What it takes to crush a pandemic

My son was born in January 2020,

shortly before the lockdown in Paris.

He was never scared
of people wearing masks

because that's all he knows.

My three-year old daughter
knows how to say [??].

That's the French word
for hydroalcoholic gel.

She actually pronounces it
better than I do.

But no one wants to be wearing a mask

or wash their hands
with hand sanitizer every 20 seconds.

So we're all desperately looking at R&D
to find us a solution: a vaccine.

It's interesting that in our minds,

we keep thinking of the vaccine discovery
like it's the Holy Grail,

but there are a couple of shortcuts here
that I'd like to unpack.

I'm not a doctor, I'm just a consultant.

My clients focus on health care --

biopharma companies, providers,
global health institutions --

and they've educated me.

We need to find the tools to fight COVID

and we need to make them
accessible to all.

First, one single vaccine
will not get us out of this.

What we need is an arsenal of tools.

We need vaccines, we need therapeutics,

we need diagnostics to make sure
that we can prevent, identify,

and treat COVID cases
in a variety of populations.

Second, it's not just
about finding a tool.

What do you think will happen
when one of those clinical trials

demonstrates that the tool is effective?

Do you think we can all
run to the pharmacy next door,

we get the product,

we take off our mask,
and we go back to French kissing?

No.

Finding an effective tool
is just one step in this big fight,

because there is a difference
between the existence of a product

and access to that product.

And now we are thinking,

oh, she means

other countries will have to wait.

Well no, that's not my point.

Not only others may have to wait,

but any of us may have to.

The humbling thing about COVID

is that because of
its speed and magnitude,

it's exposing all of us
to the same challenges

and giving us a flavor
of challenges we're not used to.

Remember when China got into lockdown.

Did you imagine that you
would be in the same situation

a few weeks after?

I certainly didn't.

Let's go to the theoretical moment
when we have a vaccine.

In this case, the next access challenge

will be supply.

The current estimate
of the global community

is that by the end of 2021,

so that's over a year after
the discovery of the vaccine,

we would have enough doses
to cover 1.2 billion

of the eight billion of us on the planet.

So who will have to wait?

How do you think about access
when supply is short?

Scenario number one:

we let the market forces play

and those who can pay the highest price
or be the fastest to negotiate deals

will get access to the product first.

It's not equitable at all,

but it's a very likely scenario.

Scenario number two:

we could all agree
based on public health rationale

who gets the product first.

Let's say we agree that
health care workers would get it first,

and then the elderly,
and then the general population.

Now, let me be a bit more provocative.

Scenario number three:

countries who have demonstrated
that they can manage the pandemic well

would get access to the product first.

It's a little bit extrapolated,

but it's not complete science fiction.

Years ago, when the supply of high quality
second-line tuberculosis drug was scarce,

a special committee was established
to determine which countries

had health systems that were strong enough

to ensure that the products
would be distributed properly

and that patients would follow
their treatment plans properly.

Those select countries got access first.

Or, scenario number four:

we could decide on a random rule,

for instance that people get
to be vaccinated on their birthday.

Now let me ask you this:

how does it feel to think of a future

where the vaccine exists

but you would still have to wear a mask

and keep your kids home from school

and you would not be able
to go to work the way you want

because you wouldn't
have access to that product.

Every day that passed
would feel unacceptable, right?

But guess what?

There are many diseases
for which we have treatments

and even cures

and yet people keep being infected

and die every year.

Let's take tuberculosis:

t10 m10