We have more than i think 760 registered for this meeting and we will do our best to get to as many questions as we can during the period but now a little bit about this event. The independent Task Force Program began in 1995 analyzing issues of critical importance to us Foreign Policy in a nonpartisan way. Once launched task forces are independent of cfr and are solely responsible for the content of their worth. And the task forceprograms 25th year cfr is launching its 78 Task Force Report and id like to welcome you to this discussion of the report and its called improving pandemic preparedness , lessons from covid19. A brief introduction of our panelists, we have cynthia burwell, cochair and president of American University and also former us secretary of health and Human Services under president obama. Welcome to you. Also joining us is frances townsend, also cochair, assistant to president bush in Homeland Security and counterterrorism and is vice chairman on general counsel of vice and ministration officer for forbes inc. , welcome and Thomas Bollyky is a senior fellow for Global Health economics and development and director of the Global Health programs at cfr and finally Patrick Stewart patrick, James H Binger senior fellow in governance and director of the International Institutions and Global Governance program at cfr. Lets jump right in. Theres a lot to get through, this is a tech report with a lot to say and im going to start with you sylvia. One issue the report now during an election and in the midst of this pandemic . Sylvia, are you there . Fran, are you there . [overlapping conversation] is she back . All right. I issued the report now before the election in the midst ofthis pandemic . I apologize, couldnt hear in general. Thank you, sorry about that. In terms of now, we wanted to get this report out as quickly as possible. The information from the report is something we believe is relevant in terms of pandemic preparedness for the future which we think is extremely important to focus on and be ready for but its important for now as we are continuing in the pandemic that we are in so now was the time as soon as we were able to do the assessments with the group of experts and we want to thank those experts. The four of us are part of this but there was a whole team at the council on Foreign Relations supporting the effort and independent members of a Bipartisan Task force were part of this and we wanted to get the information out so that it could be used to improve the conditions and situations both in health andeconomics in our nation and orprepare for the future. Fran, im going to bring you in here. What are the reports main messages about how were managing this pandemic and how we can better prepare for the next one . The next one is inevitable and i think thats the thrust of why we wanted to get the report not only out could it have something to the current pandemic and the current Pandemic Response as well as preparing for the future and the fact that another e. Pandemic is inevitable is key to why this i think this report is so important. I want to take the opportunity to take common stewart who did the lions share of the writing here and were able to pull together this Phenomenal Group of folks, policy folks and experts, some of joined us today. The idea was what can we do better next time, we have an obligation for example to protect vulnerable populations are particularly hard hit. We talk about, we look at sylvia mentioned the Economic Impact of thepandemic. Eand what we found i think everyone agrees was this preparedness is the key to blunting the impact and to reducing the enormity of that impact on populations and the economics and so what we look for this is Common Ground and preparedness is key here. At state and local levels and federal levels, testing, Contact Tracing and being prepared to do those things in a national and global way is key to preparedness and response. Sylvia, you worked on evil in the Barack Obama Administration and fran you played a role during the art outbreaks under the george w. Bush administration. Id like you to first both give a break to how you think not only the United States but the International Community obviously we will get into some of the disparities there with this pandemic at this time. I think im not sure that right now a grade is whats most helpful. I think what the report does is helpful is assess the things thatneed to be done better. And that is what we focus on in the report and i think its clear in terms of the us response and we discussed that in the report that a National Strategy is needed. And a National Strategy would include a National Approach to testing. A National Approach to Contact Tracing. And real clarity of communications that scientifically based and thats what we try to focus on are what are the things that can move us forward right now and could make sure were in good steadfor the future. Ran, one of the big takeaways you just mentioned here is the very idea that any there needs to be a plan in place or the next one coming along so what generally speaking before we dig in, what does that look like . D certainly is at the federal level you need a single point that coordinates. You look now at how many departments, it wasnt just health and Human Services but all of the expertise that had to be brought to bear across the federal government. Cdc and fda and so it really does require a single point of contact in the white house. To coordinate the tinteragency but also you know, this is going to be effective its like to be a global effort so you also need one at the ambassadorial level at the state department to really coordinate the tinternational response. I think all of those pieces need to lead to a quicker moreeffective and efficient response. Im going to bring in, right now. Very Strong Language in this report about the various iareas across the way and before we get to the other part of the report which is moving forward with specifically what should be done, there is a lot dedicated towhy we are in the place that we are now. And i want to start with chinas performance and lack of transparency early on in the pandemic, what are some of the Key Takeaways there. First, im really pleased to be here with you, im grateful for your willingness to do this event and i also want to express my gratitude to sylvia and fran for the tremendous job that they did sharing. This task force, im grateful to have the opportunity to work with them and the other Task Force Members as well as my colleagues in the large team at cfr,that is responsible for this large report. So report your right, doesnt pull any punches and in assessing what has happened globally. This pandemic, the task force is quite clear, it seems to be china china covered up over a crucial twoweek period in january early cases delayed sharing Material Information with the who and partners. Has contributed to the early fred of the virus. Both domestically in chinaand internationally. Who in terms of its response, lots to say that heroic about their limited resources and authorities. But praising china for its transparency is did not help and they were a week late in declaring this an international or Public Health emergency as an international concern. Whos tendency or deference as manifested itself in some inconsistent communication of credulous public stance towards Chinese Government claims and unqualified claim for chinas response. Thats right. Its understandable, who has limited resources and authority have to work with affected states. Its understandable that they need to maintain a relationship with china, but that said the medications from who went a bit further than that in the early days of this pandemic where they were praising china certainly has health matters. That said i think that sometimes gets confused including by the Us Administration is this is not particular to this pandemic or to china. Who has exercised the same deference in previous outbreaks, epidemics and pandemics with Effective Member states. If a member state organization and its ultimately as strong as its members make it. So the us has severed its relationship with the who for now. This report makes recommendations about that really is worthwhile to remain in the who and whatare the risks of leaving . Who is not a perfect institution. Many of itsimperfections in terms of its processes , its bureaucratic nature have been well displayed in this particular pandemic. However there is no alternative on the multilateral level for working with who on International Health crises. And ultimately, what who is primarily been doing these last months of course is coordinating internationally to the response to this pandemic, particularly in low and middle Income Countries. For the most part in low and middle Income Countries this pandemic has been quite as devastating as people expected. And in my view who dessert i think in the view of the task force who deserves some credit. For what weve seen in that regard. What countries get better and why . In the report, im going to quote again the single most important determinant it turns out has been the quality of lyrical leadership and execution. Lets use an example. South korea and the United States experienced their first reported case within 24 hours of each other. South korea having learned from his experience with middle eastern respiratory syndrome, another coronavirus. Move quickly, rapidly and aggressively. Tested three times as many citizens on a per capita basis in the United States in the early months of the pandemic. And they deployed fundamentals. Exhaustively testing, identifying those who are ill, isolating them, tracing their contacts, florentine those contacts. And they exhibit a high rate of mass wearing. Again the most part, not rocket science. What south korea did but they responded aggressively. Today, south korea was with a a population of 52 million 24,000 roughly reported cases of coronavirus, 4420 deaths. The United States has 7. 3 million cases edof coronavirus and 211 thousand deaths. This was not inevitable. Preparedness has made a difference, preparedness in the abilityto execute have made a difference in how these nations have done in this pandemic. This brings us to the United States and im going to bring in stuart now. The report calls what happened here the consequences of a failure in political leadership. It also notes pandemics are not random events area as we just heard earlier, they are predictable. They do happen. We know another one will have. The United States was unprepared. Why . The United States was unprepared and this is a problem that goes back prior to this administration. Will get to the administrations response as well but for years, lots of brew ribbon commissions like this one and official Us Government documents have outlined the eminence and threats in line with the economy and political stability of international pandemics of this sort. And yet what we found consistently as a pattern of complacency in which even after some of the emergencies that we had, the dust has been very little investment at the National Level in pandemic preparedness so a lot of it is just one of a structural inability in the us political system to treat pandemic preparedness as the National Security that is on a par with national defense. Every 700 billion in the pentagon and us military spending and yet what brought the United States to its knees in 2020 was a patent and we need to recognize that. In terms of getting beyond just the longterm lack of preparedness that has affected the United States weve already pointed to a few of the failures on behalf of the United States once the pandemic was upon us. The lack of a recomprehensive nationwide system of testing and tracing, too often elected political leaders weather in the white house or governors mansions or in the halls were flying blind about the trajectory so you either had to have blunt force responses to this Public Health emergency or you took a cavalier attitude because you didnt know which way it was going. Another thing that i think has been really debilitating and is the lack of clear Public Health guidance from leaders. I think too often much of what weve heard ffrom the president on down oand often by governors as well is a lack of willingness to put science first and so it sort of is contradictory, unclear or incoherent and sometimes politicized Public Health guidance which doesnt provide american citizens with what they need to know from their elected leaders which is whats the risk here and what are some common sense precautions that you and i can take to protect our families and communities and i think those things have been lacking in this pandemic. The report also before i moved to some of the recommendations report makes quite an important point that the response was slow andthat cost lives. That the government seemed to have known much earlier on what was going on and yet it wasnt until midmarch that actually anything was really mobilized. Again, im not sure i personally can add much more to the revelations in Bob Woodwards book and other press reports in this regard but the task force does make the point and has charts to this effect that if in interventions had occurred hopefully even two weeks earlier that there would have been a lot of lower loss of life and toms discussion of the courier case i think is highly indicative here. We have a death rate that is 80 times that of south korea and infection rate that is 50 times greater and yet the first reception was within a day of the United States when it had its first infection so it suggests that china and the who have some answering to do. T there are failures in the way the United States responded internationally. You mentioned be intentional role of medication in chain of command and disseminating information and how that really struggles here so moving forward , how should the federal government better work with state and local entities to convey information . Whose responsibility is itto ensure Accurate Information is being shared with the public . There are lots of things we point out as a real imperative is to try and get some level of clarity about roles and responsibilities among the federal government, the government and municipal authorities so we dont have a as one of our members described as a caricature of the articles of confederation in Pandemic Response or you have sort of 50 flowers released at the state level blooming people are adopting quite different approaches and so we call for the executive branch to make an inquiry and a study in terms of trying to remove some of those ambiguities including over the use of the Strategic National stockpile which became something of a political football as you recall early on in the pandemic. Im going to bring sylvia back in because we a little bit of time before we open it up toquestions. Horrific death rates among blacks , latin and indigenous populations as well as essential workers , the elderly. How can we better protect Vulnerable People . As we think about the vulnerable populations that we need to focus on two things. We need to focus on the here and now in terms of the pandemic and can be done right now to help. Some of that is about making sure we have the right data of information and some that is about communicating clearly the scientific information to these populations lyto make sure they know and have the tools they need to prevent it at the subsistence level and the third thing ourpolicy things you can do to make a difference. We know these populations and the foldable populations have certain types of social determinants that may prevent their ability to prevent spread area for example we know that certain populations may be living close together so how do you provide policy options for people if they need to isolate so they dont spread the disease further to their family, if they dont have that ability to do that in their own home . We have to then focus on the longerterm issue that if created some of that disparity and inequity that we see the real Underlying Health conditions, people of color in our nation and minority populations result from years of structural issues and so thats the other thing as we come out on the pandemic, we need to focus on why is it that there are more of the preexisting conditions that make this disease worse in those populations and whether that access to healthcare, we know the number of insured is again another place where there inequity in the country. But the Affordable Care act great progress against that. We also know that there are inequities and when were doing trials in terms of who participate in these trials for drugs or vaccines, for all kinds of things so there are issues now and then there are issues in the longerterm really need to be focused on though the next time this happens where not in the same place as we move through that we do everything we can take care of some of those inequities that exist. Ran, id like to ask you your thoughts on really a state of Public Health in the United States. Thats an issue that the report really talks about being a need to provide this sort of safety net for the country in times like this. What you find is if you lookacross the 50 states , the culpability in each of the states is quite different and nowhere is it adequately funded or staffed and this is where the federal government can really provide funding. If we fund this i think it was stuart who referred to photo budgeting. If we really believe this is a National Security threat and we need to fund it interNational Security threat, not just talk about. When we look at the impact of this pandemic you realize why its so important to have a comprehensive federal Health Security project that is a funded and regularly supported and replenished as part of our federal procurement system. The Strategic National stockpile because of the inequities among the states can be the essential procurer of ppe so that there is adequate supply even in states where publichealth system is weaker than other parts of the country. Part of the federal governments responsibility is to be able to even out the inequity that exists among the states. Back to Stuarts Point about roles and responsibility. The federal government isnt going to be able to solve this for everyone in the states do have a responsibility to prepare themselves or to identify their shortfalls so that the federal government can help them meet those shortfalls. Im going to bring in stuart and also tom, if you can this as well. We are going to see a vaccine probably several some point. How do you ensure equitable access to a vaccine within the United States and globally . Ac i will be brief here because the expert on this is tom , hes the expert on seen nationalism but our report does talk about the importance of supporting an International Mechanism that that position on equity built into it based on Public Health and not simply trying to lock up supplies for citizens but calm, i think you see to that. Thank you for that and its a great question. We are weeks and potentially months away from a vaccine. There is a hsmultilateral initiative that the report report seeks to supporting two share vaccines. It is being led World Health Organization and partners. That said, many wealthy nations are engaging in advanced purchase agreements which are inherently libelous. We now leave this program for whats expected to be a short Senate Pro Forma session with no legislative business