Virtual via Geneva to Washington D.C.
Atul Gawande: Thank you, it’s good to be here for this launch of the U.S’s Global Health Security Strategy. USAID is very proud to be one of the key implementing agencies. And when I came in, getting to work on these problems with our sister agencies, one of the things I realized is that we are evaluating and responding to, and taking action on emerging and changing threats virtually every day, certainly every week, across the interagency. And I've come to think of the global health security strategy as one in which we are building what you might think of as an immune system for the world. Our bodies work to prevent, to detect, and then to rapidly respond to invading organisms by stopping them from growth or containing them, and helping keep us safe as individual human beings. And this is the construct that we are contributing to for the world.
At the center of our work is ensuring partnerships across the body of the world. Those partnerships -- our bilateral partnerships -- we learned after Ebola about the power of partnering and investing in Africa in particular, and the approaches that we took to strengthen systems to prevent, detect, and respond lead to faster and better responses to subsequent outbreaks of Ebola...to Marburg virus...to Lassa fever, and showed us what is possible. The COVID-19 pandemic brought a respiratory virus that had taxed us enormously and required us to build and point our way towards even faster response capabilities, and a global stretch that touches every region of the world. And you'll see that the 50 countries we're partnered with are stretched everywhere.
Our strategy lays out those 50 countries and USAID is among the agencies making major investments to address everything from training frontline workers, building emergency operations, and learning from the rising number of disease outbreaks that already occur on a regular basis.
Also critical to our work are the multilateral partnerships we have, such as the U.S. government's strong and long standing partnership with Gavi, the Global Vaccine Alliance. I am here, I just arrived this morning in Geneva where we are gathering for a several-day meeting on our long term strategy for Gavi, including pandemic preparedness and response. And we're also welcoming Dr. Sania Nishtar as our new CEO. Dr. Nishtar, you've only been in place here for the past month. And just to introduce you to folks, you're a U.K.-trained cardiologist, a 30-year fierce advocate for global health, most recently as a senator in Pakistan. And, and now you're here as our CEO for the Vaccine Alliance, Gavi. I wonder if you can tell us what you see ahead in your work with Gavi, in particular, on pandemic preparedness.
Sania Nishtar: Good day to everyone. It's an honor and a privilege to be here on the panel. And right at the very outset, I want to congratulate the U.S. government on this landmark legislative win and the launch of your strategy. This is clearly a very important agenda. But it's an agenda that is both multi-dimensional as well as multi-stakeholder. So as the incoming CEO of Gavi, I'm very conscious that as a multilateral partnership with the mandate to ensure equitable access to vaccines, that we don't just focus on the vaccines, but also the political will and the systems to deliver them.
And that's part of what we will be discussing over the next three days, with reference to the next phase of Gavi's five-year strategy which in our internal balance, we called a 6.0. I just want to give you a sense of the four things that are relevant to the global architecture of PPPR insofar as Gavi is concerned, because we all understand from the global perspective, there are a number of different agencies that have different roles to play. And we should try to make sure that we don't duplicate, but that we exploit synergy and build appropriate partnerships.
So the four things that I think are relevant in the global architecture where Gavi has a clear mandate – the first of them is called a First Response Fund. I'm very pleased to let you know that the Board of GAVI has approved the establishment of this fund. And we are on the way to operationalizing it. The fund will provide 500 million U.S. dollars at-risk capital for the most serious emergencies. And these funds will be pre-positioned and funded. And a $2 billion line of credit from the U.S. Development Finance Corporation and the European Investment Bank will also be made available under the rubric of this First Response Fund.
The second thing that we're working on, is what's called the African Vaccine Manufacturing Accelerator. Now, I'm sure you all know that we refer to this as AVMA. We refer to this as AVMA, and the background of this is quite well known. The background relates to the inequity in access to vaccines which the African continent had to endure. And as a response to that, our board has approved $1 billion and we are launching this initiative on June the 20th. The idea is to put in place an innovative financing instrument and advanced market commitment essentially to the tune of $1 billion to promote vaccine manufacturing in Africa. And I think this initiative is a classical example of how partnerships come into play to get a solution on the ground, because in setting up and in building capacity for vaccine manufacturing in Africa, a number of different stakeholders have to play their role. So WHO as the normative agency has a very clear normative and regulatory role. CEPI has a role in terms of the catalytic action that it can promote. The country has several layers of work in terms of creating the investment climate, making interest rates work for investors, creating the right investment, you know, business friendly environment, hand-holding industry, creating the right policy framework. And of course, we as an entity, have a role to come in with our innovative instruments, when the capacity is built. And this, and I may be repeating myself, but just for emphasis, we will be launching it on June the 20th. This year, $1 billion has been set aside by our board. And I think that this builds further on the lessons learned during the pandemic.
Very briefly – 30 seconds – the two other areas where Gavi is playing a role within this landscape. One of them relates to stockpiling of doses. And not just the stockpiling of doses but also paying attention to some of the immunization systems-related delivery channels, which are crucial for delivery, such as investments in the logistics and supply chain management systems. Our largest investments this year will be in some very important outbreak-prone diseases such as Ebola, cholera and yellow fever. And we are very conscious that we have to be nimble in an era where climate change is very seriously interplaying in the outbreak of diseases in different parts of the world. So to summarize, once again, reiterating that we are one of the several global players. We take our work seriously. It's related to equitable access to vaccines. And there are three particular areas where we are engaged heavily, not just in the planning and ideation stage, but we have instruments designed, we have set aside monies, we have board approvals, and we are well on our way to operationalizing them. And over the next three days, Atul, as a respected board member, will hear a lot more from us about what's underway and look forward to his views and the guidance from the U.S. government. Thank you Atul, and I'll go back to you.
Atul Gawande: Thank you Dr. Nishtar. I will turn it over to the moderator. But just to say, just the example of zero day financing addresses a major failure during COVID, where we had a distributor for vaccines, we had a new vaccine, but we did not have the ability to mobilize cash so low- and middle-income countries could begin to fight the virus with vaccines at home. The zero day financing means that there are finances from day one, so they can put orders in along with everybody else. Very important for the future. Thank you.
Global Health Security
