS A CROSS DISCIPLINARY EFFORT INVOLVING THE MEDICAL CENTER, THE SCHOOL OF INTERNATIONAL AND PUBLIC AFFAIRS AND THE EARTH INSTITUTE'S INTERNATIONAL RESEARCH INSTITUTE FOR CLIMATE IT WILL BE LED BY DOCTOR MADELEINE THOMPSON AND DOCTOR WILMOT JAMES WILMOT JAMES WAS A MEMBER OF SOUTH AFRICA'S PARLIAMENT AND PROVIDED LEADERSHIP TO THAT NATION ON A RANGE OF PUBLIC HEALTH MATTERS IN A MINISTERIAL CAPACITY HE IS A VISITING PROFESSOR AT THE COLUMBIA MEDICAL CENTER AND SCHOOL OF PUBLIC AFFAIRS THIRD, THIS EVENT DIVIDES US WITH AN OPPORTUNITY TO TAKE STOCK OF HOW THE UNIVERSITY IS HELPING TO ADDRESS PROBLEMS OF GLOBAL DIMENSION, ESPECIALLY AT THIS CONSEQUENTIAL MOMENT IN WORLD HISTORY

IT IS IMPORTANT FOR COLUMBIA TO BE PONDERING ITS RESPONSIBILITY IN THIS REGARD AND WE HAVE BEEN GLOBAL SOCIETIES CHALLENGES ARE MORE SHARPLY DELINEATED THAN EVER BEFORE ALL I HAVE TO DO IS SAY THAT WITH EMPHASIS AND EVERYONE KNOWS WHAT I MEAN IT HAS BECOME INCREASINGLY CLEAR THAT 20th CENTURY INSTITUTIONS AND NORMS ARE NOT SUFFICIENT FOR ADDRESSING THE COMPLEXITY AND SCALE OF THESE PROBLEMS

WITH THIS IN MIND, WE HAVE LAUNCHED A FAR-REACHING NEW INITIATIVE CALLED CLUMPY AT WORLD PROJECTS — COLUMBIA WORLD PROJECTS IT WILL HAVE A PROFOUND EFFECT IN THE COMING YEARS ITS CENTRAL PURPOSE IS TO HARNESS THE UNIVERSITY'S CAPACITIES AND KNOWLEDGE IN THE SERVICE OF PRACTICAL SOLUTIONS, ALWAYS WITH AN OPENNESS AND AN EMPHASIS ON WORKING ACROSS AND BEYOND DISCIPLINES AND WITH PARTNERS BEYOND ACADEMIA FOLLOWING THE REMARKS OF DR

TEDROS WE WILL HEAR FROM A PANEL THAT INCLUDES ELIZABETH CAMERON WHO IS BECOME THE SENIOR DIRECTOR AT THE NUCLEAR THREAT INITIATIVE AFTER SERVING ON PRESIDENT OBAMA'S SECURITY COUNCIL GAVIN SCHMIDT THE DIRECTOR OF NASA GODDARD INSTITUTE FOR SPACE STUDIES AT THE EARTH INSTITUTE'S INTERNATIONAL RESEARCH INSTITUTE FOR CLIMATE AND ARE WELL KNOWN JEFFREY D SACHS , ALL OF US KNOW AND APPRECIATE THE LEADERSHIP HE HAS PROVIDED TO THIS UNIVERSITY AND TO THE UNITED NATIONS AND BEYOND ON SUSTAINABLE ELEMENT AND FAR MORE WE THANK ALL OF YOU AND OUR SPEAKER DRTEDROS FOR THE CONTRIBUTIONS THAT YOU ARE MAKING TO IMPROVE MOBILE HEALTH AND WELL-BEING

PLEASE JOIN ME IN WELCOMING THE WORLD HEALTH ORGANIZATION'S NEW DIRECTOR GENERAL DRTEDROS [APPLAUSE] >> THANK YOU THANK YOU VERY MUCH FOR THE KIND INTRODUCTION DEAR PRESIDENT BOLLINGER PROFESSOR SACHS, THIS THING WITH COLLEAGUES AND LADIES AND GENTLEMEN, BEFORE I BEGIN MY ADDRESS, LET ME FIRST EXPRESS MY DEEP PERSONAL CONCERN FOR THE PEOPLE OF THE CARIBBEAN ISLANDS

THEY SUFFER THIS RELENTLESS WAVE OF HURRICANES THIS IS A FURTHER REMINDER OF THE MERCILESS SEQUENCES OF OUR CHANGING CLIMATE SHATTERED HOMES, SHATTERED LIVES WHO STANDS READY TO DO ALL WE CAN DO TO ASSIST BUT NOW LET ME TAKE YOU ON A JOURNEY

IT STARTS WITH A SINGLE CASE IN A MILITARY CAMP IN KANSAS A COOK REPORTS TO THE MEDICAL CENTER COMPLAINING OF FEVER A SORE THROAT AND ACHES AND PAINS

WITHIN MINUTES A SECOND SOLDIER IS ADMITTED WITH SIMILAR SYMPTOMS BY LUNCHTIME THE COUNT HAS REACHED MORE THAN 100 AND MORE THAN 500 BY THE END OF THE WEEK THE FOLLOWING WEEK THE VIRUS REACHES NEW YORK MANHATTAN BATTALIONS ARE SENT TO FIGHT A WAR IN FOREIGN LANDS

THE CONFINED LIVING QUARTERS AND MASSIVE MOVEMENTS OF TROOPS PROVIDE THE IDEAL CONDITIONS FOR THE VIRUS TO SPREAD WITHIN MONTHS THE EPITOME SWEEPS ACROSS FIVE CONTINENTS IT'S SYMPTOMS INCLUDE NAUSEA, DIARRHEA, AND DARK SPOTS ON THE CHEEKS THE VIRUS TAKES HOLD, PATIENTS TURN BLUE THEY SUFFOCATE AS THEIR LUNGS FILL WITH BLOOD

THERE ARE NO VACCINES TO STOP THE VIRUS AND NO DRUGS TO TREAT IT MANY OF ITS VICTIMS ARE YOUNG CUTDOWN IN THEIR MOST PRODUCTIVE YEARS SCHOOLS, PLACES OF WORSHIP, THEATERS, AND OTHER PUBLIC PLACES ARE CLOSE

HERE IN NEW YORK BUSINESSES ARE CLOSING, TIMES ARE STAGGERED IN ORDER TO AVOID CONGESTION ON PUBLIC TRANSPORT FUNERALS ARE LIMITED TO — LIMITED TO 15 MINUTES THERE IS A SHORTAGE OF COFFINS AND THEN, AS SUDDENLY AND AS INEXPLICABLY AS IT STARTED, THE PANDEMIC ENDS ONE THIRD OF THE WORLD'S POPULATION HAS BEEN INFECTED

INCLUDING 25% OF THE US POPULATION 50 MILLION PEOPLE ARE DEAD THIS IS NOT SOME FUTURE APOCALYPTIC SCENARIO

THIS HAPPENED, AS YOU MAY KNOW, 100 YEARS AGO THE SO-CALLED SPANISH FLU WHICH MAY IN FACT HAVE STARTED HERE IN THE US IT KILLED MORE PEOPLE THAN THE FIRST OR ITSELF

AND YET IT WAS OVERSHADOWED BY THE WAR AND FADED QUICKLY FROM PUBLIC AWARENESS ITS LESSONS ARE JUST AS RELEVANT TODAY AS THEY WERE THEN THAT A DEVASTATING EPIDEMIC CAN START IN ANY COUNTRY AT ANY TIME AND KILL MILLIONS OF PEOPLE

BECAUSE WE ARE NOT PREPARED BUT, WE DO NOT HAVE TO STRETCH BACK THAT FAR TO BE REMINDED OF THE CONSEQUENCES OF EPIDEMICS, THIS CENTURY WE HAVE WITNESSED OUT BREAKS OF CYRUS, H1N1, VERSE AND 87 AND NINE EACH OF THESE HAS RESULTED IN SICKNESS, FEAR, AND ECONOMIC LOSS OF COURSE THE MOST DRAMATIC EPIDEMIC OF OUR TIME WAS THE EBOLA OUTBREAK OF 2014 AND 2015 ALTHOUGH IT AFFECTED THREE WESTERN AFRICA COUNTRIES, IT EXPOSED FAULTLINES IN GLOBAL HEALTH SECURITY

THAT PUT US ALL AT RISK ITS SEVERITY WAS CAUSED IN LARGE PART BY THE WEAKNESS OF THE HEALTH SYSTEM WHICH WAS ILL-EQUIPPED TO DETECT EBOLA AND WAS STRETCHED BEYOND THE LIMITED CASSA PAT — CAPACITY TO RESPOND IT WAS NOT JUST THE VIRUS ITSELF THE KILLED, IN LIBERIA THE EPIDEMIC CONTRIBUTE TO A DECLINE IN OUTPATIENT VISITS

SIERRA LEONE EXPERIENCED A 39% DROP IN CHILDREN BEING TREATED FOR MALARIA AND 21% DROP IN CHILDREN RECEIVING BASIC IMMUNIZATIONS YOU KNOW WHAT WOULD HAPPEN TO THESE KIDS IN GUINEA PRIMARY MEDICAL CONSULTATIONS AND HOSPITALIZATIONS DROPPED BY MORE THAN HALF AND VACCINATIONS BY ONE THIRD COMPARED TO 2013

IN SHORT, THE WHOLE HEALTH SYSTEMS — SYSTEM COLLAPSED THE SHOCKWAVES OF EPIDEMICS ARE FELT WELL BEYOND THE DEVASTATED FAMILIES AND LONG AFTER THE LAST SURVIVORS LEAVE TREATMENT CENTERS IN 2003 SARS CLOSED UP TO — COST UP TO $59 BILLION ACCORDING TO THE ASIAN DEVELOPMENT BANK IN 2009 THE H1N1 ENDEMIC WHITE 2

8 BILLION OF MEXICO'S TOURISM INDUSTRY AND LED TO A TRADE DEFICIT OF US$27 BILLION AS A RESULT OF THE EBOLA OUTBREAK, THE INTERNATIONAL MONETARY FUND REDUCED ITS GROWTH PROJECTIONS FOR ALL OF SUB-SAHARAN AFRICA BY 10% EBOLA ALSO CAUSED COMMODITY PRICES TO PLUMMET AND LED TO HIGHER UNEMPLOYMENT AND PHYSICAL DEFICITS EBOLA TOLD US A VALUABLE — TAUGHT US A VALUABLE LESSON GLOBAL HEALTH SECURITY IS ONLY AS STRONG AS ITS WEAKEST LINK

I REPEAT, MOBILE HEALTH SECURITY IS ONLY AS STRONG AS ITS WEAKEST LINK LET'S PUT IT ANOTHER WAY NO ONE IS SAFE UNTIL WE ARE ALL SAFE THIS MEANS ALL COUNTRIES NEED TO HAVE RESILIENT AND ROBUST SYSTEMS TO PREVENT, DETECT AND RESPOND TO PUBLIC HEALTH EMERGENCIES AT A NATIONAL LEVEL WE MUST SUPPORT GOVERNMENTS TO BUILD THAT CAPACITY

EVERY MONTH WHO SCREENS AROUND 5000 SIGNALS OF NEW OUTBREAKS ACROSS THE WORLD WE MONITOR THESE CAREFULLY BECAUSE IGNORING ANYONE OF THEM CAN BE THE DIFFERENCE BETWEEN A GLOBAL SPREAD OF THE DEADLY DISEASE AND RAPID INTERRUPTION OF TRANSMISSION

EVERY DAY, SOMEWHERE IN THE WORLD WHO IS OUT IN THE FIELD WITH LOCAL OFFICIALS INVESTIGATING THE POTENTIAL OUTBREAK WHEN AN ALERT SOUNDED EARLY ENOUGH, AS WHEN IT EBOLA ROQUE IN THE DEMOCRATIC REPUBLIC OF THE CONGO EARLIER THIS YEAR, WE CAN MOVE QUICKLY TO SUPPORT GOVERNMENTS AND STOP THE OUTBREAK AT ITS STORES

— SOURCE THAT OUTBREAK IN NEED TO MAKE — WAS CONTAINED IN A FEW WEEKS ALSO, TOO FREQUENTLY THE TRAGEDY OF WAR CREATES THE PERFECT CONDITIONS FOR DISEASE TO SPREAD WHEN INFRASTRUCTURE IS DAMAGED OR DESTROYED, WHEN HEALTH WORKERS ARE TARGETED AND KILLED WHEN ESSENTIAL MEDICINE CANNOT GET THROUGH TO THE PEOPLE WHO NEED IT THE MOST

THE WORLD DEFENSES AGAINST EPIDEMICS START TO CRUMBLE IT WAS NO COINCIDENCE THAT SPANISH FLU, THE GREATEST EPIDEMIC ERUPTED IN THE MIDDLE OF WHAT WAS THEN THE GREATEST WAR THE WORLD HAD KNOWN IT WAS NO COINCIDENCE THAT EBOLA SPREAD IN COUNTRIES THAT HAVE SUFFERED FROM YEARS OF WAR IT IS NO ACCIDENT THAT CHOLERA IS SICKENING THOUSANDS IN YEMEN AS WE SPEAK OF COURSE EPIDEMICS ARE NOT THE ONLY THREAT TO GLOBAL HEALTH SECURITY

NATURAL DISASTERS, CHEMICAL AND BIOLOGICAL ATTACKS, FOOD INSECURITY AND THE EFFECTS OF CLIMATE CHANGE, WILL HAVE THE POTENTIAL TO PUT PEOPLE'S HEALTH AT RISK THAT IS ESPECIALLY TRUE FOR ANTIMICROBIAL RESISTANCE THE WORLD ABILITY TO RESPOND TO INFECTIOUS DISEASE HAS BEEN UNDERMINED BY THE FAILURE TO ENSURE THAT MEDICINES REMAIN EFFECTIVE MANY HAVE BECOME RESISTANT TO THE DRUGS WE HAVE AND FEW REPLACEMENTS ARE IN THE PIPELINE

IN FACT, TODAY WE ARE LAUNCHING A NEW REPORT ABOUT THE STATE OF RESEARCH AND DEVELOPMENT AGAINST SOME OF THE BACTERIA THAT POSE THE BIGGEST THREAT TO HUMAN HEALTH IT SHOWS THE CUPBOARD IS DISTURBINGLY BEAR WE HAVE NOTHING URGENT INVESTMENTS IN RESEARCH AND DEVELOPMENT ARE NEEDED BUT WE ALSO NEED NEW THINKING ABOUT WAYS TO INCENTIVIZE OUR PARTNERS IN THE PHARMACEUTICAL INDUSTRY TO MAKE THOSE INVESTMENTS

BUT RESEARCH AND DEVELOP AND — ACTION IS NEEDED ACROSS ALL SECTORS FOR EXAMPLE WE ARE WORKING CLOSELY TO UNDERSTAND HOW VERSE IS CROSSING FROM ANIMALS INTO HUMANS WE COLLABORATE WITH AGRICULTURAL SECTOR TO DETECT, AND MONITOR AND RESPOND INFLUENCES DENCH INFLUENCE VIRUSES WITH PANDEMIC POTENTIAL AT THE SAME TIME AS WE PREPARE FOR OUTBREAKS AND OTHER EMERGENCIES WE MUST ADDRESS ONE OF THE MOST PERVASIVE CAUSES OF INSECURITY THE LACK OF ACCESS OF THE MOST VULNERABLE PEOPLE TO ESSENTIAL HEALTH SERVICES

THERE ARE TWO SIDES OF THE SAME COIN UNIVERSAL HEALTH COVERAGE IS BASED ON THE MODERN CONVICTION THAT HEALTH IS HUMAN RIGHT, THEY REFUSE TO ACCEPT A WORLD IN WHICH PEOPLE GET SICK AND DIE, SIMPLY BECAUSE THEY ARE POOR IT MEANS SIMPLY PUT, EVERYONE CAN GET THE HEALTH SERVICES THEY NEED, WHEN AND WHERE THEY NEED THEM WITHOUT FACING FINANCIAL HARDSHIP IT SOUNDS OBVIOUS, IF ONLY IT WAS

BUT THE REALITY THAT MORE THAN 400 MILLION PEOPLE AROUND THE WORLD LACK ACCESS TO ESSENTIAL HEALTH SERVICES, THERE ARE SOME PEOPLE WHO ARGUE THAT THE ESTIMATE IS MORE THAN 400 MILLION, AND AT LEAST 100 MILLION PEOPLE ARE PUSHED INTO POVERTY EVERY SINGLE YEAR BECAUSE OF THE COST OF PAYING FOR CARE OUT OF THEIR OWN POCKETS IT IS IMPORTANT TO EMPHASIZE THAT UNIVERSAL HEALTH COVERAGE IS MORE THAN UNIVERSAL HEALTH CARE YES IT INCLUDES CARE, BUT IT INCLUDES — IT ALSO MEANS PEOPLE CAN GET CARE WITHOUT RISKING FINANCIAL RUIN AFTER ALL, WHAT GOOD ARE HEALTH SERVICES IF PEOPLE DON'T USE THEM BECAUSE THEY CAN'T AFFORD THEM? BUT UNIVERSAL HEALTH COVERAGE GOES WITH INDIVIDUAL HEALTH SERVICES, PREVENTING DISEASES AT THE POPULATION LEVEL MANY OF THESE DO NOT NEED HEALTH INFRASTRUCTURE HEALTH WORKERS TO BE EFFECTIVE

SUCH AS TOBACCO TAXATION AND PROMOTING HEALTHY EATING A HEALTH SYSTEM THAT IS DELIVERING UNIVERSAL HEALTH COVERAGE ALSO INCLUDES PERIODIC SERVICES SUCH AS IMMUNIZATION AND SCREENINGS A STRONG NETWORK OF PRIMARY CARE CLINICS, OF EVERYDAY HEALTH NEEDS, AND THE ABILITY TO PROVIDE MORE COMPLEX CARE IN HOSPITALS WHEN WE DESCRIBE HEALTH SYSTEMS IN THESE TERMS, OUR MINDS MAY IMMEDIATELY JUMP TO THE WEALTHY ECONOMIES OF WESTERN EUROPE

BUT WE SHOULD ALSO THINK OF COUNTRIES SUCH AS CHINA, RWANDA, THAILAND, AND TURKEY ALL OF WHICH HAVE MADE STRIDES IN IMPROVING ACCESS AND SERVICES AND IN MAKING THOSE SERVICES AFFORDABLE FOR THEIR PEOPLE TAKE CHINA IN THE PAST 20 YEARS CHINA HAS EIGHT LARGE INVESTMENTS IN ITS HEALTH INFRASTRUCTURE MAKING HEALTH SERVICES MORE EQUALLY ACCESSIBLE TO THE VAST POPULATION

THE RESULT HAS BEEN LARGE DECLINES IN CHILD AND MATERNAL MORTALITY IMPROVED OUTCOMES AND LIFE EXPECTANCY IN RWANDA, HEALTH SYSTEM REFORMS OVER THE PAST 15 YEARS INCLUDING THE PROVISION OF PREVENTIVE SERVICES FREE OF CHARGE TO THE ENTIRE POPULATION IT IS ALSO MEANT MORE MOTHERS SURVIVE CHILDBIRTH AND MORE CHILDREN TO CELEBRATE THEIR FIRST BIRTHDAY RWANDA'S TREATY-BASED INSURANCE COVERS MORE THAN 80% OF THE POPULATION

IN A COUNTRY WHERE 90% OF PEOPLE WORK IN THE INFORMAL SECTOR HERE IS THE POINT FAR FROM BEING A LUXURY, THAT ONLY RICH COUNTRIES CAN AFFORD, EVIDENCE AND EXPERIENCE BOTH SHOW THAT UNIVERSAL HEALTH COVERAGE IS WITHIN REACH FOR ALL COUNTRIES AT ALL INCOME LEVELS EVERY NATION CAN DO MORE WITH THE RESOURCES IT HAS

A RECENT WHO STUDY SHOWS 85% OF THE COSTS OF ACHIEVING HEALTH TARGETS CAN BE MET FROM DOMESTIC RESOURCES THOSE INVESTMENTS WOULD PREVENT 87 MILLION PREMATURE DEATHS GLOBALLY BY 2030

AND ADD AS MUCH AS A POINT FOR YEARS TO LIFE EXPECTANCY IN SOME COUNTRIES — 84 YEARS TO LIFE EXPECTANCY IN SOME COUNTRIES SOME COUNTRIES WILL CONTINUE TO NEED AID BUT FOR THE MAJORITY UNIVERSAL HEALTH COVERAGE IS AFFORDABLE AND ACHIEVABLE MORE THAN THAT, UNIVERSAL HEALTH COVERAGE IS POLITICALLY SMART

BECAUSE JUST AS EPIDEMICS CAN CRIPPLE AN ECONOMY, UNIVERSAL HEALTH COVERAGE CAN HELP IT GROW THE STRONG RESILIENT SYSTEMS ARE INTEGRAL TO STRONG RESILIENT ECONOMIES THE LOGIC IS CLEAR WHEN PEOPLE ARE HEALTHY, ENTIRE COMMUNITIES AND NATIONS THRIVE WHEN CHILDREN SURVIVE TO ADULTHOOD THEY BECOME PRODUCTIVE MEMBERS OF SOCIETY

WHEN WOMEN SURVIVE CHILDBIRTH THEY CAN RETURN TO WORKING OR CARING FOR THE FAMILIES WHEN COMMUNITIES ARE FREE FROM POLLUTION, HARMFUL PRODUCTS AND OTHER CAUSES OF DISEASE, THEY PROSPER IT'S SIMPLE EVERYONE KNOWS THIS TOO OFTEN GOVERNMENTS SEE THE HEALTH SECTOR AS A COST TO BE CONTAINED

THIS IS WRONG HEALTH IS AN INVESTMENT TO BE NURTURED BUT THE INVESTMENT IN HEALTH IS VERY COMPELLING THE WORLD TOP ECONOMISTS ESTIMATE THAT EVERY SINGLE DOLLAR SPENT ON HEALTH YIELDS UP TO US$20 IN FULL INCOME GROWTH WITHIN A GENERATION THE HEALTH SECTOR IS A GROWING SOURCE OF JOBS

AMONG OECD COUNTRIES EMPLOYMENT IN THE HEALTH AND SOCIAL SECTORS GREW BY 48% BETWEEN 2000 IN THE HEALTH AND SOCIAL SECTORS GREW BY 48% BETWEEN 2020 14 WHILE JOBS IN INDUSTRY AND AGRICULTURE DECLINED AND BECAUSE — JOBS FOR HEALTH WORKERS ARE ALSO JOBS FOR WOMEN ALL OF THIS MEANS THAT FOR MOST COUNTRIES, THE ONLY REAL BARRIER IS POLITICAL WILL THE ONLY REAL BARRIER IS POLITICAL WILL

WITHOUT EXCEPTION, EVERY COUNTRY WITH UNIVERSAL HEALTH COVERAGE OR SOMETHING CLOSE TO IT HAS GOTTEN THERE BECAUSE AT SOME POINT IN ITS HISTORY ITS LEADERS ACTED WITH FORESIGHT, COURAGE AND MORAL CONVICTION THAT IS MAKING A DIFFERENCE BETWEEN COUNTRIES NOT RESOURCES THERE IS NO SINGLE PASS EVERY COUNTRY MUST FIND ITS OWN WAY

IN THE CONTRACT — CONTEXT OF ITS OWN CIRCUMSTANCES BUT THE STARTING POINT IS A DETERMINATION TO CREATE A HEALTH SYSTEM THAT ON ONE HAND PROTECTS INDIVIDUALS AND FAMILIES FROM INCAPACITATING ILLNESS AND FINANCIAL CATASTROPHIC AND ON THE OTHER, GUARDS AGAINST HEALTH THREATS THAT CAN CRIPPLE AN ENTIRE ECONOMY SO WHAT CAN WE DO? IN MY FIRST WEEK AS DIRECTOR GENERAL, I WAS HONORED TO BE INVITED TO ADDRESS THE G 20 IN HAMBURG ON THIS VERY TOPIC OF HEALTH SECURITY I WILL TELL YOU WHAT I TOLD THEM FIRST, WE NEED TO SUPPORT COUNTRIES TO MAKE PROGRESS TOWARD UNIVERSAL HEALTH COVERAGE

BY STRENGTHENING HEALTH SYSTEMS, ESPECIALLY IN THE MOST FRAGILE PARTS OF THE WORLD AND THOSE IN THE GRIP OF CONFLICT THIS IS WHAT WHO

DOES ALL AROUND THE WORLD EVERY DAY IT'S NOT ALWAYS GLAMOROUS WORK BUT IT'S EXTREMELY IMPORTANT SECOND, WE MUST PRIORITIZE RESEARCH AND DEVELOPMENT OF NEW MEDICAL COUNTERMEASURES THROUGH THE WHO

BLUEPRINT IT IDENTIFIES THE PATHOGENS THAT ARE THE MOST LIKELY TO SPARK AN EPIDEMIC DEVELOPING NEW VACCINES AND DRUGS IS NOT THE WHOLE SOLUTION BUT IT IS AN IMPORTANT PART OF IT THIRD, IT IS VITAL THAT WE MAP GLOBAL CAPACITIES FOR EMERGENCY PREPAREDNESS AND RESPONSE

UNLESS WE KNOW WHICH COUNTRIES HAVE ITS CAPACITIES, IT'S IMPOSSIBLE TO DEPLOY THEM QUICKLY WHEN A FIRE STARTS, IT'S THE WRONG TIME TO ASK, WHERE IS THE EXTENT SURE? — FIRE EXTINCTION? AND FORTH, REGULAR EXERCISE IS NEEDED TO STRESS TEST OUR PLANS — AND CHECK LOGISTICS THIS IS LIKE A MILITARY DRILL OR A SIMULATION EXERCISE

AGAIN, AN EPIDEMIC IS THE WRONG TIME TO DISCOVER OUR PREPARATIONS HAVE BEEN INSUFFICIENT OR THAT WE HAVE OVERLOOKED CRUCIAL COMPONENTS OF THE RESPONSE FINALLY AND FIFTH, WE NEED TO SUSTAINABLY FINANCE THE GLOBAL HEALTH SECURITY SYSTEM TO PREVENT, DETECT AND RESPOND TO THREATS GOVERNMENTS MUST WALK THE TALK TO ENSURE A GUARANTEED LEVEL OF CONTINGENCY FINANCING FOR HEALTH EMERGENCIES FINANCING WHEN THERE IS PANIC DOESN'T HELP

I THINK WE HAVE TO FINANCE IT DURING NORMAL TIMES AND PREPARE FOR IT DELIVERING ON THESE PRIORITIES WILL COST MONEY BUT ONLY A FRACTION OF WHAT REMAINING UNPREPARED WOULD COST LADIES AND GENTLEMEN, WE DO NOT KNOW WHERE OR WHEN THE NEXT GLOBAL PANDEMIC WILL OCCUR BUT WE DO KNOW THAT IT WILL EXACT A TERRIBLE TOLL

BOTH ON HUMAN LIFE AND ON THE GLOBAL ECONOMY AND EVEN MAY CAUSE POLITICAL INSTABILITY BUT WE DO NOT HAVE TO STAND IDLY BY AND WAIT FOR DISASTER TO STRIKE WE CAN BE PREPARED, OUTBREAKS ARE INEVITABLE BUT EPIDEMICS ARE PREVENTABLE

THIS IS NOT ONLY A JOB FOR THOSE OF US IN THE HEALTH SECTOR, EVERYONE HAS A ROLE TO PLAY FROM THOSE WHO ENSURE THE SAFETY OF OUR FOOD TO THOSE WHO STRIVE FOR HELP IN THE WORLD PREVENTING CONFLICT HELPS PREVENT DISEASE AND PEACE AND SECURITY IS IMPORTANT GUARDING AGAINST EPIDEMICS AND BUILDING RESILIENT SYSTEMS REQUIRES DETERMINED SOULS AND BRIGHT MINDS

TO PREVENT DISEASE AND TO PREVENT CONFLICT THE WORLD IS PROFOUNDLY CHANGING IN A NEGATIVE WAY FOR THOSE REASONS, I'M ENCOURAGED THAT A UNIVERSITY WITH THE STATURE OF COLUMBIA IS LAUNCHING A GLOBAL HEALTH SECURITY AND DIPLOMACY PROGRAM MAYBE A GIFT FOR ME TO EQUIP LEADERS WITH THE KNOWLEDGE AND SKILL TO SOLVE THE CONFLICTS AND CHALLENGES WE FACE I WISH YOU EVERY SUCCESS AND LOOK FORWARD TO WORKING WITH YOU CLOSELY

I THINK YOU THANK YOU VERY MUCH [APPLAUSE] — I THINK YOU THANK YOU VERY MUCH [APPLAUSE]

>>> THANK YOU VERY MUCH TO DRTEDROS FOR HIS LEADERSHIP AT THE WHO AND HIS VISION FOR ADVANCING THE GOALS OF GLOBAL HEALTH MY NAME IS WILMOT JAMES AND I AM A SOUTH AFRICAN MEMBER OF PARLIAMENT HERE AT COLUMBIA UNIVERSITY AS A VISITING PROFESSOR IN NONCLINICAL PEDIATRICS FOR INTERNATIONAL AFFAIRS IT IS A NOVEL JOINT APPOINTMENT IN TIES TOGETHER THE FIELD OF INTERNATIONAL AFFAIRS WITH THE BUSINESS OF MEDICINE AND PUBLIC HEALTH BEFORE I INVITE OUR ESTEEMED RESPONDENTS TO REACT TO THE ADDRESS, IT IS MY PLEASURE TO INTRODUCE YOU TO THE WORKING GROUP ON HEALTH SECURITY AND DIPLOMACY IN THE PROGRAM THAT GOES BY THE SAME NAME

I'M HONORED TO LEAD IT TOGETHER WITH MY COLLEAGUE DOCTOR THOMPSON SINCE JULY I HAVE BEEN WORKING WITH COLLEAGUES IN MEDICINE, PUBLIC HEALTH, CLIMATE SCIENCE, — SCIENCE, AND INTERNATIONAL AFFAIRS IN PUTTING TOGETHER AN INTERDISCIPLINARY AND INTERSEXUAL — — DESCRIBING THE BROCHURE WILL FIND IN YOUR SEAT THE PURPOSE OF THE PROGRAM, AS THIS IS A UNIVERSITY, IS TO EDUCATE AND TRAIN A NEW GENERATION OF HEALTH SECURITY AND DIPLOMACY RESEARCHERS PROFESSIONALS AND LEADERS IN A CONTEXT DESCRIBED WELL BY DR

BOLLINGER AND DRTEDROS BY IMMERSING THEM IN THE BEST AVAILABLE MEDICAL, PUBLIC HEALTH, CLIMATE SCIENCE, AND DIPLOMATIC KNOWLEDGE THERE IS AND WITH A SPECIAL FOCUS ON THE NEEDS AND INTERESTS OF CHILDREN IT IS A GREAT OPPORTUNITY FOR COLUMBIA TO HAVE SUCH A PROGRAM AT A TIME WHEN THE CURRENT ADMINISTRATION IN THE US

SENDS A RATHER SONG — STRONG SIGNAL THAT IT SEEKS TO PULL BACK FROM ITS GLOBAL LEADERSHIP ROLE IN HEALTH THE FACT IS THAT THE WORLD TODAY FACES BOTH OLD AND NEW RISKS TO HEALTH THERE ARE A GLOBAL SCOPE TO ALL OF WHICH — CONTRIBUTE TO MANAGING NO SINGLE INSTITUTION OR GOVERNMENT CAN DO SO ON ITS OWN

IT IS AND MUST BE A SHARED RESPONSIBILITY DRIVEN BY A SINGLE COMMON PURPOSE OF ADVANCING HUMAN HEALTH WORLDWIDE A FOCUS ON THE MEDICINE, THE PUBLIC HEALTH, DIPLOMACY AND HEALTH RISK MANAGEMENT IS PORTRAYED IN THE SLIDE IT IS WITH THIS INTRODUCTION THAT I INVITE DOCTOR JEFFREY D SACHS TO RESPOND

HE REQUIRES NO INTRODUCTION BUT I WILL NEVERTHELESS POINT OUT THAT HE IS A PROFESSOR OF ECONOMICS, THE LEADER OF DEVELOPMENT AND HE IS AN AUTHOR AND COLUMNIST HE IS THE FOUNDER OF THE EARTH INSTITUTE, THE AUTHOR OF THE MILLENNIUM DEVELOPMENT GOALS AND AN ADVISOR AT THE HIGHEST LEVEL TO THE UNITED NATIONS AND GOVERNMENTS WORLDWIDE I'VE ASKED HIM AS I HAVE THE OTHER RESPONDENTS, AS I HAVE TO MODERATE THE PANEL, TO ALLOW FOR DISCUSSION AND QUESTIONS WHICH YOU MAY NOT KNOW IS BY TRADITION ONLY TO BE ASKED BY STUDENTS AT THE END WOULD YOU PLEASE WELCOME DOCTOR JEFF TRAN19

[APPLAUSE]– DOCTOR JEFFREY D SACHS ADOT — [APPLAUSE] >> WELCOME WE ARE IN GOOD HANDS

YOU AGREE? WE ARE IN WONDERFUL HANDS WITH DRTEDROS AT THE HEAD OF WHO

IT'S A CRUCIAL INSTITUTION AT A VERY COMPLICATED TIME I AM PROFOUNDLY GRATIFIED THAT YOU HAVE HIGHLIGHTED EVERY ONE OF THE MAJOR CHALLENGES WE STILL HAVE BASIC CHALLENGES OF THE MOST BASIC HEALTH IN POOR COUNTRIES

STILL 6 MILLION KIDS ARE DYING EVERY YEAR UNDER THE AGE OF FIVE OVERWHELMINGLY IN VERY POOR PLACES, OVERWHELMINGLY OF READILY PREVENTABLE AND TREATABLE DISEASES THAT IS ONE KIND OF CRISIS THAT IS SIGNIFICANT WE HAVE AS YOU SAID, THE EMERGING AND REEMERGING DISEASES WE HAVE BEEN BATTERED NOW THROUGHOUT HUMAN HISTORY, BUT ESPECIALLY IN RECENT DECADES BY ONE NEW DISEASE AFTER ANOTHER REMEMBER THAT AIDS IT SELF IS IT SO GNOSIS OF A CENTURY AGO THAT BECAUSE OF THE MEAGER SURVEILLANCE WAS CIRCULATING IN AFRICA INFECTING MILLIONS AND MILLIONS OF PEOPLE FOR AN ESTIMATED 60 YEARS AND WAS NOT DETERMINED UNTIL IT WAS IDENTIFIED IN SAN FRANCISCO IN 1981

THAT IS A PRETTY PATHETIC AND VERY TRAGIC FACT BECAUSE THE EVENT THAT PROBABLY TRIGGERED THE EMERGENCE OF AIDS TOOK PLACE SOMEWHERE IN WEST AFRICA PROBABLY AROUND 1920 THIS IS HOW BAD SURVEILLANCE IS THE RISKS ARE OBVIOUS THE IRONY OF PUBLIC HEALTH IS IT IS SUCH AN INCREDIBLY GOOD FIELD

IT IS SO CAPABLE SO SMART YOU GET AN INCREDIBLE AMOUNT FOR VERY LITTLE IT'S NOT A LOT OF MONEY TO SAVE MILLIONS OF LIVES PER YEAR AND YET RAISING THAT LITTLE AMOUNT OF MONEY IS SOMETIMES UNBELIEVABLY DIFFICULT

HOW BIG THE FIGHTS WERE TO GET AIDS TREATMENT STARTED HOW BIG THE FIGHTS WERE TO GET SOME KIND OF ORGANIZED MALARIA RESPONSE A BIG THE FIGHTS ARE RIGHT NOW TO HELP POOR COUNTRIES TO DEPLOY COMMITTEE HEALTH WORKERS I HAVE BEEN ON THIS NOTE TOGETHER WITH MY WIFE WHO AS YOU KNOW LEADS A CAMPAIGN FOR COMMUNITY HEALTH WORKERS, WORLDWIDE, AND EVEN IN THE MIDDLE OF THE WORLD — IRBIL AND IT — BOLA — IRBIL EPIDEMIC IT WAS NOT CLEAR TO GET RESPONSE IT WAS PATHETIC

THE WORLD BANK WHICH I AM ON A EMAIL EXCHANGE WITH TODAY CANNOT PUT ONE FOOT IN FRONT OF THE NEXT TO ACTUALLY GET FINANCING OUT GLOBAL FUND, WHICH I HELPED START 17 YEARS AGO, AND WHICH DRTEDROS CHAIRED FOR A BRILLIANT PERIOD, SOMETIMES CAN'T MOVE EVEN WHEN IT'S ABSOLUTELY URGENT TO MOVE THEN THERE ARE THE COMPLEXITIES AND CHALLENGES THAT ARE QUITE DIFFERENT FROM THOSE OF POVERTY THOUGH THEY ARE SPREADING TO POOR COUNTRIES

AS YOU SAID, THE FOOD INDUSTRY IS KILLING US THIS IS QUITE HARD BECAUSE THE FOOD INDUSTRY IS POWERFUL IT HAS VAST LOBBYING AND IT IS AN INDUSTRY THAT PRODUCES OBESE GENERIC PRODUCTS — OBESE PRODUCTS AND HAS MADE ADULT AMERICANS ADDICTED TO UNHEALTHY THINGS OF COURSE, THE MORE YOU TRAVEL THE WORLD THE MORE YOU COME BACK TO THE UNITED STATES AND SAY, THAT IS NOT FOOD

WHAT WE SEE HERE IS NOT FOOD IT IS ORGANIC PROBABLY, MOSTLY BUT IT IS NOT FOOD AND IT IS HORRIBLE THIS IS ONE OF THE GREAT HEALTH THREATS WE FACE BUT IT IS VERY POLITICAL JUST AS TOBACCO IS VERY POLITICAL

EVEN WHEN YOU KNOW IT, YOU CAN IDENTIFY, YOU KNOW THAT SUGAR BEVERAGES ARE HORRIBLE FOR HEALTH AND FOR MENTAL WELL- BEING AND FOR MANY OTHER THINGS WE CAN'T MOVE BECAUSE MODERN CAPITALISM, I ALWAYS SAY I WANT TO BE IN A BUSINESS NEXT TIME THAT HAS AN ADDICTIVE PRODUCT YOU GET LOTS OF CUSTOMERS ALL THE TIME THIS IS HOW OUR SYSTEM WORKS

BUILD ADDICTIONS, MAKE A LARGE PROFITS, HIGHER LOTS OF LOBBYISTS, AND SUSTAIN THE ADDICTION AS LONG AS POSSIBLE, WHETHER IT'S TO BACA — TOBACCO, SODA OIL AND GAS AND COAL IT'S BASICALLY THE SAME MODEL WE ALSO HAVE A BIG PROBLEM OF RESEARCHING — RESEARCH AND DEVELOPMENT THE US

IS INCREDIBLY PRODUCTIVE RIGHT NOW WORLD SCIENCE IS INCREDIBLY PRODUCTIVE IN NEW RESEARCH BUT WE'RE GOING BACKWARDS ON BRINGING THE RESEARCH TO ACCESS AS WE HAVE PRIVATIZED RESEARCH RECENTLY, AND BIG PRIVATE MONEY GOES INTO RESEARCH WHICH IS A TRIBUTE TO OUR CAPITAL MARKETS, WE ARE PRODUCING MORE AND MORE RAKE THROUGH DRUGS THAT ARE BEING PRICED — BREAKTHROUGH DRUGS WHICH ARE BEING PRICED AT $100,000, NOW THE NEW CANCER DRUGS ARE AT $500,000 PER TREATMENT DOSE THIS IS REALLY BROKEN

WE HAVE A CURE FOR HEPATITIS C WHICH IS A WONDERFUL DRUG DEVELOPED BY A SMALL BIOTECH COMPANY WITH NIH SUPPORT IT WAS PURCHASED IN 2011 FOR $11 MILLION THIS CHEMICAL, IT PASSED THE FINAL PHASE 3 TRIALS AND THEN GILEAD — SINCE 2012 THE PILLS COST ONE DOLLAR TO MAKE

THEY CHARGE $1000 PER PILL IT IS SEVEN WEEKS, 84 PILLS FOR A TREATMENT DOSE FOR WHAT COSTS $84 TO MANUFACTURE, THEY ARE CHARGING $84,000 OF COURSE, THERE ARE SOME DISCOUNTS, THEY ALWAYS TELL ME IT'S ONLY $40,000 IF YOU TAKE THE DISCOUNTS THE STRATEGY IS, WE HAVE A SYSTEM WHERE THERE ARE TWO OR 3 MILLION HEPATITIS C INFECTED PEOPLE

THEY ARE DYING SLOWLY OF LIVER DISEASE AND THE GOVERNMENT IS THE ONLY PROVIDER REALLY, EXCEPT FOR SOME HIGH-COST PRIVATE INSURANCE, AND THE GOVERNMENT SAYS YOU HAVE TO BE PRETTY FAR GONE BEFORE WE'RE GOING TO TREAT YOU AND SO PEOPLE ARE BASICALLY TOLD, WHEN YOU ARE NEAR DEATH COME BACK THEN YOU CAN GET THIS DRUG IF THIS DRUG OR MASS SUPPLIED WOULD ACTUALLY AND HEPATITIS C BECAUSE THIS IS A FULL CURE

THIS IS NOT LIKE HIV THIS IS A FULL CURE WE COULD BREAK TRANSMISSION, WICKED AND THE DISEASE THIS IS A HORRIFIC — WE COULD BREAK THE DISEASE THIS IS A HORRIFIC MISAPPLICATION OF PATENT RIGHTS

HORRIFIC I FIND IT FASCINATING WHEN I WRITE ABOUT IT I GET LOTS OF HATE MAIL FOR — HATE MAIL FROM WALL STREET THEY SAY WHAT ARE YOU TALKING ABOUT? I OFTEN WRITE BACK, PEOPLE ARE DYING AND SERIOUS PEOPLE RIGHT BACK, SO? AND I WRITE PEOPLE ARE DYING LARGE NUMBERS

SO, THAT'S HOW THE SYSTEM WORKS CAN'T GET OVER IT AND THAT REALLY IS A MENTAL DISEASE BECAUSE THAT IS NOT A SYSTEM NOT A SYSTEM THAT IS PRODUCING RESULTS IF WE PROVIDE LOTS OF WONDERFUL NEW $500,000 TREATMENTS FOR CANCER, THAT IS NOT A SYSTEM THAT IS DOING WHAT IT NEEDS TO DO

THIS IS YET ANOTHER CHALLENGE BECAUSE WE ARE ON AN ABSOLUTE SCIENTIFIC REVOLUTION RIGHT NOW WE DO NOT HAVE A MODEL OF SOCIAL JUSTICE TO GO ALONG WITH THE SCIENTIFIC REVOLUTION ALL OF THIS IS TO SAY THAT YOU HAVE YOUR HANDS FULL WE LOVE YOU AND WE WANT TO HELP YOU THANK YOU

[APPLAUSE] >> THANK YOU VERY MUCH IF I COULD NOW CALL ON BETH CAMERON WHO IS THE SENIOR DIRECTOR, GLOBAL BIOLOGICAL POLICY AND PROGRAMS, NUCLEAR THREAT INITIATIVE , SHE PREVIOUSLY SERVED AT THE NATIONAL SECURITY COUNCIL IN THE PREVIOUS ADMINISTRATION WHERE SHE WAS INSTRUMENTAL IN LAUNCHING THE GLOBAL HEALTH SECURITY AGENDA AND WORKED IN THE FOLLOWING AREAS, BIO SECURITY, BIO DEFENSE, EMERGING INFECTIOUS DISEASES, RESEARCH AND BIOTERRORISM[APPLAUSE] >> ON THANK YOU — THANK YOU FOR INVITING ME IN HOSTING THIS EVENT AND MOST IMPORTANTLY DR

TEDROS THANK YOU FOR YOUR LEADERSHIP WHAT I'M GOING TO SPEAK ABOUT IS A LITTLE BIT ABOUT THE FUTURE OF THE GLOBAL HEALTH SECURITY AGENDA WHICH IS AN ORGANIZATION OF COUNTRIES, NONGOVERNMENTAL ORGANIZATION, THE PRIVATE SECTOR AND NEXT GENERATION LEADERS THAT EXIST TO SUPPORT THE WHO EFFORT TO IMPLEMENT THE REGULATIONS

WHAT YOU SEE IS THAT EVERYTHING I'M GOING TO SAY STRESSES AND EMPHASIZES WHAT WE HAVE HEARD FROM YOU AND YOUR GREAT LEADERSHIP AT WHO FIRST, IN GLOBAL HEALTH SECURITY, W

HO LEADERSHIP IS ESSENTIAL NOT ONLY WH

O BUT ALSO THE WORLD ORGANIZATION FOR ANIMAL HEALTH AND THE FOOD AND POSITIONAL — OF THE UN IS A GREAT LEADERSHIP THAT HAPPENS BETWEEN THE ORGANIZATIONS WHICH IS INCREDIBLE TO SEE AN ABSOLUTELY ESSENTIAL TO THE CHALLENGES THAT DRTEDROS OUTLINED I DON'T HAVE TO CONVINCE THIS AUDIENCE, AFTER HEARING FROM DR

TEDROS THE PANDEMICS ARE CRITICAL I THINK THE STORY YOU TOLD OF THE 1918 FLU WAS THE MOST POIGNANT FLEXION OF THIS ISSUE BUT I DO THINK IT IS IMPORTANT AT AN ACADEMIC UNIVERSITY AND THOSE OF YOU IN THE AUDIENCE WHO MAY NOT BE IN GOVERNMENT TO THINK A LITTLE NOT ONLY ABOUT HEALTH AND HOW HEALTH IMPACTS SECURITY AND NATIONAL SECURITY AS A STAFFER IN THE WHITE HOUSE DURING THE EBOLA CRISIS, I SAW FIRSTHAND HAPPENS TO HEADS OF STATE IN GOVERNMENT FAR FROM AFFECTED COUNTRIES WHO ARE HAVING A HARD TIME WRAPPING THEIR HEAD AROUND WHAT THE EBOLA OUTBREAK IN WEST AFRICA MIGHT MEAN FOR THEM THERE WAS ABSOLUTELY AND NEED FOR INTELLECTUAL CAPITAL COMING OUT OF OUR UNIVERSITIES, COMING OUT OF OUR CIVIL SOCIETY TO INFORM THE GOVERNMENT IN THAT SITUATION

I'M SO PLEASED TO HEAR ABOUT THE NEW CENTER BEING LAUNCHED HERE TODAY I THINK HEALTH DIPLOMACY IS GOING TO BE A VITAL FIELD FOR THE FUTURE AND I ENCOURAGE SOME OF THE STUDENTS IN THE AUDIENCE TO CONSIDER THAT WE NEED YOU AND WHO

NEED YOU THE GLOBAL HEALTH SECURITY AGENDA IS A VOLUNTARY ORGANIZATION OF COUNTRIES LAUNCHED AFTER THE FIRST CASES OF EBOLA OCCURRED IN GUINEA BUT BEFORE THEY WERE REPORTED TO WHO

THIS IS PUT TOGETHER IN RESPONSE TO THE FACT THAT LESS THAN 20% OF COUNTRIES ACTUALLY MADE THE DEADLINE FOR LAMENTING THE WHO HEALTH REGULATIONS

THE GHS A WAS LAUNCHED IN FEBRUARY IN FEBRUARY 2014 WITH A NUMBER OF LIKE-MINDED COUNTRIES WITH A NUMBER OF BACKGROUNDS AND HEALTH SYSTEMS WITH THE IDEA THAT COUNTRIES AND SECTORS, NOT JUST THE HEALTH SECTOR BUT MINISTRIES OF FINANCE, FOREIGN AFFAIRS, DEFENSE, NEEDED TO COME TOGETHER TO TALK ABOUT ALL OF THE DIFFERENT ASSETS OF MOBILE HEALTH SECURITY FROM NATURAL THREATS TO BIOTERRORISM COUNTRIES WERE ASKED TO MAKE SPECIFIC COMMITMENTS THOSE WERE ASKED TO BE MADE AND REPORTED BACK ON OVER A PERIOD OF TIME THE GOAL THERE WAS REALLY TO RAISE ATTENTION TO THE LEVEL OF HEADS OF STATE HAS BEEN VERY SUCCESSFUL AS DR

TEDROS MENTIONED THE G20 AND G7 HAVE FOCUSED ON THIS FOR THE LAST COUPLE OF CYCLES IT IS VITAL TO BE MAINTAINED AND HAPPY IT'S HAPPENING HERE BECAUSE THIS IS AN ISSUE THAT NEEDS TO STAY ON THE RADAR SCREEN OF HEADS OF STATE, — JUST LIKE OTHER TRANSNATIONAL THREATS ALSO TO INCENTIVIZE ACCOUNTABILITY

ACCOUNTABILITY WITHIN GOVERNMENTS FOR THEIR OWN HEALTH SYSTEM BUT ALSO ACCOUNT ABILITY FOR THOSE WHO SAY AND MAKE COMMITMENTS THEY ARE GOING TO HELP OTHERS HOW IS THAT HAPPENING? HOW IS IT HAPPENING IN COUNTRY AND OUR DONORS COURT MEETING AND TRACKING PROGRESS TOGETHER — THIS IS SOMETHING I HAVE HEARD FROM GLOBAL HEALTH LEADERS ACROSS THE BOARD IT'S REALLY IMPORTANT TO BE ACCOUNTABLE

ULTIMATELY THE BACKGROUND OF THIS SLIDE IS NOT BECAUSE IT'S A PRETTY COLOR, IT'S THE COVER OF A REPORT THAT WAS PUT OUT EARLIER THIS YEAR CALLED THE INTERNATIONAL WORKING GROUP ON PANDEMIC FINANCING YOU HEARD THE ABSOLUTE IMPORTANCE OF FINANCING HEALTH AND HEALTH THE SECURITY — AND HEALTH SECURITY IT'S NOT JUST ABOUT ASKING FOR MONEY, IT'S ABOUT SUSTAINING CAPABILITY OVER A LONG-TERM PERIOD TONELLI TO BREAK THE CYCLE WHERE WE PANIC WHEN WE HAVE AN OUTBREAK AND SPEND LOTS OF MONEY AND THEN NEGLECT THE PERIOD WE DON'T HAVE ONE WERE THE INVESTMENTS ARE LESS COSTLY AND MORE IMPORTANT

THE GLOBAL HEALTH SECURITY AGENDA IN CLOSE PARTNERSHIP WITH THE WHO HAS MADE A NUMBER OF ACHIEVEMENTS THE ONE I QUICKLY I WANT TO HIGHLIGHT , ACTUALLY I WILL HIGHLIGHT TWO OF THEM, THE IMPORTANCE OF METRICS

THROUGH THE GLOBAL HEALTH SECURITY AGENDA WORKING WITH WHO, A SET OF TARGETS HAVE BEEN ADOPTED FOR THE INTERNATIONAL HEALTH REGULATIONS WHICH HAVE BEEN FOLDED INTO THE WH

O DEVALUATIONS FOR HR IMPLEMENTATION THIS PROCESS WAS CRITICAL IF YOU WOULD'VE ASKED ME WHEN WE LAUNCHED GHSA IF WE WOULD'VE GOTTEN TO THIS POINT, AND IF YOU'D ASKED MOST OF OUR COLLEAGUES AT WH

O, THEY WOULD'VE SAID NO HAVING ASSESSORS COME INTO COUNTRIES AND LOOKING AT HEALTH CAPACITY AND PUBLISHING THE RESULT, IT'S NEVER GOING TO HAPPEN BUT IT HAS HAPPENED

WHO HAS A HUGE TEAM THAT HAS NOW DONE ASSESSMENTS IN 50 COUNTRIES WORKING WITH EXPERTS AROUND THE WORLD THAT NEEDS TO CONTINUE

I KNOW IT IS BEING STRONGLY SUPPORTED UNDER DRTEDROS' LEADERSHIP GHSA HAS BECOME A PLATFORM FOR BRINGING IN THE PRIVATE SECTOR, ACADEMIC UNIVERSITY AND CIVIL SOCIETY THAT IS THE PLACE WHERE ORGANIZATIONS LIKE THE CENTER BEING LAUNCHED HERE TODAY AT COLUMBIA CAN PLAY A CRITICAL ROLE HOW DO YOU TAKE SPECIFIC GOALS IN GLOBAL HEALTH SECURITY, RALLY COMMUNITIES AROUND THEM IN A MEASURABLE WAY, AND THEN ACTUALLY MONITOR AND EVALUATE THE PROGRESS OVER TIME? THAT IS ONE OF THE QUESTIONS WE ASKED WHEN GHSA WAS LAUNCHED

IT'S A PLACE WHERE PROGRESS HAS BEEN MADE BUT A LOT MORE PROGRESS, ESPECIALLY FROM THE NONGOVERNMENTAL SECTOR NEEDS TO CONTINUE I MENTIONED THE JOINT EXTERNAL EVALUATIONS AND ON THE RIGHT SIDE OF THE SLIDE IS AN EXAMPLE OF WHAT ONE OF THE EVALUATIONS RESULTS LOOKS LIKE I HIGHLIGHT THIS EXAMPLE BECAUSE IT'S WHAT MOST COUNTRIES LOOK LIKE THERE'S A LOT OF YELLOW, A LITTLE GREEN, AND SOME RED THE GOAL HERE IS TO TURN ALL OF THAT READ AND YELLOW INTO GREEN

— THAT COLOR RED AND YELLOW INTO GREEN THE LAST THING I WILL SAY QUICKLY, I WILL HIGHLIGHT THREE CHALLENGES IN GLOBAL HEALTH SECURITY THAT I THINK THE GLOBAL HEALTH SECURITY AGENDA IS FOCUSED ON I KNOW ALSO WHO

IS FOCUSED ON AS WELL LEVERAGING THE COMMITMENTS THAT ARE OUT THERE THROUGH THE LAST COUPLE OF G7 AND G 38 — G20 CYCLES MANY HIGHLIGHTS HAVE BEEN MADE THIS IS ONE EXAMPLE, THE G7 HAS MADE A COMMITMENT TO ASSIST 76 COUNTRIES TO IMPLEMENT THE INTERNATIONAL HEALTH REGULATIONS THAT IS A FANTASTIC A MINUTE

IT'S REALLY HARD TO TRACK DOWN WHO HAS DONE WHAT OFFER HOW LONG AND TO MEASURE THE RESULTS I THINK THAT IS ANOTHER PLACE WHERE CIVIL SOCIETY CAN HELP THE MEASURING RESULTS, BY LOOKING AT WHAT'S BEEN DONE AND FOR HELPING KEEP COUNTRIES ON TRACK FOR THE COMMITMENT THEY MADE SECOND, I MENTIONED ACCOUNTABILITY I THINK IF YOU LOOK AT WHAT THE ULTIMATE GOAL IS, THERE WILL BE AN EXTERNAL EVALUATION IN EVERY COUNTRY

EVERY COUNTRY WILL HAVE A NATIONAL PLAN BY EVERY COUNTRY I DON'T JUST MEAN COUNTRIES THAT HAVE HAD MORE CHALLENGES TO THEIR HEALTH SYSTEM, I MEAN EVERY COUNTRY THE UNITED STATES WENT THROUGH A JOINT EXTERNAL EVALUATION WHEN I WAS AT THE WHITE HOUSE AND WE FOUND PROBLEMS THAT NEEDED TO BE FIXED HAVING A NATIONAL PLAN, FINANCING A NATIONAL PLAN, HAVING THE POLITICAL COMMITMENT TO KEEP THE FINANCING GOING AND THEN ULTIMATELY CONTINUING EFFORT BY HELPING OTHERS TO GET PREPARED THE NONGOVERNMENTAL GLOBAL HEALTH SECURITY CONSORTIUM PUT OUT A CALL FOR THE UPCOMING MINISTERIAL FOR GHSA WHICH WILL BE HELD NEXT MONTH

WE ASKED THAT BY 2019 COULD 75 COUNTRIES REALISTICALLY HAVE A NATIONAL PLAN BASED ON THE WORK WHO IS DOING? COULD THOSE NATIONAL PLANS BE FINANCED? COULD THERE BE A FINANCIAL STRATEGY IN PLACE? THIS IS A HUGE HOLE A LOT OF PEOPLE THOUGHT IT MIGHT NOT BE ACHIEVABLE

BUT I ASK THOSE OF YOU IN THE AUDIENCE AND DRTEDROS TO CONSIDER THIS GOAL, BECAUSE ULTIMATELY IF IT COUNTRY HAS A FINANCED NATIONAL PLAN IT'S MORE LIKELY THEY WILL BE ABLE TO IMPLEMENT IT AND GET PREPARED FINALLY, JUST TO REALLY EMPHASIZE AND FOOT STOMP A POINT THAT DRTEDROS MADE, WHICH IS LOOKING AT HEALTH SECURITY IS REALLY IMPORTANT IN AND OF ITSELF

BUT IT'S VITAL TO LOOK AT HEALTH SECURITY AND THE BROADER CONTEXT OF HEALTH SYSTEMS ACROSS THE BOARD AND ALSO UNIVERSAL HEALTH COVERAGE THESE ARE ISSUES LEADERS HAVE FOCUSED ON OVER THE LAST SEVERAL YEARS MORE AND MORE UNDER DRTEDROS' LEADERSHIP AND WITH CONTINUING INTEREST FROM COUNTRIES AROUND THE WORLD UNIVERSAL HEALTH COVERAGE IS BECOMING AN IMPORTANT ISSUE GLOBAL HEALTH SECURITY SHOULD NOT COMPETE WITH THIS

IT SHOULD COMPLEMENT THIS TEAM PREPARED FOR PANDEMIC THREATS IS PART OF YOUR OVERALL HEALTH SYSTEM AND PART OF ACCESS TO SERVICES HE SAW HOW THOSE WERE INTERTWINED UP CLOSE AND PERSONALLY DURING THE EBOLA OUTBREAK URGING THOSE OF YOU THAT WORK IN THIS FIELD TO THINK ABOUT THESE NOT AS COMPETING PRIORITIES BUT AS THREE AREAS THAT ACTUALLY ALL NEED TO GET ATTENTION AND FOCUS I WILL STOP THERE AND SAY I'M INCREDIBLY PLEASED TO BE THERE — INCREDIBLY PLEASED TO BE HERE AND THANK YOU DR

TEDROS FOR COMING[APPLAUSE] >> I MUST SAY THAT THE PANELISTS ARE EXTREMELY DISCIPLINED THANK YOU VERY MUCH THANK YOU FOR YOUR CONTRIBUTION

THE FINAL RESPONDENT IS DOCTOR GAVIN SCHMIDT CLIMATE SCIENTIST AND DIRECTOR, NASA/GODDARD INSTITUTE FOR SPACE STUDIES, THE EARTH INSTITUTE, COLUMBIA UNIVERSITY HE WORKS IN UNDERSTANDING THE DRIVERS OF CLIMATE CHANGE HE WAS A WINNER OF THE ADU CLIMATE COMMUNICATION PRIZE IN 2011 HIS 2010 TED TALK HAS BEEN SEEN BY MORE THAN 1 MILLION PEOPLE THINK YOU FOR COMING

[APPLAUSE]- – THANK YOU FOR COMING[APPLAUSE] >> THANK YOU VERY MUCH HONORED PANELISTS, RESPECTED GUEST'S I'M GOING TO TALK A LITTLE BIT ABOUT CLIMATE CHANGE AND THE IMPACT THAT THAT HAS ON HUMAN HEALTH AND WELL-BEING NASA IS ONE OF THE LEAD AGENCIES THAT MONITORS CLIMATE CHANGE, THAT STUDIES THE PROCESSES THAT UNDERLIE OUR UNDERSTANDING OF HOW THE CLIMATE SYSTEM AND WORTH IT — EARTH SYSTEM WORK

IT BUILDS THE MODELS USED — TO UNDERSTAND WHY THINGS HAVE CHANGED BEFORE AND WHY THEY ARE CHANGING NOW CLIMATE CHANGE IS OFTEN THOUGHT OF AS A PURELY PHYSICAL PHENOMENA CHANGES IN THE TEMPERATURE, THE RAINFALL, THE WINDS THE STORMS BUT AT ITS HEART, CLIMATE CHANGE IS A HUMAN PROBLEM

BECAUSE ALL OF THOSE THINGS DO NOT OCCUR IN A VACUUM THEY DO NOT OCCUR ON A PLANET WHERE THERE IS NO SOCIETY OR NEW INFRASTRUCTURE ARE CONCERNS — ARE CONCERNS ABOUT CLIMATE CHANGE — ARE CONCERNS ABOUT CLIMATE CHANGE ARE ASSOCIATED NOT WITH JUST THE INTELLECTUAL PURSUIT OF UNDERSTANDING, BUT WITH THE VERY REAL IMPACT THAT CLIMATE CHANGE HAS ON PEOPLE, SOCIETIES, AND ECOSYSTEMS WHEN IT COMES TO HUMAN HEALTH, THE IMPACTS OF CLIMATE CHANGE RANGE FROM THE OBVIOUS AND PERHAPS NOT THAT SERIOUS, TO THE INDIRECT AND PERHAPS DEVASTATING WE CAN ALL THINK OF WHAT HAPPENS TO HUMAN HEALTH IN PLACES WHERE THERE ARE GREATER NUMBERS OF HEAT WAVES

PEOPLE WHO SUFFER THROUGH HEAT, A CLASSIC EXAMPLE IN EUROPE IN 2003 TENS OF THOUSANDS OF PEOPLE DIED PREMATURELY BECAUSE OF THE HEAT WAVE AND AN INSUFFICIENT AMOUNT OF OPERATION, AIR- CONDITIONING, AND LOOKING AFTER PEOPLE WE COULD SEE PEOPLE DROWNED WHEN THERE ARE FLOODING EVENTS WE CAN SEE PEOPLE INJURED BY STRONG WINDS THIS LAST MONTH HAS BEEN A CATALOG OF DIRECT WEATHER, PERHAPS CLIMATE IMPACT OF EVENTS, TAKING A TOLL ON HUMAN HEALTH

BUT I THINK THE MORE WORRYING AND CONCERNING ASPECTS ARE THE INDIRECT ONES WHAT HAPPENS TO INFRASTRUCTURE WHEN THERE ARE INCREASES IN INTENSE PRECIPITATION? WHAT HAPPENS TO INFRASTRUCTURE WHEN THERE ARE INCREASING NUMBERS OF THE HEAT WAVES? WHAT HAPPENS TO SOCIETIES AND SYSTEMS AND UTILITIES AND POWER LINES AND SEWAGE SYSTEMS WHEN THERE ARE LARGE FLOODING EVENTS? THOSE ARE THE KINDS OF INDIRECT IMPACTS THAT LEAD DIRECTLY TO HEALTH CONSEQUENCES ONE OF THE BIGGEST PROBLEMS IN MIAMI, IN MIAMI-DADE COUNTY IS THE FACT THAT WHEN THERE IS FLOODING, THERE IS AN ENORMOUS AMOUNT OF SEWAGE THAT IS KEPT IN SEPTIC TANKS BECAUSE MOST OF THE HOUSES ARE NOT CONNECTED TO PROPER SEWAGE LINES SO WHEN THE WATERS FLOOD AND RISE, IT'S NOT WATER, IT'S SEWAGE IN HOUSTON, WHEN THE WATERS ROSE THEY FLOODED CHEMICAL PLANTS AGAIN PRODUCING SLICKS OF NOT WATER BUT TOXIC POLLUTANTS

THESE ARE VERY DIRECT HEALTH IMPACTS ON THE POPULATIONS THERE ARE OTHER ASPECTS, THEIR DISEASE VECTORS, PESTS, PARASITES, WHOSE LIFECYCLE DEPENDS ON CERTAIN ASPECTS OF THE CLIMATE THE TEMPERATURE WHETHER IT GETS COLD DURING THE WINTER OR NOT IS A BIG FACTOR IN THE PINE BEETLE OUTBREAK AGAIN, WHICH IS LEADING TO INCREASED RISK OF FIRE, ANOTHER HEALTH IMPACT

THE INDIRECT IMPACTS OF CLIMATE CHANGE ON SYSTEMS THAT ARE PERHAPS ALREADY STRESSED BY MANY OTHER STRESSORS, ARE GOING TO BE, AND THIS IS A PREDICTION, ARE GOING TO BE THE BIGGEST IMPACT NOW OUR ABILITY TO ASSESS THE COSTS AND DAMAGES ASSOCIATED WITH THESE INDIRECT IMPACTS OF CLIMATE CHANGE IS AT ITS INFANCY THERE'S GREAT WORK BEING DONE AT THIS UNIVERSITY AND OTHERS ON TRYING TO LINK THESE THINGS TOGETHER AND TO TRY AND GET ESTIMATES OF THE INDIRECT COSTS IT IS STILL VERY MUCH A WORK IN PROGRESS AND ONE HOPEFULLY THAT THE NEW INSTITUTE WILL BE ABLE TO ADDRESS MORE THOROUGHLY

WE CAN ALSO STEP BACK A LITTLE, WHAT ARE THE CAUSES OF CLIMATE CHANGE? WHAT ARE WE ACTUALLY DOING TO CREATE CLIMATE CHANGE? WE ARE BURNING FOSSIL FUELS AND WEIRD BEFORE STATING– BEFORE STING — D4 STATION THOSE ACTIONS IN THEMSELVES HAVE OTHER DIRECT IMPACTS WHEN YOU BURN FOSSIL FUELS, YOU PRODUCE SMOKE IN GREATER NUMBERS OF BRONCHIAL PROBLEMS AND ASTHMA ASSOCIATED WHEN YOU INCREASE THE AMOUNT OF CARBON DIOXIDE IN THE AIR AND THE ACIDITY OF THE OCEAN AFFECTING COMMUNITIES AND ECOSYSTEMS, ALL ACROSS THE SURFACE WHEN WE CHANGE HOW WE PRACTICE AGRICULTURE, WE INCREASE THE AMOUNT OF NITRATES IN THE SYSTEM, THAT GOES INTO THE WATERWAYS AND IMPACTS ALGAE AND BLUES AND HUMAN HEALTH WHEN WE'RE LOOKING FORWARD IN SEEING WHAT OUR CHOICES ARE AS SOCIETIES TO MITIGATE, TO ADAPT, WE HAVE TO BE ABLE TO PUT ALL OF THESE THINGS TOGETHER, ASSESS NOT JUST WITH THE CLIMATE IMPACTS WILL BE IN THE DIRECT AND INDIRECT IMPACTS BUT WHAT THE DIRECT IMPACTS OF THE ACTIONS WE ARE TAKING WE'LL HAVE

WE HAVE DONE ANALYSES FOR THE UN ENVIRONMENTAL PROGRAM THAT DEMONSTRATE VERY CHEAP MEASURES TO REDUCE BLACK CARBON, METHANE ADMISSIONS — EMISSIONS, IT CAN HAVE ENORMOUS BENEFITS NOT JUST FOR CLIMATE AND AIR POLLUTION, BUT FOR HUMAN HEALTH AND FOR THE ECONOMY DIRECTLY EVEN IF YOU DON'T INCLUDE THE INDIRECT CLIMATE EVENTS LIKE I MENTIONED EARLIER AGAIN, WE ARE AT THE BEGINNING OF THINKING IN A JOINED UP ONLY ABOUT THESE CLIMATE IS ONE STRESSOR

IT IS STRIVING — IT IS ADDING TO OTHERS, WAR, ECONOMIC COLLAPSE, — IT IS NOT NECESSARILY THE ONLY DRIVER WITH A SINGLE CAUSE OF MANY OF THE PROBLEMS WE'RE GOING TO SEE IT IS GOING TO BE INCREASINGLY ONE OF THE KEY AND IMPORTANT ELEMENTS IN THOSE EVENTS WHEN WE'RE DOING THAT PREPARATION, WHEN WE'RE STRESS TESTING OUR SYSTEMS, WE NEED TO BE FACTORING IN THE SEA LEVEL RISE, WE NEED TO BE FACTORING IN THE FLOODING, WE NEED TO BE FACTORING IN THE CHANGES IN DISEASE FACTORS AND THE IMPACTS ON EMISSIONS THIS IS A HUGE CHALLENGE BOTH INTELLECTUALLY AND FOR SOCIETY

JEFF MENTIONED HOW DIFFICULT IT CAN BE WHEN YOU HAVE SITUATIONS OR TOPICS THAT ARE HEAVILY POLITICIZED, CLIMATE CHANGE IS ONE OF THOSE TOPICS BUT THAT SHOULD REDOUBLE OUR ENTHUSIASM AND OUR PROMISE TO DO A BETTER JOB ON INCORPORATING ALL OF THESE FACTORS INTO THE GLOBAL HEALTH AGENDA THANK YOU VERY MUCH[APPLAUSE] >> THANK YOU TO DR SCHMIDT

LADIES AND GENTLEMEN I WILL START THE DISCUSSION AND WE WILL HAVE THE PANELISTS RESPOND TO SOME QUESTIONS WE WILL LEAVE SOME TIME, DEPENDING ON HOW MUCH TIME WE HAVE, BUT WE SHOULD TAKE AT LEAST THREE QUESTIONS FROM THE FLOOR THEN WE WILL CLOSE AT 6:30 PROMPTLY IF I MAY BEGIN BY SAYING THE FOLLOWING, THE US

SPENDS $14 BILLION ON GLOBAL HEALTH, THAT'S EXCLUDING ON ITSELF THE UK SPENDS $4 BILLION THE BUDGET OF THE WHO

IS BETWEEN $19 MILLION AND $2 MILLION MOST OF THE WORLD DEPENDS ON THE WHO

FOR HEALTH AND RESPONSES TO EMERGENCIES WITH THE AMOUNT OF MONEY THAT THE WHO

HAS , IT IS I'M SURE, SEVERELY STRETCHED IN MANY WAYS THE QUESTION THAT I WOULD LIKE TO POSE FIRST TO DRTEDROS IS, IN WHICH WAYS WILL HE INCREASE THE REVENUE FLOW FROM MEMBER STATES IN TERMS OF FEES AND VOLUNTARY CONTRIBUTIONS FOR PROGRAMS, AND HOW IN THIS NEW WORLD OF PUBLIC-PRIVATE PARTNERSHIPS, WHAT SMART WAYS THAT HE HAS IN MIND IN FORGING COLLABORATIONS WITH A RANGE OF PLAYERS IN THE GLOBAL HEALTH AREA I WOULD LIKE TO DRAW ON DOCTOR SACHS AS WELL WHAT IS HIS VIEW, WHAT ARE HIS APPROACHES AND NEW IDEAS IN TERMS OF GENERATING MORE REVENUE FOR THE W

HO TO DO ITS WORK >> THANK YOU I THINK THE FINANCING WILL DEPEND ON WHETHER MEMBER STATES BELIEVE IT'S RELEVANT OR NOT

I THINK FROM MANY OF THE MEETINGS, AND TODAY IN THE PRESENTATION, WHO RELEVANCE CUT NO ONE QUESTIONS IT FOR OUR GLOBAL HEALTH SECURITY AN ORGANIZATION LIKE W

HO IS IMPORTANT SO EVERYONE UNDERLINES THAT IS TRUE, FROM THERE YOU HAVE TO RESOURCE IT

IF YOU BELIEVE THIS ORGANIZATION IS YOURS, THEN YOU HAVE TO COMMIT TO PAY FOR ITS ACTIVITIES AND THERE ARE SOME THINGS WE ARE PUTTING TOGETHER NOW IN ORDER TO ADDRESS FINANCIAL PROBLEMS, NOT ONLY ASKING FOR MEMBER STATES BUT ALSO SOME THINGS INTERNALLY NUMBER 1, PRIORITIZATION IS IMPORTANT THAT CREATES VALUE W

HO SHOULD BE ABLE TO PRIORITIZE WHAT IT DOES AND FOCUS ON MAJOR IMPORTANT ISSUES NUMBER 2, IN ADDITION TO THE TRADITIONAL DONORS, EXPANDING THE DONOR BASE IS IMPORTANT WE HAVE ALREADY SEEN SIGNS THAT SOME COUNTRIES ARE WILLING TO CONTRIBUTE

NUMBER 3, EVEN WITH THE EXISTING DONORS, THE FUNDING SHOULD BE FLEXIBLE SOMETIMES YOU HAVE SOME MONEY AND YOUR MARKET FOR SOMETHING BUT YOU HAVE SHORTAGES FOR OTHER THINGS THAT ARE A PRIORITY WH

O SHOULD BE TRUSTED BY THE MEMBER STATES SO BASKET FUNDING OR FLEXIBLE FUNDING IS IMPORTANT BUT IN ADDITION TO THAT WE NEED TO MOVE INTO NEW MECHANISMS ALSO INNOVATIVE FINANCING YOU SAY PRIVATE SECTOR, PRIVATE SECTOR IS KEY

WE HAVE TO INVOLVE PRIVATE SECTOR AS A SOURCE OF FINANCING ALSO OF COURSE, IT SHOULDN'T BE IN A WAY THAT AFFECTS THE FUNCTIONS BECAUSE THOUGH SHOULD ALSO BE — THERE SHOULD BE A BALANCE SOMETHING WE HAVE SEEN, MAYBE YOU CAN GIVE ME SOME FEEDBACK, THE INNOVATIVE FINANCING COULD INCREASE MORE RESOURCES TO WHO

ONE AREA IS WHO IS A KNOWLEDGE-BASED ORGANIZATIONS ARE HOW CAN WE USE — HAVE MET AND THEY ARE WILLING

WILLING TO HELP IN USING THOSE PLATFORMS BE MOBILE OVER FACEBOOK AND GOOGLE IN ORDER TO RAISE FUNDING FOR WHO YOU MAY NOT BELIEVE IT

FOR INSTANCE, — PANIC AND NEGLECT DURING PANIC A LOT OF MONEY COMES BECAUSE THAT IS DURING ACTUAL EPIDEMICS BUT AS SOON AS THEIR — THAT IS GONE THERE IS NEGLECT FROM THE CONTINGENCY FUND WE NEED FOR WH

O $100 MILLION, THERE IS A DEFICIT OF MORE THAN 50% IT IS REALLY SAD THERE SHOULD BE A FLEXIBLE AND SUSTAINABLE FINANCING AND THAT WE BELIEVE SHOULD INCLUDE THE NEW FINANCING AKIN-ISMS, THE INNOVATIVE ONES, THAT SHOULD BE SUSTAINABLE AND FLEXIBLE WE ARE EXPLORING ALL THE AVENUES

INCLUDING THE MEMBER STATES WHICH WE EXPECT TO INCREASE VOLUNTARY CONTRIBUTIONS THAN THE LAST PART ON FINANCING IS THERE IS A FINANCE DIALOGUE WITH MEMBER STATES TO RAISE MONEY THAT MODEL DOESN'T WORK IT PUTS WHO

ON ONE SIDE AND MEMBERS ON THE OTHER SIDE WHO BEGGING AND THE MEMBER STATES AS DONORS

BUT THE OBJECTIVES OF WHO ARE THE MEMBER STATES OBJECTIVES THERE IS NO US AND THEM

THERE'S ONLY US MEMBER STATES SHOULD TAKE RESPONSIBILITY IN RAISING FUNDS SO THE MODEL SHOULD CHANGE THAT IS ONE THING WE ARE UNDERLINING AND MEMBER STATES ARE CONSIDERING THIS SERIOUSLY

THE SECOND IS WHEN WE DISCUSS RAISING FUNDS FOR WHO, INSTEAD OF STARTING FROM FINANCING WH

O WE SHOULD START FROM DISCUSSING ABOUT FINANCING GLOBAL AGENDA WITHIN THAT WHAT IS NEEDED FOR WHO

INTO OUR RESOURCE MOBILIZATION WE'RE BRINGING THESE TWO MAJOR SHIFTS ONE, IT'S NOT US AND THEM MEMBER STATES HAVE THE OBLIGATION TO RAISE THE FUNDING AND 2 WE RAISE THE FUNDING AND WE HAVE TO RAISE ENOUGH FUNDING FOR THE BIG EMBLEM WHICH IS RESOURCES, GLOBAL AGENDA AND WITHIN THAT RESOURCING W

HO BASED ON ITS NEEDS SO BASED ON THESE SHIFTS WE HAVE STARTED DIALOGUE WITH MEMBER STATES AND WE'RE SEEING GOOD SIGNS AND WE WILL PUSH IN THAT DIRECTION I WOULD BE HAPPY TO LISTEN TO WHAT JEFF SAYS AND HE IS ALREADY HELPING ME

HE KNOWS THIS BETTER IT IS HIS TERRITORY HE PROMISED TO CONTINUE TO HELP WHO

I'M GLAD I HAVE A PARTNER HERE THANK YOU >> DOCTOR SACHS, IN YOUR RESPONSE COULD YOU ADDRESS THE QUESTION OF CHILDREN AND THE MILLENNIUM DEVELOPMENT GOALS ON CHILD HEALTH? AND THE RELATIONSHIP BETWEEN UNICEF WHICH IS RESPONSIBLE FOR CHILD HEALTH AND THE WH

O AND RESPOND TO THE QUESTION OF FINANCING >> ALMOST EVERYTHING SAID ABOUT FINANCING IN THE PUBLIC DEBATE IS CONFUSION WE HAD IT WHEN TRUMP YESTERDAY SAID HOW THE UN IS BLOATED AND WE'RE GOING TO NEED TO SEE CUTS AND SO FORTH

THE US CONTRIBUTION TO THE UN, TO THE BASIC BUDGET IS $600 MILLION PER YEAR THAT'S 75 HOURS OF PENTAGON SPENDING

THERE IS NOTHING BLOATED WE'RE STARVING THE INTERNATIONAL SYSTEM IT'S NOT A BLOATED SYSTEM WE'RE STARVING IT THIS THING WE ARE NOT STARVING IS A MILITARY MACHINE WHERE THE SENATE YESTERDAY DISGRACEFULLY VOTED $700 BILLION BUDGET CUT EVEN MORE THAN TRUMP ASKED FOR

AND TO GO BEYOND TRUMP THEY HAVE TO BE CRAZY AND AFRAID THIS IS THE FIRST POINT WE DON'T USE OUR WEALTH AT ALL SANELY AND NOT AS PEOPLE THINK AND NOT AS WE NEED TO DO SO WE UNDER INVEST INCREDIBLY IN THIS A SECOND POINT THAT WAS TAKEN IS THAT EACH COUNTRY SHOULD LOOK AFTER ITSELF

THIS IS PRESSED ALL THE TIME THIS IS BOGUS WE SHOULD LOOK AFTER EACH OTHER WE NEED TO BREAK THIS HOLD WHICH COMES FROM THIS COUNTRY, SHE IS A LOUSY NOVELIST THAT IS CONFUSED FOR A PHILOSOPHER ONLY IN AMERICA DO YOU WANT A PHILOSOPHER? GO READ ARISTOTLE

A RANT — IT IS POOR FICTION, THIS IDEA YOU'RE ON YOUR OWN REALLY PERMEATES THE GLOBAL DISCOURSE EVEN IN YOUR CHARTS, THERE WASN'T POVERTY EVERY COUNTRY SUPPOSED TO HAVE THEIR PLAN BUT SOME COUNTRIES CAN'T HAVE THEIR PLAN THEY DON'T HAVE A BUDGET TO DO THIS BUT IF I GO TO OMB EVEN UNDER THE OBAMA ADMINISTRATION IT WAS IMPOSSIBLE TO GET THIS STUFF

WE HAVE TO BE REALISTIC, ALWAYS LOOKING AT WHAT ARE NEEDS AND WHAT THE BUDGETS ARE AND WE HAVE TO BREAK THE MYTH THAT THIS SHOULD BE LEFT TO THE PRIVATE SECTOR I WENT TO FACEBOOK A COUPLE OF YEARS AGO AND SAID I WANT HELP ON GLOBAL EDUCATION THEY SAID WHERE YOU COMING HERE? GO TO WASHINGTON WE ARE A BUSINESS

OKAY, I SAID YOU PAY YOUR TAXES AND I WILL GO TO WASHINGTON AND THEN I WAS THROWN OUT OF THE BUILDING WE HAVE A GAME GOING ON, THESE COMPANIES DON'T PAY THEIR TAXES, THEY ARE ALL IN THEIR TAX HIDEAWAYS, WHICH BY THE WAY THEY ARE GOING TO HAVE TO VISIT THEIR WAY — VISIT THEIR MONEY SOME OTHER PLACE BECAUSE THEY HAVE BEEN DESTROYED BY THE HURRICANES WHICH IS WHERE THE HEDGE FUND INDUSTRY DECIDES — RESIDES I DON'T KNOW WHAT THE GOING TO DO TO VISIT THEIR MONEY THIS WEEK AND WE DON'T HAVE THE PUBLIC REVENUE

WE HAVE A MESS, BUT THE GOVERNMENT SHOULD NOT BE THE ONE TO DO THINGS IT'S NOT EFFICIENT BUT IF YOU LOOK AT THE GREAT SCIENTIFIC BREAKTHROUGHS THAT HAVE COME FOR THE LAST 75 YEARS, THEY HAVE COME IN GOVERNMENT WORK WEATHER IN NASA, OR DARPA, WE GET A LOT OF INNOVATION OUT OF THE DEFENSE DEPARTMENT BECAUSE THAT'S WHERE WE INVEST PUBLIC MONEY, FORTUNATELY THEY DO CIVILIAN WORK, NATIONAL INSTITUTE OF HEALTH, WE SHOULD BE PUTTING A LOT OF MONEY INTO WH

O IT TO HELP THE AGENDA BUT THIS IS ALMOST UNIMAGINABLE RIGHT NOW THE TRUTH IS, AND I WILL STOP, WE ARE SO RICH YOU CANNOT REALLY BELIEVE IT UNTIL YOU WALK IN MIDTOWN ON THE EAST SIDE AND THEN YOU KNOW IT

BECAUSE THINGS ARE BOOMING HERE THERE IS SO MUCH WEALTH YOU CAN'T EVEN IMAGINE, THE RESTAURANTS ARE PACKED I WONDER HOW MANY HUNDREDS, HOW DO THEY PAY THESE MEALS? BECAUSE THERE'S A LOT OF WEALTH BUT NO ONE IS PAYING THEIR TAXES AND THE TAXES, IF THEY ARE PAID ARE GOING TO THE MILITARY

AND THEN WE ARE HEARING THIS LIKE WE HEAR FROM THE PRESIDENT WHO IS A VERY CONFUSED PERSON ANYWAY, BUT SOMEONE GAVE HIM SOMETHING TO SAY, THAT SAYS, THE UN IS BLOATED IT TURNS OUT APPARENTLY JUST HIS GOLF TRIPS GOING TO COST THE TAXPAYERS MORE THAN $60 MILLION PER YEAR, MAYBE WELL MORE THAN $60 MILLION BY ONE ESTIMATE MORE THAN $100 MILLION PER YEAR THAT'S A GOOD PLACE TO START FOR INNOVATIVE FINANCING DONALD TRUMP COULD PAY FOR HIS OWN GOLF TRIP AND MAYBE THE U

S GOVERNMENT COULD PAY FOR WHO MY OTHER ADVICE WOULD BE SERIOUSLY, THE US IS NOW THE DRAG ON THE WHOLE INTERNATIONAL SYSTEM IT SAYS NO TO ALL FINANCE AND THEN IT SAYS TO OTHERS, YOU DON'T PAY EITHER BECAUSE WE ARE EX-SHARING CAUGHT WE DON'T WANT TO LOSE OUR VETO IT TRIES TO HOLD EVERYBODY TO MINIMUM

I'M LOOKING FORWARD TO THE DAY WHEN CHINA IS GOING TO AMPLY FUND THESE INSTITUTIONS, INDY IS GOING TO AMPLY FUND THESE INSTITUTIONS OTHER COUNTRIES ARE GOING TO AMPLY FUND THESE INSTITUTIONS THE UNITED STATES DOESN'T WANT TO DO IT, EVERYONE WILL KNOW WE ARE ALL GOING TO SURVIVE IT'S NOT SUCH A BIG DEAL BECAUSE THERE IS THE REST OF THE WORLD AT THE U

S SHOULD NOT LET WHAT IS ABSOLUTELY NECESSARY HOLD BACK THE REST OF THE WORLD THIS CRAZINESS COMING FROM THIS COUNTRY CANNOT BE THE LIMITING FACTOR FOR THE FINANCING WE NEED SO THERE[APPLAUSE] >> WE CERTAINLY THINK DR

SACHS FOR HIS LEADERSHIP ON THESE ISSUES IF I CAN TURN TO DOCTOR CAMERON AND ASK THE FOLLOWING QUESTION THE GLOBAL HEALTH SECURITY AGENDA WAS FINANCED THROUGH AN EMERGENCY CONGRESSIONAL OF THE BILLION DOLLARS, IT'S GOING TO RUN OUT NEXT YEAR THE QUESTION IS WHAT IS THE APPETITE IN THE CURRENT POLITICAL ENVIRONMENT? AND JUST AS A SIDE QUESTION TO THE ISSUE OF FINANCING IN THE ROLE OF THE US

MILITARY IN MEDICINE, THE US MILITARY PLAYS A HUGE ROLE, EVERY POSITIVE ROLE IN TERMS OF SOME OF THE DISCOVERY SCIENCE, VACCINE DEVELOPMENT, THINK OF WHAT THEY DO AT WALTER REED INSTITUTE, QUITE EXTRAORDINARY WORK IN THE AREA OF DISEASE DETECTION, AND SO ON AN ISSUE POLITICALLY IS HOW ONE LEVERAGES THAT I'M ASKING THE QUESTION, WHAT IS YOUR VIEW OF HOW TO LEVERAGE THAT SIDE OF THE FUNDING WITHOUT COMPROMISING SPENDING ON HEALTH AS A PUBLIC GOOD

BECAUSE IT'S OFTEN THE CRITICISM THAT IT'S DOMINATED BY MILITARY INVOLVEMENT IN FOCUSES ON THE SECURITY SIDE THAN THE PUBLIC SITE IN TERMS OF HEALTH >> THOSE ARE BOTH GREAT QUESTIONS I'M HAPPY TO ANSWER THEM I THINK IN TERMS OF THE US

GOVERNMENT FUNDING CONTRADICT THE FIRST QUESTION FIRST, US GOVERNMENT RECEIVES APPROXIMATELY $1 BILLION FOR GLOBAL HEALTH SECURITY IN THE MIDDLE OF THE EVIL OUTBREAK THAT WAS EXTRAORDINARY TO BE HONEST IT WAS FORWARD THINKING

IT WAS LOOKING AT THE FUTURE WHILE IN THE MIDDLE OF A CRISIS IT WAS HARD TO GET THAT FUNDING OUT OF A REPUBLICAN CONGRESS I WILL TELL YOU BUT THEY PROVIDED IT THE CRITICAL POINT WITH THAT FUNDING THOUGH WAS THAT IT WAS TIED TO SPECIFIC METRICS THAT NEEDED TO BE ACHIEVED BY THE FUNDERS IN COOPERATION WITH THE GOVERNMENT'S

I DON'T MEAN TO IMPLY THEY WERE ALL ON THE COUNTRIES, THEY WERE ALSO ON OUR OWN SPENDING TO MAKE SURE THAT WE UNDERSTOOD WHAT WE WERE DOING AND THAT WOULD HELP BUILD SUSTAINABLE CAPACITY THAT WOULD HELP IMPLEMENT THE IHR THE OFFICE OF MANAGEMENT AND BUDGET LOOKED AT THE GLOBAL HEALTH SECURITY AGENDA AND ITS TARGETS THAT HAVE BEEN BUILT BEFORE THE FUNDING CAME IN AND MADE THE DECISION TO ASK FOR THAT FUNDING BECAUSE THEY KNEW IT COULD BE MEASURED BECAUSE THERE WERE SOME TARGETS THAT HAD BEEN ACHIEVED AND BECAUSE WHO

AND OTHERS ALREADY AT THE TABLE THAT WAS ESSENTIAL I THINK IN ORDER TO MAINTAIN FUNDING FOR GLOBAL HEALTH SECURITY IN THE CURRENT CLIMATE, AND THEY WILL SAY THE TRUMP ADMINISTRATION HAS SUPPORTED THIS ISSUE RHETORICALLY, THEY SAID THEY SUPPORT GLOBAL HEALTH SECURITY AND THE AGENDA, I THINK IN ORDER TO SEE FUNDING FOR THIS, THERE HAS TO BE AN EXTRAORDINARY EFFORT TO ADVOCATE FOR IT AND FOR CONGRESS TO PROVIDE IT AND TO BE ABLE TO SHOW THAT IT IS A COMMON GOOD THAT IS ESSENTIAL FOR GLOBAL PEACE AND SECURITY AND US

NATIONAL SECURITY I THINK THOSE ARGUMENTS CAN BE MADE BUT I THINK THE FUNDING NEEDS TO COME IN FOR CDC AND USAID AND THE BUDGETS THAT ARE OUT THERE FOR THE DEPARTMENT OF DEFENSE AND STATE TO BE AT THE TABLE AND GLOBAL HEALTH AND SECURITY NEED TO BE MAINTAINED BECAUSE THE MULTISECTORAL BUDGET HELPS BRING A LITTLE SECTORS TO THE TABLE AND OTHER COUNTRIES THAT'S VERY HELPFUL WHEN YOU ARE HAVING FINANCING CONVERSATIONS AND WHEN YOU'RE TRYING TO LOOK AT MEASURABLE GOALS I'LL TAKE THIS OPPORTUNITY TO QUICKLY RESPOND TO WHAT DOCTOR SACHS SAID

I COMPLETELY AGREE THAT NOT ALL COUNTRIES CAN DO THIS ON THEIR OWN AND ABSOLUTELY SHOULDN'T BUT I DO THINK EVERY COUNTRY THAT HAS A GOVERNMENT, RECOGNIZING THERE ARE COUNTRIES AND POPULATIONS IN THE WORLD THAT DON'T HAVE THAT LUXURY AT THE MOMENT, CAN LOOK AT THE PLANNING PUT IN PLACE AND WH

O HAS WORKED IN PLACES ALL OVER THE WORLD INCLUDING COUNTRIES THAT ABSOLUTELY CAN'T FIND ITS THIS FOR THEMSELVES TO PUT TOGETHER A HEALTH SECURITY PLAN THE HEALTH SECURITY PLAN IS TAILORED TO THEIR PRIORITIES AND NEEDS THAT IS VITAL AND I THINK THAT'S HELPFUL IN BRINGING SECTORS OF GOVERNMENT PLACES THAT OTHERWISE WOULDN'T BE ABLE TO FOCUS ON THIS ISSUE BUT PROVIDING HEALTH AND SUPPORT

AT THE PLACE WHERE WHO AND ITS LOCAL LEADERSHIP IS ESSENTIAL WE LOOK AT SUPPORTING W

HO JUST CRITICAL, WE SHOULD BE LOOKING NOT ONLY AT SUPPORT IN GENEVA, BUT TO IMPLY THAT YOU SAID THAT, BUT WE SHOULD BE LOOKING AT SUPPORTING THE WHO

LOCAL OFFICES AND THE EXPERTS ON THE GROUND WORKING THERE AND ALSO SUPPORTING HOW THEY PLUG IN TO THE BROADER DONOR EFFORT THEY CAN'T DO IT ALONE EITHER THEY NEED THE DONOR GOVERNMENTS TO HELP WE NEED THEM THERE AS WELL TO BE THE GLUE

QUICKLY TO RESPOND TO YOUR QUESTION ON MILITARY AND DEPARTMENT OF DEFENSE, ONE OF THE ROLES I PLAY AT THE US GOVERNMENT WAS IN OVERSEEING US FUNDING THROUGH DOD FOR BIOLOGICAL THREAT REDUCTION WHICH FOCUSES ON BIO SURVEILLANCE, BIO SECURITY, I WORKED CLOSELY WITH DEFENSE HEALTH PROGRAMS THAT HAVE LABORATORIES ALL OVER THE WORLD, SOME OF WHICH HAVE BEEN STANDING IN PLACES LIKE CAIRO, THAILAND IN KENYA FOR MORE THAN 50 YEARS

THE WAY THAT THOSE PROGRAMS ARE MOST SUCCESSFUL IS WHEN THEY ARE INTEGRATED INTO THE FABRIC OF THE SOCIETIES IN WHICH THEY WORK IN CAIRO, WHEN I WOULD VISIT EGYPT, THE WHO — THE WHO OFFICE FOR OUR OVERSEAS LABORATORY AND OUR OWN U

S GOVERNMENT PROGRAMS WORKED HAND IN GLOVE IN SOME SITUATIONS I WAS IN, IT WOULD SAY, I'M WORRIED ABOUT THE DEPARTMENT OF DEFENSE INVOLVEMENT BUT I WELCOME 3 YOU WANT TO BE IN A SITUATION WHERE THOSE EXPERTS ARE PART OF THE FABRIC WORKING WITH THE W

HO AND THE HOST GOVERNMENT IT'S IMPORTANTLY CONTINUE OUR INVESTMENT IN THOSE AREAS BUT THAT WE DO IT NOT AT THE EXPENSE OF CENTERS FOR DISEASE CONTROL OR THE USAID OR THE WHO — W

HO RIGHT NOW MOST OF THE US

GOVERNMENT SPENDING FOR GLOBAL HEALTH SECURITY INCLUDING IN PLACES LIKE LIBERIA, WHERE THE DEPARTMENT OF DEFENSE IS HELPING OF A CENTRAL REFERENCE LAB WITH THE GOVERNMENT, THAT IS FROM THE DEPARTMENT OF DEFENSE I'M NOT SAYING THAT'S THE WAY IT SHOULD BE BUT IT'S IMPORTANT IT'S HELPFUL IN BUILDING SAFE AND SECURE FACILITIES AND ITS HELPFUL BECAUSE IT IS AT LEAST A FUNDING AND WE NEEDED >> THANK YOU VERY MUCH I WOULD LIKE TO TURN TO DR

SCHMIDT AND THE QUESTION OF CLIMATE CHANGE AND SOME OF THE PRACTICAL THINGS BEYOND WHAT IT IS HE DESCRIBED BUT BY FOCUSING ON WHAT HAS BEEN OFTEN DESCRIBED AS MARKET FAILURE IN THE DELIVERY OF VACCINES AND MEDICAL COUNTERMEASURES WHEN IT'S NEEDED IT'S PARTICULARLY TRUE DURING EMERGENCIES AND CATASTROPHES I'D LIKE US TO REMEMBER THAT IT'S NOT JUST PANDEMIC INFECTIOUS DISEASES BUT ALSO ACCIDENTAL CHEMICAL SPILLAGES OR BIOLOGICAL SPILLOVERS, RADIOLOGICAL AND SO ON

THERE ARE A RANGE OF THINGS THEY ALL REQUIRE A DEGREE OF HOSPITAL READINESS IN ORDER TO COPE AND THEY REQUIRE VERY IMPORTANTLY, THE DELIVERY OF VACCINES WHICH PREVENT INFECTIONS AND MEDICAL THERAPIES TO DEAL WITH DISEASE TO START WITH YOU DR

SCHMIDT, CAN YOU TELL US WHAT WOULD BE HELPFUL TO KNOW ABOUT CLIMATE IN ORDER FOR PEOPLE WHO DELIVER VACCINES FOR EXAMPLE, GLOBALLY, IT'S A LOGISTICAL QUESTION, WHAT SHOULD THEY KNOW ABOUT CLIMATE VARIABILITY THAT WOULD ALLOW THEM TO PLAN EFFECTIVELY, ESPECIALLY WHEN DEALING WITH EMERGENCIES? >> THAT'S A LITTLE OUTSIDE OF MIGHT WHEELHOUSE LET ME SEE IF I COULD SAY SOMETHING INTELLIGENT SO, ONE OF THE PROBLEM THAT EXISTS IN DELIVERY OF VACCINES TO THE MORE FAR-FLUNG AND DISCONNECTED PARTS OF THE WORLD IS THAT WE DON'T ACTUALLY HAVE GOOD WEATHER FORECASTS FOR THESE PLACES WE DON'T HAVE ENOUGH ON THE GROUND MEASUREMENTS OF TEMPERATURE, RAINFALL AND THE WINDS THAT WOULD BE ABLE TO FEED INTO THE GLOBAL MODELS THE PRODUCE THE FORECAST THAT CAN BE USEFUL OUR ABILITY TO FORECAST THE WEATHER IN PLACES LIKE CENTRAL AFRICA IS MUCH POOR IN OUR ABILITY TO FORECAST THE WEATHER IN THE U

S FOR YOUR THOSE ARE THINGS THAT CAN BE FIXED WITH INCREASING INVESTMENT IN AUTOMATED WEATHER STATIONS THERE WAS A PROJECT THE COLUMBIA WORKED WITH TO PUT AUTOMATIC WEATHER STATIONS ON CELL PHONE TOWERS SO AS THE CELL PHONE TOWERS REACHED FURTHER IN, MORE INFORMATION WOULD COME BACK AS WELL

I DON'T THINK THAT THE MORE LONG-TERM PROJECTIONS THAT WE ARE WORKING ON AT THE 20, 30, 40 YOUR LEVEL ARE A PARTICULAR HELP — YEAR LEVEL ARE OF A PARTICULAR HELP IN THE JUST TICKLE ISSUES AT THE NOTION THAT YOU NEED TO BE THINKING ABOUT THE ENVIRONMENT TO WHICH YOU ARE GOING AND BE ABLE TO TRACK WHAT IS HAPPENING THERE, WHEN IT'S GOING TO HAPPEN, EVEN IN THE SHORT TERM, IS OBVIOUSLY SOMETHING WE WORK QUITE A LOT ON HOW DID I DO? >> THANK YOU VERY MUCH IT'S A GENERAL PROBLEM THERE IS MARKET FAILURE IN TERMS OF GETTING VACCINES TO THE RIGHT PLACE AT THE RIGHT TIME

THE BIGGER QUESTION WAS RAISED BY DRTEDROS IN TERMS OF HAVING A PIPELINE OF MEDICAL THERAPIES AVAILABLE THAT IS PROACTIVE THE WHO

LIST OF MOST LIKELY OUTBREAKS THAT WILL OCCUR IN THE AREA OF INFECTIOUS DISEASES YOU CAN GO TO THE WEBSITE TO SEE THAT YOU MENTIONED IN YOUR TALK, HOW DO YOU SEE STIMULATING RESEARCH AND DEVELOPMENT WHEN IT COMES TO VACCINE DEVELOPMENT? IT'S AN ROAD PROCESS THERE HAS TO BE A PIPELINE THAT IS AVAILABLE TO PRODUCE THOSE VACCINES WHAT IS THE PERSPECTIVE ON THE PART OF THE W

HO TO HELP THAT PROCESS? >> ON VACCINES AND RESEARCH, I THINK IT WILL BE IMPORTANT FIRST OF ALL FOR THOSE WITH — IMPORTANT GOVERNMENTS — GOVERNMENTS SHOULD BE WILLING TO INVEST BECAUSE THERE ARE MARKET FAILURES OR THE PRIVATE SECTOR WILL NEVER GO TO THAT TERRITORY THAT IS ONE

THE SECOND, FOR THOSE THAT HAVE SOME INTEREST IN THE PRIVATE SECTOR, I THINK THE ADVANCED MARKET, THAT WOULD BE IMPORTANT A COMBINATION OF THE TWO GOVERNMENTS PLUS THE ADVANCED MARKET COMMITMENTS FOR THE PRIVATE SECTOR THIS WOULD REALLY HELP BY THE WAY, ON THE DRUGS FOR HEPATITIS C, WHEN AREA, WE ARE DOING THAT, US$120

THAT WILL HELP AND WE CAN GO TO ELIMINATION NOW >> JUST NOT IN THE US IN ADDITION TO GENERIC, I THINK BUILDING THE MANUFACTURING CAPACITY OF COUNTRIES IS IMPORTANT A SPECIAL — AS YOU KNOW UNDER THE GLOBAL PROGRAM, MANY MANUFACTURING INDUSTRIES ARE MIGRATING OUT OF CHINA THAT IS A GOOD OPPORTUNITY WITH AN INCREASING INDUSTRY IN CHINA

THAT COULD BE USED TO INCREASE THE MANUFACTURING CAPACITY OF THE DEVELOPING WORLD, INDUSTRIALIZATION, THAT CAN COME WITH THAT AND INDUSTRIALIZATION MEANS INNOVATION I THINK USING THOSE OPPORTUNITIES WOULD BE IMPORTANT THAT COULD BE APPLIED FOR VACCINES AS WE KNOW, MANY OF THE EXPENSIVE MEDICINES OR VACCINES AT THE END OF THE DAY THE ISSUE IS THE SUPPLY AND DEMAND ISSUE

SO, IF WE INCREASE SUPPLY, THE PRICE WOULD BE LOWERED THAT IS WHY INCREASING THE MANUFACTURING INDUSTRY OF DEVELOPING WORLD COULD INCREASE COMPETITION AND BRING COMPETITION AND COMPETITION CAN HELP OF COURSE THERE WAS A HIGH- LEVEL RECOMMENDATION LAST YEAR AND THERE ARE SOME RECOMMENDATIONS FOR THE HIGH- LEVEL, — BUT THESE ARE STRATEGIC SOLUTIONS WE NEED TO TAKE ME A COMMENT ON CLIMATE CHANGE? — ME I COMMENT ON CLIMATE CHANGE? THAT WAS MY PRIORITY WHEN I WAS CAMPAIGNING FOR THIS POSITION ON CLIMATE CHANGE AND HEALTH, MAYBE I WOULD LIKE TO RAISE TWO ISSUES

WHO IS MAINLY FOCUSED ON ADAPTATION — MITIGATION

THE HEALTH IMPACT OF INCREASED CARBON RELEASE, AND ITS IMPACT ON HEALTH WHO SHOULD RAISE THE ALARM

MORE ADVOCACY AND VERY VOCAL ON MITIGATION MITIGATION IS PREVENTION WHO

IS FOR PREVENTION WE CANNOT JUST BE AN ADAPTATION AND ONLY FIX THE PROBLEMS AS THEY ARISE WHICH WE CANNOT FIX ANYWAY CLIMATE CHANGE IS A SERIOUS PROBLEM FOR THE WHOLE WORLD BUT AT THE SAME TIME, IT'S ALSO A PROBLEM BUT THERE ARE COUNTRIES THAT ARE MORE AFFECTED DISPROPORTIONATELY THAN OTHERS

WE NEED TO HELP THOSE WITH A SENSE OF URGENCY THESE ARE THE SMALL ISLAND DEVELOPING STATES THEY HAVE TO BE SUPPORTED AND WHO

IS STARTING A NEW INITIATIVE CLIMATE CHANGE AND HEALTH INITIATIVE AND WE WILL GIVE THE MORE SUPPORT BECAUSE THEY ARE IS PROPORTIONATELY AFFECTED THAT INITIATIVE WILL HAVE PROBLEMS AND PROJECTS THAT WILL COME FROM THE SAME SYSTEMS NO ONE SHOULD — THEY SHOULD BE THE ONES WHO TELL US HOW WE CAN HELP THEM AND WE CAN FACILITATE AND HELP

THIS IS ONE OF THE INITIATIVES WE'RE GOING TO WORK ON I KNOW WE WILL HELP IN MAKING THIS SUCCEED BUT WE HAVE TO REALLY HELP THOSE WHO ARE REALLY DISPROPORTIONATELY AFFECTED >> I WOULD LIKE TO STAY FOR A MINUTE ON VACCINES YOU MAY HAVE NOTICED — CLINICAL TRIALS FOR TWO VACCINES

FOR ZIKA VIRUS WHAT THEY SAID WAS TWO REASONS, ONE IS THE EPIDEMIOLOGY OF ZIKA VIRUS AND THE OTHER IS THE — TRUMP ADMINISTRATION THE WHOLE QUESTION OF THE PRODUCTION OF VACCINES HAS BEEN A BOOM AND BUST BUSINESS WHEN THERE IS A CRISIS THERE IS A LOT OF MONEY AND EFFORT, BUT WHEN IT EBBS THIS DECLINES IT IS A RISKY INVESTMENT

THE QUESTION IS, HOW DO WE GET IN MORE STABLE FUNDING IN THE VACCINE BUSINESS? — >> I THINK IT'S INTERESTING TO THINK ABOUT ANOTHER VACCINE CASE HALF CENTURY AGO, WHICH WAS THE POLIO EPIDEMIC FRANKLIN ROOSEVELT CREATED WHAT BECAME CALLED THE MARCH OF DIMES THE MARCH OF DIMES REFUNDED — FUNDED THE UNIVERSITY OF PITTSBURGH RESEARCH COMPANY CAME UP AT THE VACCINE HE WAS ASKED FAMOUSLY, WHO OWNS THE VACCINE? WHO OWNS THE PATENT? HE SAYS THE PUBLIC OF COURSE COULD YOU PATENT THE SUNSHINE? THAT IS A WONDERFUL SENTIMENT THE VACCINE WAS MADE PUBLIC

IT WENT TO RAPID APPLICATION THE EPIDEMIC WAS ENDED IN THE HEIGHT INCOME COUNTRIES NOW WE'RE ON THE VERGE OF FULL ERADICATION THE POINT IS, IT'S A DIFFERENT INTELLECTUAL PROPERTY DEVELOPMENT MODEL A PUBLIC CHANNEL

BECAUSE OF THE CHALLENGES OF VACCINES, THE TREMENDOUS PUBLIC GOOD ASPECTS FOR VERY POOR PEOPLE, THE MARKET RISKS AND THE FLUCTUATIONS, THERE SHOULD BE A MASSIVE PUBLIC EFFORT FOR DEVELOPMENT OF VACCINES AND THEIR PROPAGATION THERE CAN BE A RESEARCH ARM ATTACHED TO GAVI AS A MECHANISM OF THIS I WANT TO SAY ANOTHER WORD ABOUT CLIMATE ISSUE AND AID WE TALK ABOUT AID FOR HARD-HIT COUNTRIES BUT IF THIS WERE A COURT OF LAW, THOSE COUNTRIES WOULD HAVE CLAIMS

DAMAGES FOR WHAT IN LAW WOULD BE CALLED THE PUBLIC NUISANCE, THAT THEIR RIGHT TO THE RAND HAS BEEN DAMAGED BY OUTSIDE INTERFERENCE IN THIS CASE BY THE RICH COUNTRIES WE HAVE AN OBLIGATION TO PAY UNDER THE PARIS CLIMATE AGREEMENT WE CALL IT LOSSES AND DAMAGES WHICH IS A CATEGORY BUT WHEN THE RICH COUNTRIES NEGOTIATED THAT, THEY SAID IT'S NOT COMPENSATION

BUT OF COURSE IT'S COMPENSATION IT SHOULD BE COMPENSATION BECAUSE THE OVERWHELMING RESPONSIBILITY FOR, CHANGE IS NOT A SMALL ISLAND DEVELOPING STATES OR THE HORN OF AFRICA OR THE CARIBBEAN AND OTHERS, IT IS THE RICH COUNTRIES YOU CAN EVEN FIND — FIND THE COMPANIES BECAUSE EXXON AND CHEVRON ARE AT THE TOP OF THE LIST OF HISTORICAL RESPONSIBILITY THEY SHOULD BE NABBED RACKLEY IN COURT FOR THEIR RESPONSIBILITY

WE HAVE TO CHANGE — DIRECTLY IN COURT FOR THEIR RESPONSIBILITY WE HAVE TO CHANGE THE LANGUAGE THIS COMES BACK TO THE IDEA THAT SOMEHOW WE THINK WE ARE IMMUNE TO RESPONSIBILITY BUT WE HAVE TO BE HELD ACCOUNTABLE FOR THE RESPONSIBILITY I WANT TO PUT AID, NOT AS AN IRRELEVANT CATEGORY, I WANT TO PUT AID IN COMPENSATION AS THE RELEVANT CATEGORY >> THANK YOU VERY MUCH

I JUST GOT A NOTE TO SAY THAT DRTEDROS HAS ANOTHER ENGAGEMENT AND HE HAS TO BE THERE NOW [LAUGHTER] SO I WAS HOPING TO GET AT LEAST TWO QUESTIONS FROM STUDENTS AND I'M GOING TO ASK YOU TO COME TO THE MICROPHONE >> I WILL INTRODUCE MYSELF QUICKLY

HAVE A QUESTION FOR DR SACHS CAN ASK THAT AFTER DRTEDROS THANK YOU SO MUCH FOR BEING HERE

I ACTUALLY USED TO BE AT THE UNITED NATIONS, I WAS A FORMER ADVISOR TO THE GROUP OF FRIENDS FOR GENDER PARITY WE ARE 100 COUNTRIES ADVOCATING FOR GENDER EQUAL LEADERSHIP OF THE UN SECRETARIAT IT WAS IN A CONVERSATION WITH ONE OF YOUR PREDECESSORS, WHICH IS ONE OF THE REASONS I'M HERE PURSUING A DEGREE IN MEDICINE, MY QUESTION IS WITH THIS GROWING PATTERN OF ISOLATION WORLDWIDE AND THE LACK OF FUNDING WE HAVE TALKED ABOUT A LOT, THERE ARE MAJOR GAPS IN THE GLOBAL HEALTH AGENDA WHERE EXACTLY THE PRIVATE SECTOR CAN FILL IN THOSE GAPS, NOT JUST IN TERMS OF RAISING FUNDS AND FINANCING CERTAIN ASPECTS, BUT IN TERMS OF THE ROAD PROCESS OR MAYBE DONATING CERTAIN DRUGS THAT ARE IN NEED IN CERTAIN PLACES WHICH IS DIFFICULT THAT LEADS INTO MY SECOND QUESTION

>> PLEASE HOLD IN YOUR SECOND QUESTION I'M GOING TO ASK DRTEDROS TO RESPOND HE DOES HAVE TO LEAVE I'M AFRAID THERE WON'T BE ANY FURTHER QUESTIONS TO DR

TEDROS >> THIS ISN'T THE QUESTION, JUST TO FINISH THE QUESTION, HOW YOU CAN INCENTIVIZE THE PRIVATE SECTOR TO BE INVOLVED AND TAKE OWNERSHIP IN THIS GLOBAL HEALTH AGENDA >> YOU ARE GIVING ME ONE THANK YOU IT HAS ACTUALLY TWO QUESTIONS

I THINK YOU RAISED THE GENDER PARITY ISSUE AND THEN I DON'T KNOW WHY YOU FORGOT IT I THOUGHT THAT WAS THE QUESTION I CAN REFRAME IT LIKE A QUESTION ARE YOU GOING TO DO GENDER PARITY IN YOUR TOP LEADERSHIP? >> MY QUESTION IS CLARIFY, THERE ARE MAJOR GAPS NOT JUST FINANCING AND FUNDING IN THE GLOBAL HEALTH AGENDA, HOW THE PRIVATE SECTOR CAN FILL IN THOSE GAPS THAT YOU CAN IDENTIFY AND ALSO HOW YOU CAN INCENTIVIZE THE PRIVATE SECTOR TO TAKE OWNERSHIP AND BE PART OF THE SOLUTION

>> ONE OF THE OPPORTUNITIES WE HAVE IS THE FRAMEWORK TO ENGAGE THE PRIVATE UNITED STATES ACTORS THE PRIVATE SECTOR BEING ONE WE HAVE THAT FRAMEWORK THAT WAS CREATED LAST YEAR BASED ON THAT, THAT OPENS UP OPPORTUNITIES TO ENGAGE THE UNITED STATES ACTORS AND WE WILL TRY TO BENEFIT FROM THEIR CONTRIBUTIONS

BUT WE HAVE, ONE THING I NEED TO ADMIT IS, WHO IS A BIT AFRAID OF ENGAGING THE PRIVATE SECTOR I THINK THAT IS WHAT YOU'RE UP TO

AND WE SHOULDN'T REALLY BE WORRIED BY THAT THERE SHOULDN'T BE ANY CONDITION TO ENGAGE THE PRIVATE SECTOR WE KNOW WHERE THE CONFLICTS OF INTEREST MAY ARISE WE SHOULD BE CONSCIOUS ABOUT THAT BUT THERE SHOULDN'T BE FEAR IN ENGAGING THE PRIVATE SECTOR

IT ALL STARTS FROM THERE WE HAVE TO CHANGE THE MINDSET AND WE HAVE TO BELIEVE WE CAN WORK WITH THE PRIVATE SECTOR WHILE STILL SAFEGUARDING THE AREAS THAT SHOULD BE SAFEGUARDED OR REALLY MANAGING THE CONFLICT OF INTEREST

TO DO THAT, FOR THE PRIVATE SECTOR, WE NEED TO HAVE A CLEAR STRATEGY BASED ON THE PRIORITIES WE HAVE TO SEEK THEIR ENGAGEMENT FIRST WE SHOULD KNOW OUR PRIORITIES AND THEN SIT DOWN AND DISCUSS THE PRIORITIES IN THE ENGAGEMENT SHOULD NOT BE AT THE GLOBAL LEVEL ONLY, IT SHOULD GO UP TO COUNTRY LEVEL ON HOW THE PARTNERSHIPS COULD BENEFIT THE GLOBAL AGENDA WHICH IS A PRIORITY FOR ALL OF US INCLUDING THE PRIVATE SECTOR

SO THIS IS THE FRAMEWORK WE ARE TRYING TO FOLLOW AND I HAVE ALREADY SPOKEN TO SOME OF THEM IN THE LAST 79 DAYS SINCE I HAVE STARTED MY NEW POST, AND THE ENGAGEMENT I HAD WAS VERY CANDID WE HAD A CANDID DISCUSSION, IT ALL STARTS THERE WE NEED TO BE HONEST WITH EACH OTHER SO WE WILL INVOLVE THEM IN MANY OF THE MAJOR ISSUES THAT WE HAVE AND WE WILL NEED THEIR SUPPORT

IT SHOULDN'T BE AS YOU RIGHTLY SAY JUST FINANCE MANY AREAS WHERE WE CAN PARTNER OUR PARTNERSHIP SHOULD BE BASED ON TRUST AND ALSO VERY CANDID DISCUSSIONS AND HONEST RELATIONSHIPS THANK YOU >> THANK YOU VERY MUCH DRTEDROS

WE NOW HAVE TO RELEASE DRTEDROS IS A FORMER POLITICIAN I UNDERSTAND WHAT THIS MEANS WE HAVE TO DO THAT I WOULD LIKE TO THANK HIM FOR COMING

[APPLAUSE] >> AS HE IS WALKING OUT TO SAY IT IS OF THE GREATEST IMPORTANCE THAT WE SUPPORT THE WORK OF WHO THE ONLY GLOBAL BODY WITH UNIVERSAL LEGITIMACY

ANYONE WHO DOES ANY WORK ANYWHERE IN THE WORLD REQUIRES COVER FROM THE WHO THEREFORE IT'S QUITE IMPORTANT FOR US TO SUPPORTED

AND HIS WORK WE STARTED LATE AND WITH YOUR INDULGENCE AND WILL RUN UNTIL 25 MINUTES UNTIL SEVEN TO GIVE STUDENTS A CHANCE FOR QUESTIONS ASK A QUESTION AS QUICKLY AS POSSIBLE >> MY NAME IS LUKE NELSON I AM A STUDENT HERE

I AM STUDYING PSYCHOLOGY LAST SUMMER I WAS ONE OF A FEW UNDERGRADUATE STUDENTS WHO GOT A CHANCE TO GO TO HAITI AND STUDY MATERNAL HEALTHCARE AND ACCESSIBILITY TO MATERNAL HEALTH CARE I HAD A CHANCE TO RETRAIN COMMUNITY HEALTHCARE WORKERS AND PROVIDE QUALITY CONTROL AND THE WORK THEY DO ONE THING I DID NOTICE WAS A SENSE OF DISCOURAGEMENT AND A SENSE OF SADNESS SURROUNDING THE ISSUES AND TIREDNESS IN TERMS OF THE WORK THAT THEY ACTUALLY DO I GUESS MY QUESTION MORE SPECIFICALLY IS, WITHIN THE GLOBAL DISCOURSE, AND WITH HAITI'S ECONOMIC DEPENDENCE ON EMERGENCY FUNDING AND THE LOWERING OF FUNDING THROUGHOUT THE YEARS BY ORGANIZATIONS LIKE THE USAID AND OTHER PRIVATE SECTOR FUNDERS, WHAT GOES INTO RANKING AND UNDERSTANDING WHICH COUNTRIES TAKE PRIORITY IN TERMS OF THE HELP AND THE WORK THAT IS NEEDED TO BE DONE WITHIN THAT COUNTRY, BUT ALSO I GUESS HAS THE TERM GLOBAL HEALTH SECURITY BEEN ADOPTED TO ENCOURAGE COUNTRIES WHO CAN SPEARHEAD THESE INITIATIVES LACKS OR MORE SO, HOW DO YOU MOTIVATE THESE 70+ COUNTRIES GIVEN THE UNIQUE CIRCUMSTANCES THAT THEY FACE >> THANK YOU VERY MUCH

IF YOU CAN HOLD THE RESPONSE I WILL TAKE THE NEXT PERSON AS WELL >> I'M A POSTDOC STUDENT AT COLUMBIA AND HAVE A QUESTION FOR DR SACHS AS YOU DESCRIBE THE FOOD SYSTEM HURTS US AN OVERALL POPULATION HEALTH I WANTED TO KNOW WHAT YOU THOUGHT WOULD BE EFFECTIVE AND SPECIFIC WAYS TO RESPOND

THE FOOD INDUSTRY SYSTEM >> IF YOU CAN DEAL WITH THAT QUESTION, AND ON THE QUESTION OF HAITI, IF DOCTOR CAMERON CAN RESPOND TO THAT THE GLOBAL SECURITY AGENDA GO-AHEAD >> I WANT TO SAY SOMETHING ABOUT HAITI, VERY QUICKLY

THERE ARE TWO KINDS OF ANSWERS TO THE QUESTION ONE IS A FORMAL TEXTBOOK ANSWER WHICH COUNTRIES ARE IN WHICH LISTS, WHO NEEDS HELP AND SO FORTH THEN THERE IS THE REAL ANSWER WHICH IS GEOPOLITICS

WE DON'T CARE ABOUT HAITI PERIOD EXCEPT IF THERE IS SOME KIND OF REFUGEE MOVEMENT OR IF WE WANT TO OVERTHROW THE GOVERNMENT AND SO IF YOU ACTUALLY LOOK AT HOW HAITI GOT INTO THIS UNBELIEVABLY WEIRD SITUATION THAT IT HAS BEEN IN, AND OF COURSE THERE ARE MANY THINGS GOING ON, IF YOU GO BACK TO THE EARLY 90s, ARISTIDE WAS OVERTHROWN, THEN THE USD — THAN THE US

PUT ARISTIDE BACK IN BUT SAID YOU CAN'T REALLY STAY, SO CLINTON PUT HIM BACK IN BUT SAID YOU HAVE TO LEAVE RIGHT AWAY SO THEN THEY PUT IN PRO BALL, AND THEN ARISTIDE CAME BACK AND GEORGE W BUSH SAID I WANT TO TAKE OUT THAT GUY SO THEY TRIED TO BREAK THE GOVERNMENT FOR FIVE YEARS BETWEEN 2001 AND 2004 THEN THEY SENT IN THE CIA AND THEY OVERTHREW HIM AND THEY PUT HIM IN THE AIRPLANE AND CARRIED HIM FOR 23 HOURS TO CENTRAL AFRICAN REPUBLIC IF YOU CHECK, THE NEW YORK TIMES DID NOT REPORT THAT

BECAUSE THEY ARE IN BED WITH THE CIA WE COULDN'T EVEN GET STRAIGHT STORY OF A GUY DEPOSED IN BROAD DAYLIGHT IN OUR OWN HEMISPHERE THAN THEY PUT IN ANOTHER ONE AND THEN MASSIVE HURRICANES AND MASSIVE EARTHQUAKES AND MISMANAGEMENT, AND BILL CLINTON IN CHARGE, NOTHING RECOVERED IT'S UNBELIEVABLE THAT'S CALLED GEOPOLITICS

WE BROKE THE COUNTRY'S ECONOMY BY REPEATED BOYCOTTS SOLVED NOTHING AND THERE IS SOME NATIONAL RESPONSIBILITY ALONG THE WAY BUT BASICALLY WE WERE OBSESSED, ESPECIALLY REPUBLICANS WERE OBSESSED WITH ARISTIDE FOR 20 YEARS AND HE WAS THE ONLY POPULAR POLITICIAN IN THE COUNTRY IF YOU HAVE THE ONLY POPULAR PETITION YOU DON'T REALLY CREATE A BASE FOR LEGITIMATE ACTION THIS IS THE REAL STORY

ON FOOD, LOOK, FIRST OF ALL WE SHOULD STATE — SAY WHAT'S REALLY GOING ON I WILL GIVE YOU AN EXAMPLE LAST YEAR THE TOP NUTRITIONISTS IN THIS COUNTRY BUT A CHAPTER OF THEIR ADVISORY REPORT THAT SHOWED THAT A HEALTHY ENVIRONMENTAL FOOD PRODUCTION SYSTEM WOULD ALSO LEAD TO A HEALTHIER DIET AND THAT WOULD BE LESS BEEF BECAUSE BEEF IS DESTRUCTIVE ENVIRONMENTALLY AND THAT FOR THE HEALTH, THE AMOUNT OF THE AMERICANS ARE EATING THE OBAMA SECRETARY OF AGRICULTURE EXCISED CHAPTER 8 OF THE USDA AND SAID THAT'S BEYOND THE RECOMMENDATION BOUNDARIES

BECAUSE THE FOOD INDUSTRY APPARENTLY IS IMPORTANT AS LOBBYISTS, AND THEY DIDN'T WANT TO HAVE A CHAPTER THAT SPOKE STRAIGHTFORWARDLY ABOUT THESE RISKS WE KNOW THE BEVERAGE INDUSTRY, WE KNOW THE BEEF — WE WERE ABLE TO TAKE ON TRANS FATS BECAUSE THE NUTRITIONISTS LED A REAL CAMPAIGN ON THAT AND THE COMPANIES WERE ABLE TO FIND SOMETHING DIFFERENT BUT BASICALLY, THERE ARE A HANDFUL OF LARGE COMPANIES HERE THAT HAVE A TREMENDOUS CULPABILITY IN THE OBESITY EPIDEMIC

THEY NEED TO BE HELD TO ACCOUNT AND NEED TO COME UP WITH A PLAN FOR PHASING OUT THERE DANGEROUS PRODUCTS WE ARE THE ONLY COUNTRY, IF YOU LOOK ON THE CHARTS, WHILE WE ARE NOT THE ONLY COUNTRY, THEY ARE SPREADING IT OUT TO POOR COUNTRIES, THE DON'T HAVE DEFENSES, BUT WE ARE SO MUCH ABOVE THE OBESITY RATES OF OTHER HIGH INCOME COUNTRIES BECAUSE WE ARE SO MUCH MORE VULNERABLE TO THIS KIND OF LOBBYING >> THANK YOU VERY MUCH DO YOU WANT TO MAKE A COMMENT ON HAITI? >> I WILL BE QUICK AND SAY TWO THINGS HAITI WAS PRIORITIZED AS PART OF THE U

S GOVERNMENT COMMITMENT TO ASSIST AT LEAST 30 COUNTRIES AND THROUGH THAT PRIORITIZATION THEY ARE DEVELOPING A NATIONAL PLAN WITH A LOT OF ASSISTANCE AND RIGHTLY SO FROM CDC AND USAID THAT'S IMPORTANT

IT'S A STEP FORWARD OBVIOUSLY THERE'S A LOT OF WORK TO DO THE SECOND COMMENT I WILL MAKE IS JUST THAT THERE ISN'T — TO GET TO THE HEART OF THE QUESTION, WHICH IS A GREAT QUESTION, I DON'T THINK THERE IS CURRENTLY A RELIABLE WAY TO KNOW HOW COUNTRIES FIT WITH ONE ANOTHER HOW THEY RANK IN TERMS OF HEALTH SECURITY

AND HOW THAT FITS WITH THEIR OVERALL HEALTH SYSTEM ONE OF THE PROJECTS THAT HAVE BEEN WORKING ON, A PILOT SINCE I HAVE BEEN IT NTI IN PARTNERSHIP WITH THE JOHNS HOPKINS CENTER FOR HEALTH SECURITY, IS A GLOBAL HEALTH SECURITY INDEX AND WHETHER IT'S POSSIBLE TO CREATE ONE USING INDICATORS NOT JUST THAT RELATE TO PANDEMIC PREPAREDNESS BUT THAT ALSO TRACKBACK TO COMMUNITY HEALTH AND THE OVERALL HEALTH SYSTEM WE'RE JUST COMPLETING THE PILOT PHASE OF THIS BUT HOPEFUL THAT A TOOL LIKE THAT WOULD HELP LOOK AT ALL COUNTRIES WITH A VERY TRANSPARENT LENS SO THAT BETTER DECISIONS COULD BE MADE ABOUT WHO IS AT RISK AND WHAT THE REAL RISKS ARE WE'RE INCLUDING FACTORS ABOUT WHETHER A COUNTRY IS PREPARED AND NOT JUST FACTORS THAT THE GOVERNMENTS THEM — THEMSELVES GOOGLE I'M SORRY TO KEEP YOU WAITING

I'M GOING TO ASK YOU IF YOU CAN PUT YOUR QUESTIONS, ALL THREE, BUT THEM CRISPLY AND WE WILL GET THE PANELISTS TO RESPOND AND THEN CLOSE GO-AHEAD SIR >> I AM ALSO AN UNDERGRAD I SPENT MOST OF MY LIFE GROWING UP IN GHANA AND MY QUESTION WAS ABOUT WHAT I HAVE NOTICED I KNOW IN GHANA THEY ARE VERY LIMITED WITH UNIVERSITIES

EVEN WITH THE UNIVERSITY'S WE HAVE, VERY FEW OFFER MEDICAL PROGRAMS ARE HAVE RESEARCH CENTERS THAT HAS LED TO A LOW DOCTOR- PATIENT RATIO I LOT — I IMAGINE A LOT OF UNDERDEVELOPED COUNTRIES EXPERIENCED THE SAME THING MY QUESTION IS WHAT EFFORTS IF ANY HAVE INTERNATIONAL HEALTH ORGANIZATIONS OR MEMBER STATES IN WH

O MADE TO ADDRESS THIS PROBLEM? IF THERE ARE NO DOCTORS HOW REALLY DO IMPLEMENT HEALTH REFORMS AND WHATNOT? >> THANK YOU >> I MATTHEW I'M A FRESHMAN I WAS WONDERING — I AM MATTHEW

I AM A FRESHMAN HEARING THESE SPEAKERS HAS REINFORCED FOR ME THE NEED FOR FUNDING FOR THE WHO AND INTERNATIONAL ORGANIZATIONS

FULLY SYMPATHIZE FOR THE NEED FOR THE FUNDING THAT HAD WE BRING THESE ISSUES TO THE AVERAGE AMERICAN OR CITIZEN OF ANY COUNTRY SO WE CAN GALVANIZE PUBLIC SUPPORT FOR THESE PROGRAMS THAT SEEM FOR A LOT OF PEOPLE TO BE VERY FAR OFF ISSUES >> THANK YOU >> AND BACK DR SACHS, I THOUGHT IT WAS INTERESTING YOU USED YOUR INTRODUCTION TO TALK ABOUT DRUG PRICING

HE TALKED ABOUT THE COST OF MANUFACTURING A DRUG BUT NOT THE COST OF DRUG DISCOVERY AND JUST HOW LONG, SIMPLE STATISTICS IT TAKES 20 YEARS TO BRING AN IDEA TO AN ACTUAL MARKETED PRODUCT THE COST OF CLINICAL TRIALS IN THOSE THINGS HOW CAN YOU FINANCE THE DRUG DISCOVERY ASPECT OF THE ROAD PROCESS AND ALSO INCENTIVIZE THE ROAD PROCESS AND STILL COME UP WITH DRUGS THAT ARE REASONABLY PRICED? I THINK YOU HAVE SOME INTERESTING THINGS TO SHARE ON THAT THANK YOU

>> THANK YOU FOR THE TERRIFIC QUESTIONS I'M GOING TO ASK EACH PANELIST TO RESPOND TO WHAT THEY WOULD LIKE TO RESPOND TO AND MAKE ANY CLOSING REMARKS STARTING WITH YOU DR SCHMIDT

>> I'M JUST GOING TO PASS THE PEOPLE WHO KNOW THE ANSWERS TO THE QUESTIONS >> NO CLOSING REMARKS? >> I DON'T NEED TO TALK JUST FOR THE SAKE OF IT THANK YOU >> I WILL BE QUICK ALSO ON TWO POINTS THE DON'T ANSWER THE QUESTION IN THE INTEREST OF PASSING ALONG INFORMATION THAT MIGHT BE HELPFUL

IN THE CASE OF DOCTOR TO PATIENT RATIO, I DON'T HAVE THE ANSWER TO THE QUESTION ABOUT WHAT'S BEING DONE TO TACKLE THAT ISSUE ON EPIDEMIOLOGY AND OTHER TRAINING PROGRAMS I HAVE FOCUSED ON IN THE GLOBAL HEALTH SECURITY AGENDA, ONE OF THE ANSWERS TO YOUR QUESTIONS IS THERE DOES NEED TO BE A CONCERTED EFFORT, AND HAVING A STANDARDIZED APPROACH TO THAT AN UNDERSTANDING WITH THE ACTUAL GAPS ARE AND WHERE THEY ARE IN THE WORLD AND HOW TO ACTUALLY TACKLE THOSE GAPS GIVEN — IN THE CONTEXT OF WHAT THE LOCAL NEEDS ARE THAT IS CRITICAL IF YOU'RE INTERESTED IN HEALTH SECURITY, DONNA HAS BEEN VERY ACTIVE AND HAS A NEXT- GENERATION LEADERSHIP SUPPORT THEIR — DONNA HAS BEEN VERY ACTIVE AND HAS A NEXT VENERATION LEADERSHIP SUPPORT AND ON VACCINE DEVELOPMENT ONE OF THE ENCOURAGING THINGS THAT HAS HAPPENED OVER THE COURSE OF THE YEAR IS THE LAUNCH OF THE COALITION FOR EPIDEMIC PREPAREDNESS

IT WAS LAUNCHED TO GET SOME OF THE QUESTIONS YOU RAISED HAVE YOU SHRINK THE TIME FOR DRUGS TO GET TO MARKET, FOR CORE DRUGS WE NEED BETTER VACCINES AND THERAPEUTICS IN MY PERSONAL OPINION A LOT MORE NEEDS TO BE DONE TO GET TO THE POINT WHERE WE HAVE MEDICAL COUNTERMEASURES AND DIAGNOSTICS ON-DEMAND WHICH IS SOMETHING WE HAVE BEEN TALKING ABOUT FOR YEARS BUT WE ARE REALLY FAR AWAY FROM >> ONE QUICK POINT ON THE QUESTION OF DOCTORS AND POPULATION

BECAUSE OF MOBILE CONNECTIVITY, TELEMEDICINE AND THE ADVENT OF TRAINED COMMITTEE HEALTH WORKERS, THERE'S A TERMINUS AMOUNT OF REDESIGN OF HOW HEALTH SYSTEMS COULD REACH EVERYTHING WE DON'T NEED DOCTORS THE SAME WAY AS IN A TRADITIONAL SYSTEM WE CAN HAVE PEOPLE DOING OUTREACH YOU CAN HAVE RADIOLOGISTS OUT WORD IN THE WORLD — ANYWHERE IN THE WORLD, SOON THERE WON'T BE TOO MANY RADIOLOGISTS, YOUR PHONE WILL DO THE READING OF THE IMAGES, IT WILL TAKE THE IMAGE AND DO THE IMAGE AND INTERPRET IT THROUGH AN EXPERT LEARNING MACHINE OR LEARNING SYSTEM

THERE IS A TREMENDOUS AMOUNT OF INTERESTING INNOVATION GOING ON I WOULD ENCOURAGE STUDENTS TO WORK ON SYSTEMS REDESIGNED IN AN INFORMATION TECHNOLOGY RICH ENVIRONMENT YOU CAN DO A LOT THAT WAS NOT EVEN POSSIBLE US TO FEW YEARS AGO ON THE QUESTION OF ROAD, I SHOULD'VE ADDED THAT THE LID IN THIS DRUG — GILEAD IN THIS DRUG I MENTIONED, WHEN IT BOUGHT THE PRODUCT, PROBABLY THE KEY MOTIVE ROAD — KEY MOTIVE ROAD WAS PERHAPS $5 BILLION

GILEAD IS EARNING $15 BILLION PER YEAR ON THE DRUG THE RELATIONSHIP BETWEEN THE ROAD AND THE ULTIMATE PRICING IS NOT VERY DIRECT IT'S NOT VERY RATIONAL IT DEPENDS TREMENDOUSLY ON MARKET POWER, AND LOBBYING POWER THERE ARE MULTIPLE WAYS TO GET MUCH BETTER RESULTS, WE NEED WHAT IN THE LINGLE IS CALLED RATIONAL DRUG PRICING

WHICH EXPLICITLY TAKES INTO ACCOUNT THE ROAD INCENTIVES AND THE ACCESS ISSUES THE US SYSTEM RIGHT NOW SAYS, WE WILL BASICALLY GO OUT AND DISCOVER SOMETHING AND THEN YOU HAVE 20 YEARS OF MONOPOLY, DO WHAT YOU WANT THAT SYSTEM UNDER ANY THEORETICAL CONCEPTUAL TERMS CAN HARDLY BE WHAT WE CALL SECOND-BEST, IT CANNOT BE THE RIGHT DESIGN, THERE ARE BETTER MORE RATIONAL WAYS TO KEEP THAT BALANCE

ONE WAY BY THE WAY IS PUBLIC FUNDING AND OPEN LICENSING OF THE MEDICINES THIS COMPANY THAT I PARTICULARLY DESPISE, GILEAD, FOR MANY REASONS I DESPISE THE DAILY PEOPLE TO DIE I DESPISE THEY KEEP THE PROFITS ABROAD IN TAX HAVENS IN A COMPLETE TAX GIMMICK

I BASICALLY DESPISE THAT THEY DON'T DO ROAD ALMOST AT ALL I WON'T GO INTO IT ANYWAY, WE'RE NOT GETTING THE BEST OF THIS, WE'RE GETTING A LOT OF WHAT IS CALLED ME TOO INNOVATION MEANING JUDGMENT IS AMOUNT OF DUPLICATION OF ROAD EFFORTS BECAUSE IT'S ALL DESIGNED IN A PRETTY IRRATIONAL WAY TO CHASE HIGH MONOPOLY PROFIT MARGINS, NOT TO CHASE SOCIAL MEANS LET ME JUST SAY A LOT OF GOOD CONSIDERATIONS, A GOOD SENIOR THESES, A GOOD PHD DISSERTATION, MANY TRADE-OFFS, BUT WE'RE NOT EVEN CLOSE TO GETTING THOSE TRADE-OFFS RIGHT RIGHT NOW >> THANK YOU VERY MUCH

IN CLOSING, LET ME THINK DRTEDROS AND PRESIDENT LEE C BOLLINGER IN THEIR ABSENCE WE CERTAINLY KEPT THEM AS I HAVE YOU

I WOULD LIKE TO THANK THE WORLD LEADERS FORM AND OTHERS FOR HELPING US SET UP SUCH A COMPLEX EVENT AND TO ALL OF YOU FOR YOUR INTEREST IN GLOBAL HEALTH AND SUPPORTING THE WHO

AND OTHER ORGANIZATIONS ADVANCING GLOBAL HEALTH I WISH YOU A GOOD NIGHT[APPLAUSE]

Source: Youtube