We established the commission in 2018, it is extending its work in the midst of the intimate through the fall of 2022. These issues are central to the work. We are undertaking. Peggy, one of our commissioners, will be presiding. She recently stepped down from the National Academy of medicine, and was the president of the American Association for the advancement of science, and the former fda commissioner, and former Health Commissioner for the city of new york. We published an analysis that is a companion to this event. S it possible to avert chaos in the vaccine scramble . It is available at csis. Org. The proposition is nationalism dominates the scramble for vaccines. And there is a certain highrisk that low Income Countries will be left out, subject to great delay and uncertainty commander this will have destabilizing consequences. Paper have in our examined operation warp speed, what china is up to, and we have put focus on a Promising Initiative that we will hear about in a moment from peggy. The accelerator and within that the covid facility for vaccines led by gabby. The timing of this event is important as Congress Weighs new covid funding facility in the Senate Republican bill, we will hear about money for that for procurement and distribution. If that step was to be taken, it would be a big step forward in terms of broadening our approach. We are arguing for such a broadening that would blend nationalism in our approach with a more active internationalism. We will hear about that. Other speakers today include Nikolai Gilbert, the president and ceo of pass in seattle. He has agreed to join our commission. With brokering and disturbing vaccines. We are also joined by the thetegic advisor at coalition of her preparedness and innovation. Seppy is the former assistant secretary for fairness in response at health and Human Services department, thank you so much niki. And thank you to kendall for being here. I will turn it over to peggy to lead the conversation. Thank you. Peggy thank you, steve. We have a very distinguished and experienced group of panelists. We really do want to have this as a discussion. This is a critical time to be focused on vaccines. I think it is fair to say that the whole world is very actively waiting and hoping for a vaccine or vaccines to be developed. As a critical measure of protection against what has proven to be a devastating disease, covid19. And there is a lot of reason for optimism, but there are also some real concerns. Certainly, the Scientific Community has galvanized in unprecedented ways, working across sectors and across borders in order to try to develop candidate vaccines and test them. That has been extraordinary. On the other hand, we recognize that this is a Global Pandemic and in order to really combat and control a Global Pandemic, we need to ensure that people around the world have access to tools,l, publichealth importantly vaccines, yet there n enormous sense of responsibility and nationalism around developing vaccines and the access to vaccines that could limit availability, as vaccines are hard to develop, and get them through the whole research process. Manufacture, to and for a Global Response we will literally need billions and billions of doses. So we will be talking about the challenges today, the opportunities and challenges, and we will be talking in particular about an Innovative New model to try to address the issues around how to encourage accelerated research and development of important vaccine candidates, but also how they can be produced and distributed anways that take International Perspective and a perspective of equity, and a Public Health driven distribution approach. So, we will be talking a lot andt the covax activity, there is a slide to help the audience get more grounded in what is covax. That is the vaccine pillar, the act accelerator, which is six the development and production and equitable access to diagnostic, therapeutic and vaccines, the three elements of the necessary tools for an effective medical and Public Health response. This was launched in april. And it was really launched as a collaboration of both governments, importantly including the European Union and their president , but also philanthropy and notforprofit organizations coming together and recognizing this could go was as this Global Pandemic unfolding. Representsid, covax of this, and it is coled by an organization that you just heard about, the coalition for epidemic preparedness and innovation, started after the Ebola Outbreak in order to try to do research and development for vaccines against certain pathogens of pandemic potential. The foresight of that now quite appreciated. And it is coled by the Global Alliance for vaccine immunization, an entity that was created back in 2000, in order vaccines toovide hhe poorest countries throug market shaping, reducing cost and helping with vaccination programs are helped with critical partners in an alliance. So the covax facility is administered by gabi, which has a fairly long history of working in terms of procurement and facility is seen as a marketplace through which many countries, rich and poor, have access to i diversified and actively managed portfolio of vaccines. The poorest countries need Something Like this. They would have no way to actually develop or purchase vaccines for their countrys needs, but high and middle income economies can invest directly in covax vaccines for their own populations. We will talk about why that may be highly desirable. Advancedalso the covax market advanced market commitment aspect of this enterprise. That is very important in terms of the ability through donor financing to secure covid19 doses, make the commitment for purchase ahead of time, and that will help to ensure the access for a very large number of low and middle Income Countries. The goal is to deliver 2 billion doses of covid19 vaccine by the end of 2021. This depends on the successful development, approval, and manufacture of vaccines. Another huge challenge we are unrecognizedously virus and disease. We will talk about that as well. Wheny, i want to mention we turn to the panel the issues of funding. All of this sounds good but it requires the resources, importantly dollar resources although human and political commitment as well to really realize the important goals. Billionated 18. 1 to deliver these goals. The advanced manufacturing needs about 2 billion through 2021. To date has raised 800 million. They need to billion dollars for initial field trials 2 billion for initial field trials. This is absolutely fundamental to the availability for all this work to move forward. We have to do the studies. As more and more vaccine candidates are moving into Clinical Trials this is a critical gap in funding. We Steve Morrison mentioned, do need to see broader commitment of countries. A large numbere of countries, 76, that have indicated interest in committing but we need those countries to truly step up to the plate and make those commitments firm. The United States has not participated in any of the initial planning meetings or made any active commitment. Currently on the hill there was consideration of moneys to support international programs, anduding money for gave money for this is a critical time to advance those efforts the unitedensure states plays a Critical Role in this very innovative and essential International Activity to help develop and equity distribute vaccines. That is what we want to top out. I will now turn to the panelists. I dont think we need the slide. Toill start with nicole really start the discussion. She has a long history of of public the realm Health Preparedness and responding to epidemics and pandemics, including h1n1, ebola, zika, and now covid19. Also an american citizen who worked for the u. S. Government. I was told you could lay out for us a little bit why this initiative is so important and why it is in fact in the u. S. National Interest Despite all the investments the u. S. Is currently making in its own Vaccine Development programs for covid, operation warp speed. Why is it also a value for the commit to ast and program like covax . Nicole thank you for the question. I think what is important to remember, and we hear this a lot, nobody wins this race unless everybody wins. We are not safe until everyone is safe. I think from the u. S. Perspective there are a couple of really important components. It is obviously in our own interest to be sure not only their is a safe and effective vaccines for americans, but safe and effective vaccines for the world so we can end this pandemic. Vaccineeeing nationalism. Lots of countries are taking care of their own needs, which they need to, and we are seeing countries make bilateral deals to get vaccines. That is only going to drive up the price of vaccine for everyone. The u. S. Is invested in a number of candidates. We are optimistic. We dont know if they will be successful. We dont know if they will generate enough doses. This idea of the u. S. Supporting and buying into a larger pool of candidates so that it hedges its bets, it sees covax as an insurance policy for itself, makes really good sense. Finally, just thinking about our own economic recovery, our economy cant recover just by vaccinating americans. Our economy will need markets around the world to be strong and functional for our own economy to recover. That means vaccinating people around the world. Probably starting with the first tier of frontline workers. Peggy thank you, nikki. I will turn to kendall hoyt, who has been working to study some of the issues around models of collaboration and also when the market does not always work to address critical Public Health or global need. And why would a model like this necessary . Why cant the free market just recognize these needs . Nikki just laid out a critical set of reasons why the u. S. National interest, but why more broadly ways need to proceed in that might be different than we might normally expect in a global marketplace . Kendall that is a very good question. Demand is high. The market does work. It is not a market failure. But competition is a timehonored way to generate innovation. In this case it might actually hinder efforts to develop a covid vaccine. And to make it equitably available. Market vaccines will go to the highest bidder. There is limited supply early on. We did a bottle of the market. It shows if you allow free Market Forces to operate, it will cost 13 times more than if we were to do a collective procurement under a global mechanism such as covax. Cost. It is also going to reduce access to the vaccines that are available if you do it through these bilateral deals. You want covax to allow equitable distribution on the basis of need and vulnerability as opposed to nationality and ability to pay. As nikki said, we have a vested interest in ending chains of transmission as quickly as possible. It would get in the way of that. Furthermore, allowing the free market to operate through these bilateral deals is going to create incentives for protectionist measures. Things that will snarl supply chains and which will then hinder development and extend the amount of time it takes for us to effectively rule out vaccines roll out vaccines. Those are some things to consider. Peggy thank you, thank you. Turning to our european colleague, let me welcome Nikolai Gilbert both to the panel into his new leadership role. It is morning in washington, d. C. He has movers at his home in denmark, in copenhagen to help prepare him to make the journey to seattle where path is located. Path has a long history of forging partnerships across withrs and across borders government, philanthropy, notforprofit organizations, and the private sector. Perspective clearly is important as we are thinking about how to shape and hopefully support the success of a novel. Ntity like kovacs covax i was hoping you could speak a bit to the issues about how you , why thiserships Work Partnership is so critical now, and potentially provide a little nonus perspective on vaccines, nationalism versus globalism. Nikolai thank you so much, peggy. It is a pleasure to be with you all today. Those are Big Questions that you raise. There is good news. Its great timing for having a discussion on this topic. Aware ofhave became covid19 there has been an unprecedented global collaboration in the r d state in the Scientific Community. That is great. It meant r d has been able to be accelerated at an unprecedented scale. That is great news. This is what it is probably realistic we will have a vaccine available in a short time. What we have seen in terms of partnerships is a way of breaking down the barriers between public and private sector. We talked about covax. We talked about accelerator and all these new and novel approaches. Upon public and private partnerships. Academic institutions, universities, pharmaceutical companies and so forth. This is how we have been operating for the last 40 years. This isseen how extremely effective and can help accelerate development. Way, it seems to be proven on a completely unprecedented scale and with some actors. We are seeing new models. I think this covax is a unique approach, which is actually trying to also pull in all the countries around the world, no matter if they are low Income Countries, high Income Countries. Everyone has a role to play in this global effort to get a vaccine out that works and become available to all. Theously it is not only science, it is the manufacturing. Thesek you mentioned all candidates for vaccines, those that are manufactured upfront, we need to start that work now. We need to use all the resources and approaches to prepare that and provide the funding that is needed for that effort. And, from the european perspective, we talk about nationalism in the u. S. Context today. I would say as a danish citizen from europe nationalism has also been a part of the response in europe. Equipment,tarting on who has access to that, and then went on. How do you make sure who has access to the vaccines first . Now we see the European Commissioner, the head of the hard andn is pushing has been very helpful at conferences to launch the facilities and giving support from the European Union. The latest is that to counteract the eu was, negotiating on behalf of all Member States with manufacturers and producers, which is a new approach. They would have to deliver on that approach, otherwise probably the government, the National Governments are going to maybe turn towards a more nationalistic approach, which i dont hope for. Covax is a great response for the world in that sense. Peggy thank you. Wonder if nationalism even possible when it comes to vaccines or other areas of bioscience products, innovation and development. Science is a Global Enterprise now. The underlying work behind all these vaccines has been very collaborative and very international. So many of the companies are multinational in terms of how they do their work. Labs in one place, manufacturing facilities, else, critical supplies coming from Different Countries. Etc. Done wheree to be there are cases. U. S. Is not proud of its number of cases at the moment, it does mean we have a lot of opportunity to do Clinical Trials. In china, because they have more successfully controlled the spread of this Novel Coronavirus, they are having to go to other countries to do their Clinical Trials. Crossing is a lot of of borders and requirements for collaboration or benefits of collaboration to matter what. I am sort off curious. Maybe i will go back to nikki on this. Do you think it would be possible for the u. S. To just try to go it alone . This haswatched how unfolded in other instances. I should say in framing the question also, would we be where we are if china had not posted the genome in early january in terms of our ability to develop important medical countermeasures . Science has unfolded quickly and spread. People have gotten access to it without a problem. Thats another issue with Vaccine Development and collaboration in the past. Curious, from years of curious, from years of experience you now have had working on these issues. Nicole it is such a good question. When i first got into this whole field the world looked pretty different. There were lots of efforts at collaboration, particularly in the Public Health side, the surveillance side between the u. S. And other countries around the world. But from a scientific perspective, the u. S. Scientific enterprise, particularly bioscience was the envy of the world. What we have seen over the time i have done this work is a lot of the world has caught up in so many ways. As he said, we have lots of Vaccine Development and manufacturing going on in china, Vaccine Development and manufacturing in europe. We have lots and lots of interdependencies. For those interdependencies to thetion, i think that relationships have to be built on a basis of collaboration and trust. The u. S. Has been a sort of precarious position is any precarious position because it has been choosing to go it alone. In a lot of different ways. My perspective as an american of working with a number global organizations is we are viewed with increasing amounts of skepticism about whether we can be trusted. Certainly the and scientific advancements that have been made both in the United States and across the this area ofom global collaboration. You know when push comes to aree sovereign leaders under a lot of pressure to protect their own populations first. It takes an enormous amount of leadership and skill to explain to one citizen around the world that taking care of my citizens also involves taking care of the citizens around the world. If this has not shown is infection disease no snowboarders, none have. Have. Ws no borders, none seen thee have lockdowns and export controls s with personal protective equipment and supplies, lots of border closers around the world, this kind of nationalism is still alive and well. I think people really inhibit our ability to deal with the pandemic. Frankly, for the u. S. Disorder continue to regain trust as a trusted International Partner going forward, thats an issue thats a huge concern to me. Peggy i know you have done work on trying to think about and frame vaccines as a Global Public good. That is, i think from my perspective as a Public Health professional certainly true. It is a hard thing to in manyate u contexts of a crisis like this. Can you tell us about the work you have done in that domain . Nicole sure kendall sure. To refer back to nationalism, i would say our political instincts are not in sync with the practical realities of research and development in a globalized world today. That problem is part of the answer to the Global Public good problem. And, one of the things i would like to see is creating institutions and frameworks that will make collaboration more easier and easier an easier political sell and reduce disincentives. Tom and chad brown had this idea for investment fund, a pandemic agreement. I sort of envisioned Something Like a treaty that would come into force when there is a pandemic, with a code of conduct that nations would agree to. Whether it is sharing samples and data in a timely fashion, coordinating on Clinical Trials, adopting harmonized protocols, or agreeing not to have export controls or price gouging. You can think of a whole range of things that we would all agree to upfront that would allow for a much more streamlined response, a much more rational response in the moment. But, you know, in addition to other would like to see things we can do. Aree viral spillover events like Greenhouse Gas emissions. Tools andays, strategies to dissolve them collectively solve them collectively. There is a political side you can do with a treaty, but covax is an important economic piece. It is a tool that allows us to collaborate effectively and efficiently to pool our risk. A lot of the Building Blocks of what we need are already there, and howit is the who they have all come together to create Something Like covax. And theing the value power of these institutions to create the institutional createrk we need, vaccines for the public good, and make a larger project is where we need to go. Certainly treaties are one can imagine in the process of trying to think about what might be in a treaty you can make a lot of important progress forward instead of laying out all the different issues, many of which you just touched on, that can become barriers to effective thatboration and i think it would be unlikely that in the current state of politics in this country and probably many others we could really forge such a treaty. Itan exercise i could see would have real value and getting away from this either or mentality, these false dichotomies. The u. S. Can perceive efforts to get vaccines for use in our own country, but also participate in International Collaborative efforts like covax, and is a because itrategy allows you to distribute your risk and allows you to diversify your portfolio. We dont know which vaccine will make it over the finish line. Hopefully more than one. But it is really a critical time. Contracts are a step back from a treaty, yet enforceable. Way, a of an incremental change. R social peggy nikolai might have a comment on this point. Nicole to just build on kendalls comments, there were a number of things we did not anticipate. As an american, i appreciate very much the fact the u. S. Government has this and and financing system. They can pay for the basic science, Vaccine Development, pay for the manufacturing, paid up by doses and distribute it to the citizens. The rest of the world is not organized that way. As we got into Vaccine Development we realized there was no entity to pay for the scale of manufacturing that needed to happen. There was no entity that could make an advanced market commitment to purchase doses so the manufacturers could manufacture doses. That is why covax and the facility came to being. We cant bepandemic passing the 10 cup race tin cup raising money. We have to have a global system that lets us happen much more easily, faster, and with marketability. Peggy nikolai, i want to let you make whatever comment he want to make but you have been watching this from the perspective of what is happening in europe but anticipating joining our musician based in the u. S. , thEuropean CommissionEuropean Union really has stepped up to the plate in terms of leadership for shaping the accelerator and importantly the covax vaccine pillar of the effort. Of very generous in terms the pledging and fundraising. We are seeing some of the countries in europe advancing Bilateral Agreements and the eu creating its own Vaccine Initiative as well. Lots of these different tensions coming out. It isportant do you think to find the right balance as these efforts go forward . Do you think as after the idea of the accelerator was launched that the vaccine nationalism, Energy Nationalism energy began to take hold and pulling away from support for covax . How important is the adherence of the European Commission behind this effort . Nikolai before i dive into the european situation, they comment on the nationalism question you raised. Trends we have seen over the last couple of years. There is a decreasing interest overall in vaccines before covid19 hit us. The supply of vaccines to many diseases around the world affecting africa, southeast asia, and others, there has been a declining interest. That is due to profitability as well for many private sector companies. We were already on a declining interest in terms of a vaccine. And nowid19 hit us all we need to pick that up around the world. That theand this is u. S. Markets, from a pharmaceutical or biotechnology perspective, the most profitable of the world, right . Its a very interesting market for all Major Pharmaceutical Companies in the world. It is very difficult when the u. S. Administration approaching access to your products, in this case a vaccine. Therapeutics be which is something we have seen. I just think the pharmaceuticals, the biotech industry also has a role to play in this whole thing. We have seen this a bit with the accelerator. I still think we need that collective mindset coming more firmly out so that governments around the world can see it actually does not payoff to do these bilateral deals. If they see other country start to do that, it will be pressure from citizens of that country to pursue those deals and that can be hard for any politician to actually counteract that. Question, iean think there is some solidarity now in terms of lets try to do this together. There is a big difference. I dont know if it is the same in the u. S. , but in europe, the money provided for development assistance, which could finance the covax facility and market commitments for lowIncome Countries, that is part of money in the European Commission and ultimately national budgets. Int money can be allocated terms of the Global Development budget from european countries. Then there are the National Health priorities and industries that are responsible for purchasing medicine and so one. So on. That is what is making this complicated. You have funding, but i think the covax facility is designed well for that. You have availability for your own citizens, but you can contribute Via Development assistance to these facilities. I imagine this model could work for the United States. I think it is quite a great model. Europe has shown you can actually protect your citizens but also be part of international efforts. Peggy thank you. Steve, you have been quiet. Looks like maybe you wanted to comment. Steve thank you. I have been listening intently. I have two points. The first on the question of diplomacy and treaties. Keep in mind the dominant factor today is the clash between United States and china, which is worsening. The provision everyday there is a new set of provisions enacted into this. That clash, which is escalating, has paralyzed the un security council. It has dominated to such an extent that we see, with the exception of the pledging conferences organized in may and june, we see a void of highlevel diplomatic activity in this period, which is shocking and astonishing. You have a planetary crisis of health and economic stability and you do not have highlevel diplomacy at the level of state leadership looking at this with any kind of, ok, how are we going to work collaboratively towards this . That is just a very cautionary remark about the dominance of this clash in the way it is shaping the responses. United states you can make this case that has a legacy of leadership that it can embrace. It will have surplus capacity in terms of production agreements. It has in its own selfinterest to hedge his bets its bets. Gave is a known and trusted partner. Opinion is very high. The problem is how do you crack through and get some initial action that reaches outside of the nationalist approach . I remain optimistic some pathway will be found. The 3 billion in the senate bill put forward by Republican Leaders towards support is a workaround. The second point is lets not forget what is going on among lower income and lower and middle Income Countries. They witnessed this winter and rawng they had a very experience in witnessing the freeforall market for ppe, test kits, ventilators, remdesivir and the like. We have spoken with folks like abdul kareem in south africa. They just expressed a deep frustration that they cannot do the things they need to do to control this response because of the broken marketplace dominated by the highend countries high Income Countries. Africa, much of the search has come late. There were effective lockdowns in march which delayed things but they became untenable long term. Now we seeing a massive search. Look at south africa. There is a lot of anxiety around what is lying ahead. The u. N. Echo secretarygeneral put forward a 10. 3 billion appeal, the largest in Human History on health response. They are seeing multiple crises around the corner. Extreme poverty, food scarcity, economic stress, health infrastructure, damaged rebound epidemics. Whichs the context in people are making the case now we have to begin to think ahead and act on an urgent basis. They have the Institutional Capacity to move this forward but we do have a really serious political problem and trying to move forward in time. Thank you. Peggy thank you. Very insightful comments. Very sobering comments as well, and a powerful reminder of just what challenging times we live in and a powerful reminder about the importance of leadership within a nation and among nations to achieve so many critical goals. Coming back, you ended your comments talking about the realize the goals of covax. It is a much broader coalition that will be necessary to make this possible. It is a new idea, a fragile organization in very early stages. Nikki is working night and day on trying to make it work. What do you think are the key challenges right now and the biggest concerns getting the money needed to do trials . There are many other issues as well. All overlaid on the uncertainty of the science, of course. I would come back and say there is so much of this there relates to money and the financial situation. As you started out by noting, sepi estimated it needed about 2 billion basically deliver a vaccine candidate that was viable. Part of that delivery of the vaccine candidates is the final r d. A lot of that is Clinical Trials, which needs to be funded. When need to raise about 700 million to get that work done. In addition, as we have alluded to, we talked about manufacturing. One of the strategies is to be sure there is manufacturing capacity distributed around the world. In part is counter to the nationalism so if any one country wants to lockdown doses, you have to the capacity to manufacture in other places. In the considerations about access and ultimately capacity building. All of that involves transfer of technology to manufacturing facilities around the world. There are really good manufacturing facilities around the world, but the ability to scale them up and to manufacture those doses, and at the end of the day there is a global race to get them into vials and syringes. There is a glass shorted. Just like we are fighting about the supply of ppe in the ackground, bidding wars and global glass applied. Just as one of the many examples. Then you have to be sure you can get the regulatory agencies around the world together to be coordinated. But have been great so far, taking good scientific looks. And the Manufacturing Processes to make sure they will be safe and pure before they are used in populations. Those are other things. I would say even after vaccines are authorized for use Different Countries have really different abilities to monitor vaccines, post licensure. Thats another place for global collaboration will be really essential. Peggy yeah. That will be very, very important. There are multiple vaccine candidates out there. Vaccines in use and they require multiple doses. Making sure we actually know who is getting which vaccine and they get the right vaccine whether second dose would be nice if we could begin to understand which vaccines work better for which subpopulations. There is a lot of interesting and important work to be done on the r d side, as well as the safety monitoring. It all argues for a lot of transparency and exchange of information, both within the country, making sure we are collecting, but also collaboration with others as we are learning more about the and the human immune response to this virus and the nature of the virus. So we dont have too much time left. Who isturn to nikolai just coming into his role as pat h. He said he began in early january just as we were learning andt this Novel Coronavirus thinking about all the implications. Path ine experience of spearheading critical partnerships and working across sectors and across countries, looking now at covax, what are the critical issues, the time urgent challenges that have to be addressed . He things we cannot let pass if you want to see success . Many, many have vaccine candidates in our portfolio. World ind19 hit the , we are working with others to try to get some of these candidates forward and through clinical programs. We talked about the manufacturing capacity for vaccine. There but are but in a cloistered way. How do we make sure all manufacturers are upscaled and security production, quality, that we are actually helping some of these potential theircturers to uplift skills and be ready to be producing billions of doses of potential vaccine . I think that work are key isponents that seppi driving. Then there is something we had not discussed, the distribution of the vaccine. How do we get it out there when it is available and at the right price and so forth . That is really difficult. We have seen with the other humanization programs immunization programs and other things we are vaccinating for. How to get that infrastructure up and running again and put for potential coronavirus vaccinations . That is a piece we need to get ready urgently. Peggy thank you. Now, i, turning to you would like for you to comment on this set of questions. As we are moving towards closure, maybe offer a few thoughts. Are you optimistic or pessimistic about whether or not we will be able to find a path through this current scramble willds a vaccine that enable and support the kind of global collaboration we have been talking about an offer an alternative to vaccine nationalism . Then i will ask the other panelist that same ending question before we conclude. Kendall the most hopeful thing i can say in a world where diplomacy is not always an workn is that i think the path is doing to boost doingtion, that seppi is to distribute manufacturing capacity, that is diplomacy by other means. That is one way to be effective in this environment. Covax will be an interesting demonstration. This will be a test of nationalism versus collective effort. , would put my money on covax just make purely risk probability perspective. Of theon warp speed, one largest, most wellfinanced nationbased approaches, i think we have maybe six. The Research Says once you are in human trials, the probability of success to 17 . With six, you have a 67 chance. Covax has close to 10 candidates. The chances of them having a successful candidate argued, probably better. Selfinterested rationale is some vaccines for my most vulnerable population is better than no vaccine, and lots of countries will get locked into agreements with no vaccine. Covax will look like a viable alternative. Countries of how many actually sign up initially right now and what their budget is right now, over time the logic will play in its favor and i am hopeful we will have a chance to build on these institutions going forward. I am heartened you are putting your money on covax. Are you optimistic or pessimistic . Me, one of the most inspirational set of calls i have been on recently was a call with countries who had discretion of interest to join covax. Expressed an interest to join covax. There were maybe 95 countries who got on a call for two days. These are countries who are often adversaries. In many other different areas of politics and competition. Of reasonser sorts people can think of to fight one another. There they were on the phone together, thinking through and learning about how they might join forces to procure vaccine. That made me incredibly optimistic that we could find a way forward to this. They also seemed to recognize, and i want to end with this point, if we want to do this and we want to be successful, especially with getting doses early and enough doses so we dont devolve into some sort of food fight about doses, we have to get money to put down on Raw Materials and manufacturing. That is a really urgent need. The amount of money needed is Something Like the amount that is four or five days of global gdp loss we are facing now. While it seems like a big number, in the big scheme of things it is really not. I think if you spread that across all the countries that can afford to do it, it is not such a terrible problem. It is solvable. Peggy nikolai . Pessimistic or optimistic . Nikolai well, the last six months has proven the world has a common vision, a common purpose to find a vaccine against covid19. We have seen unprecedented collaboration across nations, scientific collaborations, political collaborations. It is almost like a moon landing we are going to do together. I am an optimist. We have proven we can break down barriers between us. I think with the leadership together we can move this forward. We have the infrastructure now with covax. It is just a matter of getting it to work. Peggy steve, we dont have much time but do you want to provide any last thoughts as we come to a close . Steve thank you very much, and thank you peggy for masterful moderation. I want to offer special thanks work incarroll for her putting this together and Clifton Jones for putting this together. I agree with much of what has been said. Seppi have been impressive. Fast, visionary. Risks, boldken in their thinking. The numbers look like big numbers but they arent. If we can get over this hurdle and secure the baseline required, they will be able to do great things. And have enormous impact. We need to keep our eye on the ball on the urgency of getting to that point on very under very different circumstances. We need to be realistic now. We are heading into this next phase. It will be a very difficult couple of years. We need to brace ourselves for that. We will need to be fairly rugged and the way we go about putting these plans forward and aware it is going to be a turbulent and very difficult environment for these low income and middle Income Countries. There will be no choice. All of you have shown just how much ingenuity and intellectual capacity and commitment has been brought to the table. I think all of the speakers who have been with us today who have been intellectual and institutional leaders in this field. Thank you. Peggy thank you all. Thank the panelists. Thanks to you, steve, for your tremendous leadership. Team. Ole csis this is it. Thank you all. President trump holds a News Conference today on his administrations response to the coronavirus. Watch live at 530 eastern time on cspan 5 30 eastern on cspan, cspan. Org, or listen free on the cspan radio app. The contenders,about the men who ran for the presidency and lost but changed political history all week at 8 00 p. M. Eastern on cspan. Candidate james blaine. Cspan has covered every minute of every Political Convention since 1984. We are not stopping now. This months Political Conventions will be like none other in history. With the coronavirus pandemic living, plans or gatherings are being altered. The democrats will be to nominate joe biden as their president ial candidate on monday. President trump will accept his partys nomination the next week. Watching cspan at 9 00 p. M. Eastern for live coverage of the Democratic Convention starting on monday, and the republican Convention Starting next monday, august 24. Live streaming and on demand at cspan. Org, or listen with the free cspan radio app. Cspan, your unfiltered view of politics. The Washington Post talked with leaders of the marts for our lives organization about the youth vote. March for our lives cofounder executive joint ur totor alexis conf encourage youth turnout in the election