2020 Global Pandemic HYPOTHESIZED 2 Months Before Wuhan China Lab Leak

October 29, 2019
Universal Flu Vaccine Symposium at The Milken Institute

People in this video:

Rick Bright
Director
Department of Health and Human Services | Biomedical Advanced Research and Development Authority

Anthony S. Fauci M.D.
Director
National Institute of Allergy and Infectious Diseases

Bruce Gellin
President
Sabin Vaccine Institute

Margaret "Peggy" A. Hamburg M.D.
Foreign Secretary
National Academy of Sciences | National Academy of Medicine

Michael Specter
Staff Writer
New Yorker Magazine

Casey Wright
Chief Executive Officer
Flu Lab

Health experts discussed the scientific and technological prospects of an effective universal influenza vaccine. Speakers included Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and Margaret Hamburg, former FDA commissioner. Panelists discussed the need for more funding for research, better collaboration between the private and government sectors, advances in technology in flu research and the goal of a universal flu vaccine.

Transcript:
00:00:04
HELP EXPERTS DISCUSS THE PROSPECT FOR AN EFFECTIVE UNIVERSAL VACCINE. SPEAKERS INCLUDE DOCTOR ANTHONY TOLKIEN, DIRECTOR OF THE NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES AND HAMBURG, FORMER FDA COMMISSIONER. THIS IS ABOUT AN HOUR.

00:00:20
WHY ARE WE EVEN HEAR. I WILL GIVE ONE EXAMPLE. IN 2009 THERE WAS A PANDEMIC FLU. MAKE A SWINE FLU, I DON'T KNOW WHY. IT'S BESIDE THE POINT.

00:00:37
DOING YOU WANT ENOUGH TO GO BACK AND -- OUT OF BLAKE INSTRUCTED MORE THAN 2 BILLION PEOPLE. AS FAR AS I CAN TELL AND THERE'S A LOT OF REPORTING ON THIS, THE WHO ACTED INCREDIBLY ADMIRABLY AND RAPIDLY IN GETTING VACCINE OUT. AND THE ONLY REASON THAT IT WASN'T ONE OF THE MOST DEVASTATING EPIDEMICS IN THE HISTORY OF HUMANITY IS BECAUSE THAT PERSON PARTICULAR FLU DECIDED NOT TO BE BERLIN. WE DON'T GET A VOTE BUT THE GATES FOUNDATION ELSE MODELERS WHO ARE PRETTY GOOD AND THEY ESTIMATED THAT HAD BEEN ANYTHING LIKE THE 1918 FLU, 33, 37 MILLION PEOPLE WOULD HAVE DIED AND THEN WE WOULDN'T BE HAVING THIS CONVERSATION OR AT LEAST SOME OF US WOULDN'T BECAUSE WE BEGAN. AND WHAT HAPPENS WHEN THESE SORT OF THINGS OCCUR IS IF THEY DON'T KILL A LOT OF PEOPLE WE JUST MOVE ON, ESPECIALLY WHEN IT COMES TO INFLUENZA WHICH PEOPLE SEEM TO THINK IT'S JUST A WORD THAT MEANS I DON'T FEEL WELL. IT DOESN'T, AND I THINK FOR THE FIRST QUESTION I LIKE TO ASK TONY, MAYBE YOU CAN EXPLAIN A LITTLE BIT ABOUT WHAT, WHY WOULD WE WANT UNIVERSAL VACCINES, HOW DOES THIS WORK -MARK IS A PANDEMIC THAN WHAT WE GET EVERY YEAR AND WHERE ARE WE.

00:02:06
OKAY. THANKS MIKE. JUST VERY BRIEFLY BECAUSE I KNOW WE CERTAINLY HAVE A LOT TO TALK ABOUT, BUT THE SITUATION WITH INFLUENZA I THINK THAT MANY PEOPLE IN THE AUDIENCE KNOW IS THAT UNLIKE A VIRUS LIKE THE MEASLES WHICH IF YOU HAVE THE MEASLES VIRUS AND YOU GET VACCINATED AGAINST MEASLES YOU GET INFECTED WITH MEASLES, THEN YOU ARE PROTECTED ESSENTIALLY FOR LIFE FOR THE SIMPLE REASON THAT MEASLES DOESN'T CHANGE FROM YEAR TO YEAR OR FROM DECADE TO GET THAT THEY WHEREAS INFLUENZA IS VERY UNIQUE IN THAT IT IS A VIRUS, A GROUP OF VIRUSES. THERE ARE DIFFERENT KINDS OF INFLUENZA, LET'S JUST FOCUS ON INFLUENZA A TEND TO WE USE THE TERMINOLOGY DIRECT FROM SEASON TO SEASON AND THAT THERE ARE MUTATIONS THAT CHANGE IT AND NOT SO THAT YOU REALLY NEED TO GET VACCINATED EACH YEAR. THEN YOU TRY TO ANTICIPATE THE RIGHT MATCH BETWEEN A VACCINE AND THE VIRUS THAT WILL BE CIRCULATING. AND THEN EVERY ONCE IN A WHILE AS MICHAEL ALLUDED TO YOU HAVE A VERY DRAMATIC CHANGE EITHER BY MUTATIONS OR BY EVOLUTIONS FROM ANIMAL INFLUENCES THAT JUMP SPECIES, RECOMBINE OR WHAT HAVE YOU AND YOU HAVE SOMETHING CALLED A SHIP OR A REAL BIG CHANGE. THAT'S REALLY UNIQUE. A VIRAL INFECTIONS THAT WE DEAL WITH, POLIO, SMALLPOX, MEASLES, ETC. DON'T DO THAT. DEALING WITH A CONTINUAL MOVING TARGET SEASON TO SEASON AND THE THREAT OF A PANDEMIC. SO THE TITLE OF THE SESSION IS THE QUEST FOR UNIVERSAL FLU VACCINE SO WHEN WE TALK ABOUT UNIVERSAL FLU VACCINE IT REALLY RIGHT NOW IS AN ASPIRATIONAL GOAL. IN THAT THE QUEST BEING TO MAKE A VACCINE THAT INDUCES A RESPONSE IN THE BODY SO THAT PART OF THE INFLUENZA DOESN'T CHANGE FROM SEASON TO SEASON FROM DECADE TO DECADE OR EVEN THAT MUCH WHEN YOU GET A PANDEMIC. AND SCIENTISTS NOW THROUGHOUT THE COUNTRY AND THE WORLD HAVE BEEN ABLE TO IDENTIFY OPPONENTS OF THE INFLUENZA THAT REALLY DO NOT CHANGE MUCH AT ALL AND THE CRITICAL ISSUE IS GETTING A VACCINE TO INDUCE A RESPONSE AGAINST THAT PART AREA OF UNIVERSAL FLU VACCINE IS NOT GOING TO BE, TODAY WE DON'T HAVE IT, THEN WE FLIP A SWITCH AND THE NEXT MONTH OR NEXT YEAR WE HAVE IT. IT'S GOING TO BE AN ITERATIVE PROCESS BECAUSE IF YOU LOOK AT THE DISPLAY OF IN THE BLENDS OF THEIR IN TWO MAJOR GROUPS AND THERE ARE 18 DIFFERENT AGES SO THERE'S A LOT OF WIGGLE ROOM FROM THERE THAT YOU'RE GOING TO HAVE TO COVER. SO THE QUEST ON THE ROAD TO A UNIVERSAL FLU VACCINE WOULD BE TO TAKE ONE OF THE INFLUENCES IN GROUP 1. LET'S SAY H1 AND WE KNOW THAT CHANGES BIT FROM SEASON TO SEASON TO MAKE A VACCINE THAT WOULD COVER ALL OF THE ITERATIONS OF H1. AND THEN THE NEXT STEP WOULD BE MAYBE ALL THE ITERATIONS OF WHAT'S EVER IN GROUP 1 AND THEN THERE'S ROOM TO HAS AGED THREE AND IT AND THE NEXT GO WOULD BE TO MAKE A VACCINE COVERS ALL OF THE ITERATIONS OF AGE 3 AND ON AND ON SO IT WILL BE A STEPWISE PROCESS WITH THE ULTIMATE ASPIRATIONAL GOAL OF HAVING A VACCINE YOU CAN GIVE RELATIVELY AND FREQUENTLY COMPARED TO NOW, WHICH YOU NEEDED EVERY YEAR. THAT WOULD BE EVERY FIVE YEARS, 10 YEARS OR WHAT HAVE YOU THAT OVER A BROADER ARRAY OF THE INFLUENCES THAT WE WOULD BE EXPERIENCING THE BASKET IN A NUTSHELL .

00:05:36
ONE OF THE THINGS I'VE DONE AS A JOURNALIST IS CONSTANTLY WRITE STORIES TELLING PEOPLE GET FLU VACCINES. BUT THEY REALLY KIND OF SUCK. AND PEOPLE ALWAYS SAY TO ME WHY SHOULD I GET A FLU VACCINE AND I ALWAYS SAY 23 PERCENT IS BETTER THAN ZERO PERCENT AND AS FAR AS MY MACROS THAT IS TRUE. BUT I'M WONDERING WHEN I WROTE SOMETHING FOR A REPORT THAT MANY OF YOU HAVE ACCESS TO, THE VACCINE REPORT ON INFLUENZA WE PUT OUT LAST YEAR AND I TALKED TO LITERALLY DOZENS OF PEOPLE IN THIS FIELD AND NOT ONE PERSON. I ASKED THEM AT LEAST ONE QUESTION. IS THIS AS GOOD AS WE CAN DO? NOT ONE GROUP SAID YES, NOT ONE PERSON SAID WE WERE CLOSE TO DOING IT AS WELL AS WE CAN DO. AND I'M JUST SORT OF CURIOUS, WHY ARE WE SO BAD AT PROTECTING OURSELVES FROM WHAT MANY PEOPLE CONSIDER THE SORT OF MOST LIKELY VIRUS TO CAUSE THE MOST DAMAGE TO HUMANITY? AND I'M GOING TO LET ANYONE WHO WANTS TO ANSWER THIS DO SO.

00:06:58
THANKS MICHAEL AND I WISH THE NARRATIVE WOULD HAVE COME UP ON THE VIDEO COMING THROUGH BECAUSE WHAT'S CALLED OUT IN THAT THERE IS A SENSE OF URGENCY TO ADDRESS THOSE PROBLEMS. THERE'S STILL 650,000 PEOPLE AROUND THE WORLD FROM SEASONAL INFLUENZA SCENARIO BILL GATES IS 40 DISEASE MODELING THAT SAYS WE HAD ANOTHER UPGRADE BREAK LIKE A PANDEMIC VIRUS TODAY, AND THAT SIX-MONTH TIME. WE WOULD HAVE 33 MILLION PEOPLE DEAD AND NOT ONLY THAT, THAT VIRUS HAS BEEN SEATED ALL AROUND THE GLOBE. TWO MONTHS AFTER THAT BEST TECHNOLOGIES TO MAKE VACCINES WOULD START RELEASING VACCINES. SO WE'RE STILL BEHIND GONE ON TO MAKE VACCINES. WE HAVE SOME REASONABLE VACCINE FOUNDATIONS AND WE CAN MAKE THEM BETTER BY ADDING ADJECTIVES OR WHAT WHETHER THOSE VACCINES ARE FULLY UTILIZED AND A LOT OF PARTS AROUND THE WORLD DON'T HAVE ACCESS TO THE VACCINES AT ALL SO I THINK THAT THE SENSE OF URGENCY NEEDS TO BE THERE MICHAEL BUT ALSO THE FACT THAT WE NEED TO LEVERAGE THE TOOLS WE HAVE AND AT THE SAME TIME ENVISION WHAT THAT UNIVERSAL FLU VACCINE IS IN A VERY RAPID, URGENT PACE TO GET THERE.

00:08:03
AS PART OF MY LIFE I TEACH AT STANFORD AND PEOPLE USE THIS WORD IN SILICON VALLEY WHICH I MOSTLY HATE BUT I'M GOING TO USE IT NOW. DISRUPTION READ WHY DON'T WE BLOW THE SYSTEM UP? OBVIOUSLY WE CAN'T JUST TURN OFF THE SPIGOT ON THE SYSTEM WE HAVE AND SAY EVERYONE IN THE WORLD SHOULD GET THIS FLU VACCINE WE HAVEN'T GIVEN TO ANYONE YET BUT THERE MUST BE SOME WAY THAT WE GROW VACCINES MOSTLY IN EGGS THE WAY WE DID IN 1947. WE LIVE IN A WORLD WHERE I CAN DOWNLOAD WHATEVER SONG I WANT ONTO MY PHONE AT COMMAND AND WE GROW VACCINES THE WAY WE DID 70 YEARS AGO. WHAT IS GOING ON WITH THAT?

00:08:51
I THINK I CAN TALK ON MY OWN.

00:08:56
NEVER KNEW THAT ABOUT YOU.

00:08:57
IT REALLY IS THE CASE THAT WE ARE BEHIND WHERE WE HAVE TO BE IN TERMS OF THE URGENCY OF THIS THREAT AND HOW WE'RE HARNESSING ADVANCES IN SCIENCE AND TECHNOLOGY AND HOW WE'RE MOBILIZING AS A SOCIETY TO RECOGNIZE THE MAGNITUDE AND SCALE OF THE PROBLEM BEFORE US. CLEARLY DISRUPTION COMES WITH UNCERTAINTY AND IT COMES WITH UNCERTAINTY ON MANY LEVELS, UNCERTAINTY WITHIN THE SCIENTIFIC COMMUNITY ON HOW WE DO SCIENCE, REGULATORY UNCERTAINTY WHICH I KNOW SOMETHING ABOUT AND ALSO UNCERTAINTY ABOUT ADOPTION AND ACCESS AND ALL OF THAT. I THINK ONE OF THE THINGS IS, AND I THINK HOPEFULLY ONE OF THE METRICS WE CAN HAVE ON THIS PANEL IS IT'S TIME TO STOP TALKING. IT'S TIME AND WE TALKED ABOUT THESE ISSUES FOR A LONG TIME AND THAT HAS TAKEN THE PLACE OF ACTION SOMETIMES I THINK BUT IN TERMS OF WHY WE'RE STILL GROWING IT'S MAINLY IN EGGS, I THINK A PART OF IT IS THAT IT'S JUST THE WAY WE'VE ALWAYS DONE IT. IT'S THE WAY WE KNOW WE WILL GET SOME KIND OF VACCINE OUT INTO THE MARKETPLACE AND THERE'S ALWAYS THAT IN THE MEANTIME OTHER WORK WILL BE GOING ON AND IT WILL HAVE A BREAKTHROUGH AND THE HOMILY WHEN WE HAD A VACCINE. CLEARLY THAT IS NOT GOING TO HAPPEN. I THINK IT'S ALSO THAT WE HAVEN'T HAD THIS SENSE OF URGENCY.

00:10:28
DO WE HAVE NOT GOT LOTS OF PEOPLE DIE FOR THAT SENSE OF URGENCY?

00:10:40
THE INCREDIBLE THING IS A LOT OF PEOPLE DO DIE EVERY YEAR AND YET WE ARE MOBILIZING. I WOULD HAVE TO SAY TO BE MORE POSITIVE THAT I CAN'T REALLY ANSWER THE QUESTION OF WHY IS IT TAKING US SO LONG BECAUSE I THINK IT SHOULDN'T HAVE. AND YOU KNOW, THERE REALLY IS NOT A GOOD EXCUSE. THE SCIENCE HAS HAD TO MOVE FORWARD. GAPS IN THE SCIENCE STILL PERSIST INCLUDING OUR UNDERSTANDINGS ABOUT IMMUNE PROTECTION IN ADDITION TO UNDERSTANDING THE NATURE OF THIS PARTICULAR VIRUS WHICH HAS ITS COMPLEXITIES AREA CERTAINLY PART OF THE PROBLEM HAVE BEEN THAT IT'S MUCH SAFER FOR A COMPANY TO KEEP DOING WHAT IT'S DOING AND TO TRY TO DO SOMETHING NEW BUT IT'S ALSO I THINK, WE HAVEN'T FUNDED ALL THE WORK THAT NEEDS TO BE DONE ON AN OPTIMISTIC NOTE, THERE'S A LOT GOING ON NOW AND TONY IS LEADING EFFORTS AND THERE ARE OTHER EFFORTS, THE GATES FOUNDATION, THE EUROPEAN UNION RESEARCH HORIZON 20/20. MANY OTHER ENTITIES AS WELL BUT WE'RE ALSO NOT GOOD AT COLLABORATION AND I THINK THAT NEEDS TO BE ADDRESSED AREA WE NEED TO START SHARING KNOWLEDGE, WE NEED A ROADMAP FOR RESEARCH THAT REALLY WE FOLLOW, WE IDENTIFY WHAT DO WE KNOW WHERE THE GAPS, HOW CAN WE FILL THOSE GAPS. WE NEED TO IDENTIFY WHAT ARE THE RUTS THAT WERE STUCK IN THAT WE HAVE TO GET OUT OF AND HOW ARE WE GOING TO USE ALL THE CAPABILITIES IN SCIENCE AND TECHNOLOGY TODAY AND THE ENERGY OF OUR SOCIETY AND THE SCIENTIFIC COMMUNITY TO GET THE JOB DONE.

00:12:09
THIS COLLABORATION ISSUE SEEMS PARTICULARLY INTERESTING AND URGENT TO ME BECAUSE THIS IS A VAST AMOUNT OF DATA OUT THERE AND WHAT HAPPENS IS A LOT OF IT JUST FALLS BY THE WAYSIDE. IF YOU DO A STUDY AND IT DOESN'T GET PUBLISHED IT GOES AWAY AND YET THERE MAY BE GOOD DATA. I THINK CASEY HAS SOMETHING TO SAY ABOUT THAT ABOUT OPENNESS AND COLLABORATION.

00:12:34
CANNOT TALK ABOUT THAT, CAN YOU HEAR ME -MARK GOOD DAY, IT'S MY PLEASURE TO BE HERE. I THINK ISOLATION IS OUR ENEMY AND THERE ARE OPPORTUNITIES TO EXPAND TRANSPARENCY AND EXPAND A CULTURE OF TRANSPARENCY AND OPEN DATA SHARING BUT I THINK COULD UNLOCK VICTORIES AND CREATE NEW INSIGHTS TO ACCELERATE OUR PROGRESS AND WITH THE SOLE PHILANTHROPY ON THE GROUP AND WE REALLY BUILD INTO OUR DNA A BRAVERY ABOUT ASKING REALLY HARD QUESTIONS FOR EXAMPLE, WE'VE BEEN ASKING WHAT IS THE ROLE OF PUBLICATION BIAS THEY PLAY IN LIMITING OUR PROGRESS GOING FORWARD. WHAT ARE THE OPPORTUNITIES FOR FUNDERS IN THIS SPACE TO REALLY MEANINGFULLY ELABORATE TO BUILD FUNDING OPPORTUNITIES AND DON'T STRATEGIES TOGETHER. WHAT ARE THE WAYS BY WHICH GRANTEES CAN BEHAVE AS COHORTS IN A COLLABORATIVE FASHION UNLESS IT'S AS INDIVIDUAL CONTRIBUTORS AND ONE OF THE PROGRAMS I THINK MICHAEL IS ALLUDING TO IS WE JUST ESTABLISHED A NEW COLLABORATION WITH THE CENTER FOR OPEN SCIENCE IN THE PUBLIC LIBRARY OF SCIENCE TO REALLY CREATE NEW INCENTIVES FOR RESEARCHERS TO PUBLISH NEGATIVE FINDINGS. I THINK PUBLICATION BIAS REALLY DOES LIMIT OUR OPTIONS AND IF WE CAN SHED MORE LIGHT ON DATA THAT'S NOT PUBLISHED, CAN WE CREATE NEW INCENTIVES TO BRING THAT, BRING THOSE ANALYSIS TO THE FRONT AND SHED MORE LIGHT ON THEM BUT IN MARK I THINK IT WOULD BE REALLY WONDERFUL. IS NO PROGRAM THAT WE STARTED, WE ARE ASKING RESEARCHERS TO OPEN THEIR FILE DRAWERS, ROUTE FLOPPY DISKS, WHATEVER THEY HAVE TO AND WE WILL PAY THEM TO REDUCE THAT OPPORTUNITY COST AND TO DROP DRAFT THOSE MANUSCRIPTS AND WORK AND HELP THEM GET THOSE PUBLISHED BECAUSE WE THINK THERE ARE A NUMBER OF OPPORTUNITIES AHEAD OF US IF WE SHED MORE LIGHT ON THAT INFORMATION.

00:14:44
I'M CURIOUS TO WHAT DEGREE ANY OF YOU CAN MAYBE ADDRESS THIS. IT'S A PR ISSUE IN SOME WAYS BECAUSE PEOPLE TALK ABOUT THE FLU . I HAD THE FLU. I FEEL BLUISH. ABOUT 80 PERCENT OF THE TIME I'M MAKING THAT NUMBER UP BUT IT'S A LOT OF THE TIME. YOU DON'T HAVE REALLY HAVE IT BE SO LAST NIGHT I HAD A BUG AREA I DO WHAT I DO FOR A LIVING SO I WON'T CALL IT THE STOMACH FLU BECAUSE I'M SURE IT ISN'T MOST PEOPLE WOULD CALL IT THAT READ IS THAT PART OF THE PROBLEM THAT WE DON'T HAVE APPROPRIATE NOMENCLATURE ?

00:15:18
I THINK THERE'S COMPLACENCY ON THAT SIDE AS WELL. HE MENTIONED THE INSTITUTIONAL ARCHITECTURE THAT KEEPS INNOVATION FROM HAPPENING. I THINK THOSE TWO THINGS ARE CONNECTED. THAT THE PEOPLE THROUGHOUT THE DISEASE IS SO BAD I HAD THE FLU. I GOT OVER IT. THE VACCINE IS SO BRIGHT. GOOD ENOUGH, I'LL TAKE IT THERE'S A PIECE OF IT AS WELL. I WANT TO GO BACK TO THE SABIN VACCINE INSTITUTE IS HERE IN WASHINGTON KNOWLEDGE AND INNOVATION IS ONE OF OUR COLORS AND WE TURN ASPEN TO PULL TOGETHER A GROUP AND THE IDEA WAS A DIVERSE GROUP OF THINKERS, PEOPLE FROM SCIENCE, PEOPLE FROM PHILANTHROPY, FROM JOURNALISM TO TAKE ON ISSUES IN VACCINE AND VACCINATION AND NOT SURPRISINGLY HUNDRED ANNIVERSARY OF THE 1918 FLU PANDEMIC, THAT WAS THE ISSUE AND THAT'S WHERE THE PEACE OF THE VIDEO CAME FROM.

00:16:20
BUT THAT'S WHERE THE URGENCY CAME FROM AND THE RECOGNITION IS WE NEED TO DO SOME THINGS DIFFERENTLY. THERE WAS A DISCUSSION THERE ABOUT THE SORT OF CASCADE FROM UNIFICATION TO COORDINATION TO COLLABORATION TO CONVERGENCE AND WE NEED TO SORT OF WORK OUR WAY DOWN THE PIPELINE TO MAKE SURE WE ARE ACTUALLY GETTING ALL THE WAY TO THE END TO BRING IN AS MUCH AS POSSIBLE TO TAKE ON THIS PROBLEM.

00:16:46
THE COMPLACENCY REALLY IS REAL. REFLECTING BACK ON WHEN I WAS IN GOVERNMENT NOT FROM THE LAST ADMINISTRATION BUT A FEW ADMINISTRATIONS BACK AND I WAS STARTING TO DEVELOP PUBLIC HEALTH PREPAREDNESS PROGRAMS. I WENT TO FEMA TO TALK TO THEM ABOUT DOING AN EXERCISE WITH US AND PREPARING US FOR A BIOLOGICAL THREAT AND WE WERE GOING TO DO A FLU PANDEMIC AND ARIAL AND THEY SAID WE DON'T DO INFECTIOUS DISEASE, WE DO HURRICANES. WE DO FLOODS. EARTHQUAKES, ALL KINDS OF DISASTERS. BUT DISEASE OUTBREAKS? AND I PERSUADED THEM TO PARTICIPATE . AND IT WAS A REMARKABLE THING TO WATCH THEM AS EVENTS UNFOLDED. REALIZING JUST HOW MUCH THIS KIND OF AN OUTBREAK WOULD UNDERMINE ALL OF THE SORT OF ESSENTIALS OF CIVIC LIFE. HOW IT WOULD UNDERMINE THEIR OWN ABILITY TO MOBILIZE AND RESPOND TO NEEDS. AND ALSO, THE RECOGNITION OF THE ECONOMIC COSTS IN ADDITION TO THE MEDICAL CONCERNS AND ULTIMATELY THE LOSS OF SPACE OF PEOPLE IN GOVERNMENT AND LEADERSHIP. BECAUSE OF THE FAILURE TO BE ABLE TO PROVIDE VACCINES IN A TIMELY WAY AND OTHER THINGS. SO PEOPLE JUST STILL DON'T THINK ENOUGH ABOUT WHAT THIS MEANS IN OUR DAILY LIFE AND WHAT THE IMPACTS ARE. EVEN THOUGH EVERY YEAR , WE'RE SUFFERING A LOT OF PREVENTABLE DEATHS, ILLNESS AND DISABILITY.

00:18:20
THAT'S ONE ASKED THE DARK AND UNPLEASANT QUESTION DOES SOMETHING REALLY BAD HAVE TO HAPPEN AND IT SEEMS TO ME ONE OF THE CURSES OF THE PUBLIC HEALTH WORLD IS IF YOU GUYS DO YOUR JOB WELL, EVERYONE GOES ALONG.

00:18:32
Michael Specter
BUT IF YOU DON'T OR IF YOU DO YOUR JOB WELL AND PEOPLE GET SICK ANYWAY, THEN SOMEHOW YOU JUST FAILED. AND I'M NOT SURE HOW YOU GET AROUND THAT. I'D LIKE TO TAKE A HALF STEP BACK AND MAYBE TONY IS THE PERSON TO ADDRESS THIS OR RICK. WHERE ARE WE? CAN YOU GIVE US A BETTER SENSE OF HOW FAR WE COME ON OUR APPROACH TO A UNIVERSAL VACCINE IN THE LAST DECADE? BECAUSE WE USED TO BE NOT JUST --

00:19:06
Anthony S. Fauci M.D.
MICHAEL, WE DIDN'T HAVE A REAL CONFIDENCE IN THE SCIENTIFIC BASIS THAT WE COULD ACTUALLY INDUCE A RESPONSE OR EVEN WHAT COMPONENTS OF THE VIRUS IF YOU DID HAVE IMMUNE RESPONSE AGAINST WOULD ACTUALLY BE ABLE TO BROADLY COVER. WHEN WE HAD THE EVOLUTION OF STRUCTURE BASED VACCINE DESIGN, WHEN WE USED CLAIMS TO LOOK AT THE MOLECULAR CONFIGURATION OF THE STEM, ONE OF THE TARGETS OF A UNIVERSAL FLU VACCINE CERTAINLY NOT THE ONLY TARGET BUT ONE OF THE TARGETS IF YOU LOOK AT THE HEMOAGGLUTININ MOLECULE WHICH IF YOU KIND OF METAPHORICALLY CONSTRUCT IT, IT'S KIND OF LIKE A HEAD WHICH IS A MUSHROOM WITH A STORE OR A BROCCOLI WITH A STORK, IS THAT THE PART THAT THE BODY MAKES AN IMMUNE RESPONSE AGAINST IS THE HEAD. IT'S WHAT YOU CALL HIM YOU DOMINANT. WHEN THE BODY SEES INFLUENZA IT'S MUCH PREFERS TO MAKE A RESPONSE AGAINST THE HEAD . WHEN THAT GETS IT RIGHT, THAT'S GOOD NEWS BECAUSE YOU'RE GOING TO GET PROTECTED. THE SOBERING NEWS IS THAT'S THE PART THAT DOES THE MUTATIONS THAT I MENTIONED A LITTLE BIT AGO.THE PART THAT'S THE STOCK OR THE STEM DOESN'T REALLY CHANGE MUCH AT ALL. THAT'S POTENTIALLY GOOD NEWS. A CHALLENGING NEWS IS THAT THE BODY DOESN'T WANT TO MAKE AN IMMUNE RESPONSE AGAINST THAT BECAUSE IT'S NOT IMMUNO DOMINANT AND IT REALLY HASN'T BEEN STUDIED VERY WELL. NOW THAT WE KNOW THAT IF IN FACT YOU MAKE A RESPONSE AGAINST THE PART OF THE VIRUS THAT DOESN'T CHANGE, THAT WHEN YOU LOOK AT THE RESPONSE THE BODY MAKES AND TEST IT AGAINST AN ARRAY OF VIRUSES, YOU GET A MUCH BROADER COVERAGE THAN AGAINST JUST A PARTICULAR HEAD OF THE HUMAN HEMOAGGLUTININ WHICH LIKE TO CHANGE FROM SEASON TO SEASON WHEREAS THE STEM STAYS THE SAME RELATIVELY SPEAKING. THAT'S NOT SOMETHING WE NEED 40 YEARS AGO. THAT'S SOMETHING THAT JUST NOW BEGINNING TO APPRECIATE SO WHAT INVESTIGATORS ARE DOING AND IS NOT THE ONLY TARGET, TO TAKE THAT STEM AND GET RID OF THE DISTRACTING HEAD AND STABILIZE THAT STEM AND PUT IT IN A WAY NOT WITH AN EGG, GETTING BACK TO WHAT YOU WERE SAYING. NOT GROWING THE VIRUS AT ALL BUT GETTING SEQUENCES, GETTING THE APPROPRIATE PROTEIN AND STICKING IT ON A SELF ASSEMBLING NANOPARTICLES THAT IS MUCH MORE IMMUNOGENIC. NOT ONLY IS IT MUCH MORE IMMUNOGENIC BUT YOU DON'T HAVE TO GROW IT. YOU CAN MAKE A LOT OF IT AND IF YOU DO IT RIGHT AND PARTNER WITH INDUSTRY, THAT'S THE KIND OF THING THAT DOESN'T HAVE THE VICISSITUDES OF GROWING AND EGG. THIS IS SOMETHING THAT IS 10 YEARS IN THE MAKING, NOT THE 40, 50, 60 YEARS YOU SAID WE WERE DOING THE SAME THING. A CRITICAL CHALLENGE AND IT RELATES TO ONE OF THE THINGS THAT PEGGY SAID IS THAT IN ORDER TO MAKE THE TRANSITION FROM GETTING OUT OF THE TRIED AND TRUE EGG GROWING WHICH WE KNOW GIVES US RESULTS THAT CAN BE BENEFICIAL. WE'VE DONE WELL WITH THAT BECAUSE SOMETHING THAT HAS TO BE MUCH BETTER. YOU HAVE TO PROVE THAT THIS WORKS AND THEN YOU GOT TO GO THROUGH ALL OF THE CRITICAL TRIALS, PHASE I, PHASE II, PHASE 3 AND SHOW THAT THIS PARTICULAR PRODUCT IS GOING TO BE GOOD OVER A PERIOD OF YEARS. THAT ALONE IT WORKS PERFECTLY IS GOING TO TAKE A DECADE.

00:22:52
Michael Specter:
I'M NOT A REPRESENTATIVE OF INDUSTRY BUT I'LL PRETEND I'M ONE. I NEED FLU VACCINE EVERY YEAR AND IT SELLS AND WE TAX PEOPLE TO THE DEGREE THAT IT DOES. WHY THE HELL WOULD I GO SPEND $400 MILLION TO DO THIS THING WHICH MAY BE GREAT AND THEN IT'S REALLY GREAT YOU GET IT ONCE OR TWICE BUT.

00:23:12
Anthony S. Fauci M.D.
AND THAT'S WHERE THE FEDERAL GOVERNMENT COMES IN.

Crowd Laughs

00:23:14
Anthony S. Fauci M.D.
SERIOUSLY, WHAT HAPPENS IS YOU BRING UP AN EXCELLENT POINT. OUR RESPONSIBILITY TO THE PUBLIC HEALTH AND NOT FOR PROFIT LINE HAS TO BE ABLE TO PUSH THE PROCESS TO THE POINT WHERE INDUSTRY WILL FIND IT TO BE A BENEFIT TO DO THAT. I THINK IF YOU'RE GOING TO SIT BACK AND WAIT FOR A COMPANY THAT'S BEEN GROWING VIRUS IN EGGS FOR THE LAST 30 YEARS TO SPONTANEOUSLY CHANGE WITHOUT ANY INCENTIVE, WITHOUT ANY THE RISKING, IT'S NOT GOING TO HAPPEN.

00:23:45
Rick Bright
CAN I ADD TO THIS STORY AS WELL? I THINK MY MIKE IS WORKING AREA IS NOT THAT THE FIELDS NOT ACTIVE AND AS THE DOCTOR SAID FOR 40 YEARS OR MORE THERE HAS BEEN CONCEPTS, APPROACHES AND ITS END AND FLOWED THE AMOUNT OF ENERGY FROM BIOTECH AND FROM ACADEMICS AND LARGE PHARMA. FOR A WHILE, BACK IN THE 80S AND 90S THEM TO TARGET WAS THE SEXY TARGET AND A LOT OF ENERGY FOCUSED AROUND THERE AND THEN BIG FUNDING CAME AVAILABLE ON GOVERNMENT IN 2005, 2006 WITH THE THREAT OF AVIAN INFLUENZA, SO WE HAVE A LOT OF NEW IDEAS PROPPED UP THERE WAS STILL FOCUSED ON THE FRAMEWORK THAT THE GOVERNMENT PUT OUT SAYING IT SHOULD BE AND HA-BASED AND TIMELINE DRIVEN VACCINE. AND AT THE SAME TIME WE'RE LEARNING SO MUCH ABOUT HIV VACCINES AND OTHER VACCINES FOR THE FIELD AND WE'VE BEEN FOCUSING ON ALMOST A DOGMATIC APPROACH ANTI-BODY ONLY IS LESS GOING TO SAVE THE DAY FOR INFLUENZA AND NOW THERE'S SO MUCH SCIENCE ON INVESTIGATORS, NIH LED STUDIES SHOWING HOW THE BREADTH OF IMMUNE RESPONSE IS CRITICAL FOR SO MANY OF THESE LIFELONG IMMUNE RESPONSES AND THE ENERGY NOW TRYING TO PULL THAT INTO AN INFLUENZA VACCINE APPROACH IS OUT THERE. BUT WHAT I THINK PATTY SAYS IS WE'RE SEEING A LOT OF THESE SILENT APPROACHES WHERE THERE MIGHT BE AT ANY TIME 40 DIFFERENT COMPANIES ON THE LANDSCAPE RIGHT NOW IN THE PIPELINE. ATTEMPTING IT BROADLY REACTED UNIVERSAL OR LESS REACTIVE, THERE'S VARIOUS DIFFERENT LABELS WE'RE PUTTING ON IT RIGHT NOW FOR FUNDING, PRIMARILY REASONS. BUT THEY'RE KIND OF SILENT. YOU DON'T SEE THEM LEVERAGING THE FULL SCOPE OF KNOWLEDGE THAT WE'VE LEARNED ABOUT THE BREADTH OF THE IMMUNE RESPONSE AND HOW IT PLAYS A CRITICAL ROLE AND WE'RE STILL MEASURING THE IMPACT OF OUR INFLUENZA VACCINES THROUGH SURROGATE MARKERS THAT WERE ESTABLISHED YEARS AGO FROM A BASE VACCINES, HAI TITER MUST BE GOOD ENOUGH. WERE NOT CONDUCTING LARGE ATTIC TRIALS UNDERSTANDING THE DETAILS OF THE IMMUNE RESPONSE. WE'RE NOT COMPARING THE NEW TECHNOLOGIES THAT WE'RE GETTING LICENSED TODAY FOR INFLUENZA VACCINE AGAINST EACH OTHER IN THE SEASONAL INFLUENZA WORLD EVERY SINGLE YEAR AROUND THE WORLD. WHERE WE DISTRIBUTE HUNDRED 50 MILLION DOSES OF SEASONAL VACCINE IN OUR COUNTRY EVERY YEAR, WE DON'T EVEN KNOW HOW MANY PEOPLE ARE GETTING VACCINATED, HOW MANY ARE GOING TO DELIVER THE PEOPLE, WHICH DOES NOT AND WHAT THE OUTCOME WAS SO WE CAN LEARN FROM THE KNOWLEDGE-BASED ON HOW TO OPTIMIZE OR IMPROVE OUR VACCINES. SO THERE ARE OPPORTUNITIES WE HAVE TODAY WITH A WEALTH OF KNOWLEDGE AND DATA HAS BEEN CREATED FOR A NUMBER OF YEARS THAT IS STILL BEING IGNORED BECAUSE IT'S NOT PULLED UP INTO SOME LARGER BRAIN TRUST FOR THE 40 DIFFERENT COMPANIES TO LEVERAGE AND MAKE THE BEST VACCINE APPROACH OR EVEN FOR US TO DETERMINE WHICH VACCINES WE HAVE TODAY ARE WORKING OR NOT. I THINK IF WE UNCLIPPED THE PERFORMING VACCINES ON THE MARKETPLACE TODAY, IT MIGHT BE VERY REVEALING TO TELL US WHICH OF THE TECHNOLOGIES WE HAVE AREA AND ALLOW US TO GO DEEPER INTO THOSE TECHNOLOGIES TO DETERMINE WHY THERE MORE RESPECTED. THERE ARE VACCINES LICENSED TODAY THAT ARE MORE EFFECTIVE. I THINK WE'RE JUST ERASURE IN THE TRUTH BECAUSE WE DON'T HAVE THE CAPACITY TO SPREAD THOSE VACCINES WIDELY ONCE THE TRUTH COMES OUT. BUT WE NEED TO IDENTIFY THOSE MARKERS, THOSE CHANGES AS DIFFERENTIATORS AREA AND WE NEED TO BUILD THAT BRAIN TRUST. WE NEED TO MOVE AS QUICKLY AS POSSIBLE TO GET THESE TECHNOLOGIES THAT ADDRESSED SPEED AND THE EFFECTIVENESS OF THE VACCINES. THE COUNCIL OF ECONOMIC ADVISERS FROM THE WHITE HOUSE PUT OUT A REPORT IN LINE WITH AN EXECUTIVE ORDER FROM THE WHITE HOUSE SAYING WE NEED TO PRIORITIZE DEVELOPMENT OF VACCINES FOR INFLUENZA THAT ARE FAST. AND SO RIGHT NOW, YOU JUST HAVE MEDIOCRE AND SLOW. A MEDIOCRE AND FAST VACCINE IS BETTER THAN ON THE OVER AND SLOW VACCINE BUT WE CAN MAKE BETTER VACCINES AND MAKE THEM FASTER, BUT $351 BILLION EVERY YEAR IS OUR ECONOMIC COST FOR SEASONAL INFLUENZA AND A PANDEMIC GOES INTO THE TRILLIONS OF DOLLARS. WE HAVE TO TAKE THAT SENSE OF URGENCY AND ECONOMIC ASSETS TO SETTLE DISRUPTION AND THE LIVES LOST IN THE PERSPECTIVE TO THINK HOW DO WE GATHER THIS INFORMATION AND SHARE IT IN A TARGETED WAY TO ACCELERATE DEVELOPMENT OF THE ONE OF THESE BETTER, FASTER VACCINES.

00:28:31
Michael Specter
WHAT ARE THE PRINCIPAL CONCLUSIONS OF THIS GROUP WE HAD LAST YEAR CAME WAS WE NEED A NEW ENTITY. WE NEED SOMETHING SPECIAL TO DO THIS BECAUSE I WON'T SAY WE'RE SPINNING OUR WHEELS BUT WE'RE NOT PUBLISHING WHAT WE COULD ACCOMPLISH AND MANY PEOPLE WOULD THINK WE'RE NOT GOING TO DO THAT UNLESS WE DO SOMETHING VERY FUNDAMENTALLY DIFFERENT. I'M ASSUMING YOU'RE ON BOARD WITH THAT, BRUCE?

00:29:00
Bruce Gellin
THAT'S THE ULTIMATE CONCLUSION FROM COMMUNICATION TO CONVERSION AND BRINGING ALL THOSE THINGS TOGETHER IN A COORDINATED WAY. ADDITION TO THE RESEARCH THAT DOCTOR FAUCI'S GROUP SUPPORTS, THERE'S A LOT OF BAD INDUSTRY THAT HAS PEOPLE'S PIECES OF THIS PUZZLE AREA THAT WE MADE A COMPELLING ARGUMENT THAT WE'RE FURTHER ALONG THAN WHAT WE HAD NOW BUT GIVEN THE URGENCY AND I THINK THAT WAS THE OVERARCHING THEME OF THE REPORT, GIVEN THE URGENCY WE NEED TO DO THINGS IN ADDITION TO WHAT'S ALREADY HAPPENING, WHAT ELSE CAN WE DO? HOW CAN WE BRING NEW IDEAS TO THE SPACE QUEST AND MARK I THINK WE NEED A MARTIAL MOMENT AREA WHEN I WAS IN SCHOOL ALTERS MORE NOTORIOUS SURGEONS AND THEN CAME THE OBSERVATION THAT THERE IS A BACTERIA THERE AND NOW WITH ANTIBIOTICS AND PEPTO-BISMOL AND ULCER ISN'T GOING AWAY, CANCER IS DOWN AND THE SURGEONS ARE DOING SOMETHING ELSE.

00:30:01
Bruce Gellin
WE NEED TO BRING THAT IN AS WELL. AS I'VE BEEN HERE I'M SURE I GOT THIS WRONG FOR THE PEOPLE THAT I'M LOOKING AT THIS LOGO AND IT SEEMS TO ME THAT TELLS US OUT OF THIS. WE NEED TO BRING IN STRANDS FROM DIFFERENT PLACES TRIED TO THINK OF HOW WE'RE GOING TO SOLVE THIS TOGETHER ON TOP OF THE WORK THAT IS ALREADY GOING ON.

00:30:12
Michael Specter
I'M SURE, I AM NOT EXACTLY SURE HOW WE DO THAT AND I HAVE ONE OTHER QUESTION THAT'S BEEN BUGGING ME AND MAYBE I'M WRONG ABOUT THIS. SO IT SEEMS, I KNOW THERE'S A LOT OF PEOPLE DOING GREAT FLU WORK , BUT YOUNG, SMART PHD STUDENTS AND POSTDOCS GO WHERE THERE IS FUNDING. AND THE FUNDING EXISTS BUT THERE IS GREATER FUNDING IN OTHER AREAS. I DON'T RUN INTO AN ENDLESS NUMBER OF PEOPLE AT STANFORD MEDICAL SCHOOL ARE DOING FLU RESEARCH. THEY'RE DOING GENE EDITING STUFF, NEUROLOGY. THERE'S A LOT OF THINGS THEY'RE DOING .THIS DOESN'T SEEM LIKE IT'S PRINCIPALLY ONE OF THE IMPORTANT ISSUES ON STUDENT OR BRILLIANT YOUNG RESEARCHERS MINDS. HOW DO WE CHANGE THAT? WHERE AM I WRONG?

00:31:03
Bruce Gellin
I THINK YOU'RE RIGHT BUT ONE EXAMPLE A YEAR AGO, THE GATES FOUNDATION TEAMED UP TO PUT OUT A GRAND CHALLENGE FOR THIS AND ACKNOWLEDGE ALL THE STEPS GOING ON. WE'VE SEEN THE NIH ROADMAP, A GOOD IMPORTANCE OF SOME OF THE RESEARCH BUT ON TOP OF THAT ARE THE OTHER PEOPLE WE DON'T KNOW FROM OTHER FIELDS MIGHT HAVE A SOLUTION TO THIS PROBLEM THAT DON'T KNOW THAT THEY MIGHT HAVE A SOLUTION AREA THAT I THINK A STEP FORWARD. THERE'S A LOT OF INTEREST IN THAT. WITH THAT THEY'RE TRYING TO FORCE BETTER INTERDISCIPLINARY COLLABORATION. THAT'S THE KIND OF THING THAT IS PARALLEL WITH WHAT WE'VE HEARD ABOUT FROM RICK IS THE KIND OF THING WE NEED TO LAYER ON TOP OF THIS.

00:31:42
Rick Bright
AND I THINK ALSO IT'S JUST NOT SEXY ANYMORE. IT PROBABLY HASN'T BEEN FOR QUITE SOME TIME. WHEN I WAS IN GRAD SCHOOL EVERYONE WAS WORKING HIV VACCINES AREA I WAS IN THE LABORATORY AT ROBINSON WORKING ON DNA VACCINES FOR HIV AND I CAME TO THE LAB AND EVERYONE'S WORKING HIV, THEY SAID YOU CAN DO WHAT EVERYBODY ELSE IS DOING. I'VE GOT LEFT OVER FLU MONEY ON THE FLU GRANT AND THE ONES INTERESTED IN INFLUENZA.

00:32:09
Rick Bright
THAT'S OUR BEST CHALLENGE THAT TO MAKE IT SEXY I THINK WE HAVE TO,

I LIKE THE CONCEPT DISRUPTING THE FIELD.

IF WE ARE JUST CONTINUALLY THINKING WE'RE GOING TO WORK ON ANOTHER ITERATION OR NO OFFENSE, I THINK WE NEED TO CONTINUE WHAT WE'RE DOING ANOTHER ITERATION OR ANOTHER ASSAY OR ANOTHER STEP, I DON'T KNOW IF THAT'S ENOUGH TO EXCITE AS CREATIVE THINKERS SO IN ADDITION TO DOING WHAT WE'RE DOING, WE'RE SO GLAD, I THINK IN PARALLEL THERE MIGHT BE A NEED OR EVEN AN URGENT CALL FOR AN ENTITY OF EXCITEMENT OUT THERE THAT'S COMPLETELY DISRUPTIVE, THAT'S NOT BEHOLDEN TO BUREAUCRATIC STRINGS AND PROCESSES.

00:32:45
Anthony S. Fauci M.D.
THIS DEAL WAS GALVANIZED WHEN WE A LOT OF MONEY INTO IT.

00:32:53
Anthony S. Fauci M.D.
LETS TALK ABOUT PATRIOTIC CD AND EASIEST WAY TO GET A GRAD STUDENT EXCITED ABOUT SOMETHING THAT ISN'T SEXY IS TO PUT DOWN ON IT BY HAVING A LOT OF MONEY. AND AS YOU WELL KNOW, THERE HAS BEEN MOVEMENT AMONG MEMBERS OF CONGRESS AND MARK, YOU PUT THE BILL IN FOR INCREASING THE INFLUENZA FOR UNIVERSAL FLU VACCINE BY $1 BILLION OVER FIVE YEARS WHICH IS $200 MILLION OVER EACH YEAR FOR FIVE YEARS. WHEN YOU PUT THAT KIND OF INVESTMENT, YOU WILL GET PEOPLE EXCITED NOT TO DO THE SAME THING THEY'RE ALWAYS DOING, DON'T GET NEW PEOPLE TO COME IN WITH NEW IDEAS

...THAT ARE DISRUPTIVE...

AND LOOKING AT IT FROM DIFFERENT ANGLES . WHEN YOU HAVE AN INFUSION OF RESOURCES, THAT'S HOW THE FIELD CHANGES BECAUSE THAT'S WHAT HAPPENS WITH HIV.

00:33:44
Margaret Hamburg M.D.
AND ALSO WHEN PEOPLE CARE. TONY AND I WERE TALKING YESTERDAY ABOUT THE EARLY DAYS OF HIV-AIDS AND HOW THE ACTIVISTS HELPED TO MOVE THE RESEARCH AGENDA IN POWERFUL WAYS BUT PEOPLE ALSO I THINK WHAT TO MAKE A DIFFERENCE AND IF THEY FEEL AS IF WE REALLY PUT THIS IN THE CONTEXT OF THE BURDEN OF DISEASE

(Covid-19 "put this burden of disease into context" - it was the PR Campaign)

AND WHAT IT MEANS, YOU TALK ABOUT PR BEFORE. WE HAVEN'T DONE A GOOD JOB OF THAT AND I THINK THAT WILL HELP BOTH GENERATE THE RESOURCES AND WE WILL ALSO I THINK BROUGHT ON THE BEST INSTINCTS OF PEOPLE GOING INTO SCIENCE WANT TO MAKE A DIFFERENCE. IN THIS COUNTRY AND AROUND THE WORLD.

00:34:29
Casey Wright
WERE BEING TERRIBLE PR PEOPLE BECAUSE WE'RE FLU AMBASSADORS AND WERE SAYING FLU IS NOT SEXY. AT FLU LAB, OUR MISSION IS TO DEFEAT INFLUENZA.
650,000 PEOPLE DIED LAST YEAR (2018) AND THEY WILL DIE THIS YEAR (2019). THEY WILL DIE NEXT YEAR (2020). AND WE SEEK A TRANSFORMATIVE PRODUCT. I THINK THAT WE CAN ABSOLUTELY AND IN PARALLEL WITH THE PURSUIT OF AN ITERATIVE PROCESS I THINK IN PARALLEL WE CAN YES, AND THIS. WE NEED TO SET AN AMBITION FOR THE ULTIMATE VACCINE. THAT IS PROTECTIVE, THAT IS ONCE A YEAR OR ONCE-IN-A-LIFETIME. IT IS DURABLE. IT IS FOR EVERYONE ON THIS PLANET AND IT ELIMINATES THIS ANNUAL SCOURGE AND IT ELIMINATES THE PANDEMIC THREAT. AND I THINK WE'VE ALL BEEN TALKING ABOUT THE NEED FOR URGENCY. WE SEE WHERE TALKING ABOUT A LOT OF PASSION IN OUR FIELD AND I THINK IT'S VERY IMPORTANT. BUT WE'VE REALLY BEEN ASKING OUR OUR SELVES AND OUR COMMUNITY THE REALLY HARD QUESTIONS. ARE WE ORGANIZED IN THE RIGHT WAY TO HARNESS THE NEW SCIENTIFIC INSIGHT IN THIS PASSION? ARE WE ORGANIZED IN THE RIGHT WAY TO MAKE PERMANENT PROGRESS AND MEET THIS GOAL? AND THAT'S ONE OF THE REASONS WHY WE ASKED TO SEE THE VACCINE INSTITUTE AND THE ASPEN INSTITUTE TO INTERROGATE THIS ISSUE AND THE RESULTS ARE REALLY QUITE CLEAR. THERE'S NO CLEAR GLOBAL OWNER OF THE PROBLEM AND THERE'S NO CLEAR GLOBAL OWNER OF THE SOLUTION AND IT'S HARD TO IMAGINE HOW WE WILL MAKE PERMANENT PROGRESS. IS THAT, FROM A WORLDWIDE PERSPECTIVE DOESN'T HAVE KIND OF OWNERSHIP. I THINK THIS FRAGMENTATION IS ALREADY SO AND THIS PROBLEM, THE SCALE OF IT REQUIRES UNPRECEDENTED COLLABORATION. IT REQUIRES A NEW MODEL FOR GLOBAL COLLABORATION AND DEDICATED LEADERSHIP AND AN ECOSYSTEM WILLING TO ENGAGE AND SUPPORT IT.

00:37:04
Michael Specter
SO I AGREE WITH ALL THAT. AND YOU GUYS ARE BLUE LAB IS AN EXCEPTION BUT IT SEEMS TO ME AND WHEN I'M SORT OF RODE AROUND IN THIS FIELD, PHILANTHROPISTS WANT TO MAKE A SPLASH. AND THEY DON'T WANT TO MAKE A SPLASH ON SOMETHING THAT EVERYONE THINKS IS BORING. OR THAT THERE IS A BACK SEAT, DON'T TELL ME IT'S BORING.

00:37:30
Margaret Hamburg M.D.
WE'VE GOT TO GET YOU TRAINED FIRST...

00:37:33
Michael Specter
YOU DON'T HAVE TO TRAIN ME, I'M JUST TELLING YOU THAT THE PEOPLE THAT I TALK TO HAVE A LOT OF MONEY, THEIR EYES KIND OF GLAZE OVER WHEN YOU SAY THIS STUFF. YOU WANT AN EXCEPTION TO THIS. AND IT SEEMS TO ME WHAT WE'RE TALKING ABOUT, WHAT WE'VE ALL BEEN TALKING ABOUT IS A TWO TRACK SYSTEM WHERE WE DO WHAT WE'VE BEEN DOING BECAUSE WE HAVE NO CHOICE. WE'RE NOT GOING TO DITCH THAT SYSTEM RIGHT NOW BUT WE DEVELOP SOMETHING MORE POWERFUL AND PERMANENT AND THAT REQUIRES A DIFFERENT KIND OF ENTITY. AND I'M WONDERING WHO IS GOING TO RUN THAT ENTITY BECAUSE I DON'T REALLY THINK THE GOVERNMENT IS PROBABLY THE ANSWER.

00:38:12
Rick Bright
I'LL SPEAK AS A GOVERNMENT REPRESENTATIVE, I THINK YOU'RE RIGHT ON THAT. WE ARE SO DISTRACTED BY SO MANY OTHER THINGS. I HAVE ALWAYS BEEN FIVE, 30 DIFFERENT THREADS IN AREAS UNFOCUSED AND AND AND I HE HAS SO MANY AREAS AS WELL AND WHERE YOU SAW A LOT OF MOBILIZATION, EVEN IN THE HIV WORLD WHERE SEPARATE ENTITIES ARE SET UP TO FOCUS ON HIV VACCINES. THERE IS NO SINGLE ENTITY, SINGLE FOCUSED ENTITY ON INFLUENZA AND I THINK IF THERE WAS A SINGLE FOCUSED ENTITY IN INFLUENZA AND TARGET AND THE TIMELINE WOULD BE ACCELERATED TO BRING THE BEST SCIENCE, PUTTING TOGETHER THOSE INTERDISCIPLINARY POTS. IN THIS ROOM OF PROBABLY IMMUNOLOGISTS, WHERE WORKING ON SOME VACCINES AND MAKING SOME VACCINE AT SOME POINT IN OUR LIFE BUT WE'RE NOT THE CHEMICAL ENGINEERS OR THE OTHER ENGINEERS OR ANTHROPOLOGISTS OR OTHERS WHO BRING CRITICAL INSIGHT IN HOW YOU DISRUPT AND DECONSTRUCT AN AGE-OLD PROBLEM AND WE HAD THESE VACCINES FOR 70 YEARS THIS IS AN AGE-OLD CONSTRUCT THAT REQUIRES THOSE CREATED CHEFS TO COME OUT OF THE KITCHEN, DECONSTRUCT THE CARROT CAKE AND MAKE IT LOOK LIKE SOMETHING DIFFERENT BUT THE BEST CARROT CAKE YOU'VE EVER BEEN REALLY NEED THAT FOR AN INFLUENZA VACCINE AND WE ALSO NEED TO NOT FORGET THAT FOR INFLUENZA, VACCINES ARE THE ONLY PART OF THE SOLUTION. I MEAN, IT'S SO EASY TO GET CAUGHT UP. IF YOU WANT TO GET SEXY WITH INFLUENZA YOU STAY IN THE VACCINE SPACE BUT IF YOU DRILL INTO THE DIAGNOSTIC SPACE OR THERAPEUTIC SPACE OR INTERVENTION, THOSE ARE THE EARLY STEPS THAT WILL MAKE A HUGE IMPACT ON BENDING THE CURVE FOR SEASONAL PANDEMIC OUTBREAK SO WE HAVE TO HAVE THAT SINGLE FOCUSED AND BE FOCUSED ON STOPPING THE LENS UP NOT ONLY ON MAKING US A VACCINE.

00:40:06
Anthony S. Fauci M.D.
IN CASE WE HAVEN'T FIGURED THIS OUT THIS IS REALLY VERY COMPLICATED NOT ONLY FROM THE SCIENTIFIC AND PUBLIC HEALTH STANDPOINT BUT FROM A PERCEPTION STANDPOINT SO CASEY, TAKING YOUR POINT REALLY IS NOT BORING WHEN YOU DON'T DOWN AND SEE WHAT ULTIMATE IMPACT IS BOTH CUMULATIVELY EACH YEAR AS WELL AS THE INTERMITTENT TIME THAT WE GET A PANDEMIC BUT LET ME TELL YOU HOW THINGS REALLY FALL INTO A DIFFERENT CATEGORY. IT'S THE DIVERSITY OF WHAT INFLUENZA MEANS TO THE COMMUNITY AREA SO SOME PEOPLE IN THE REAL FLU, NOT LIKE I HAVE A STOMACH FLU BUT THE REAL FLU, THEY GET BETTER. THERE'S THIS PERCEPTION IF IT'S SO SERIOUS, HOW COME PEOPLE GET FLU EACH YEAR AND IT ISN'T THE CATASTROPHE MARK WHEN YOU'RE DEALING WITH A DISEASE LIKE HIV, YOU GET HIV . WHETHER YOU'RE YOUNG, MIDDLE-AGED OR OLD YOU GET CANCER, THAT'S BAD. WHETHER YOU'RE YOUNG OR WHETHER IT'S INTERMEDIATE, WHETHER IT'S WITH INFLUENZA. SOME PEOPLE GO THROUGHOUT THEIR LIFE AND IT DOESN'T IMPACT THEM AT ALL. THERE ISN'T ANYBODY AFRAID OF INFLUENZA. YOU GO IN A FOCUS GROUP AND YOU SAY ARE YOU AFRAID OF GETTING HIV TO MARKET ABSOLUTELY . CANCER? ABSOLUTELY. AFRAID OF THE FLU? DON'T BUG ME. THAT'S THE REALITY OF HOW PEOPLE PERCEIVE FLUTE AND AS RICK SAID WHERE RESPONSIBLE FOR A VARIETY OF DISEASES MAKING COUNTERMEASURES, MALARIA, TUBERCULOSIS, EBOLA, WE'RE IN THE MIDDLE OF EBOLA RIGHT NOW. SO YOU GO TO THE DRC WHERE I WENT TO A WEEK AND A HALF AGO TO VISIT OUR SITE AND YOU ASKED SOMEBODY, ARE YOU WORRIED ABOUT INFLUENZA. THEY'LL LAUGH AT YOU. WHAT ARE YOU TALKING ABOUT INFLUENZA.

00:41:53
Anthony S. Fauci M.D.
AND MARK, DON'T VACCINATE PEOPLE BECAUSE THEY HAD ENOUGH PROBLEMS WITH MALARIA AND TUBERCULOSIS AND EBOLA - SO IT IS A PERCEPTION WHICH IS A MISPERCEPTION THAT IT IS NOT A SERIOUS DISEASE. BUT IT'S AS CASEY SAID HUNDREDS OF THOUSANDS OF PEOPLE DIE OF EACH YEAR AND WHEN YOU GET A PANDEMIC, MILLIONS AND MILLIONS OF PEOPLE. SO WE REALLY DO HAVE A PROBLEM WITH HOW THE WORLD PERCEIVES INFLUENZA AND IT IS GOING TO BE DIFFICULT TO CHANGE THAT UNLESS YOU DO IT FROM WITHIN AND SAY I DON'T CARE WHAT YOUR...

IF WE WERE TO ADDRESS THE PROBLEM IN A DISRUPTIVE WAY...

AND AN INNERVATIVE WAY BECAUSE YOU WILL NEED BOTH.

00:42:33
Michael Specter
IN THE MEANTIME, AMORTIZED, IF THE 2009 PANDEMIC HAD BEEN MUCH MORE DEADLY, WOULD THAT HAVE ENDED UP BEING A BETTER THING FOR HUMANITY? C'MON BE HONEST.

00:42:49
Anthony S. Fauci M.D.
WOULD IT HAVE BEEN? NO. BECAUSE I'M IN, WE HAD A, NOT SIMPLY A AS SERIOUS AS THE 1918, BUT WE HAD A PRETTY BAD PANDEMIC IN 1957 AND 1968. THAT DIDN'T CHANGE MUCH.
BUT WASN'T THAT BEFORE, THAT WE HAVE SOME BIOTECHNOLOGICAL TOOLS NOW THAT OUR DISPOSAL THAT WE DIDN'T THEN?

00:43:24
Margaret A. Hamburg M.D.
ABSOLUTELY THE SAD TRUTH IS WHEN THERE'S A MAJOR CRISIS THE FOCUS IS ATTENTION AND USUALLY RESOURCES AND SOME SIGNIFICANT MOBILIZATION POLICY. IT DOESN'T NECESSARILY MEAN THAT WE ARE USING RESOURCES AND THE BEST WAY POSSIBLE THOUGH BECAUSE IT DONE IN THE MOMENT OF CRISIS. AND THERE'S THROWING MONEY AT THINGS THAT SOUNDS GOOD WITHOUT ME AND THEM BEING THOUGHT THROUGH. AND THEN THERE'S WHAT WE USED TO CALL THE U-SHAPED CURVE OF CONCERN WHERE INITIAL INCREASE IN RESOURCES AND THEN WHEN THE PROBLEM FADES AND OTHER PROBLEMS EMERGE INSTEAD, EVERYTHING DROPS OFF.

[From here]
[AND, YOU KNOW, I THINK WE'VE BEEN IN THAT, WITH, WITH MANY DIFFERENT OUTBREAKS OF DISEASE, AND FLU TO SOME DEGREE AS WELL. UM, I THINK, PART OF WHAT YOU KNOW, CASEY WAS POINTING OUT, AND OTHERS ON THIS PANEL AS WELL, THAT NUMBER ONE, WE NEED THIS TIME TO BE DIFFERENT AND WE ALSO NEED TO, TO REALLY ORGANIZE OURSELVES IN A WAY WHERE THERE WILL BE ACCOUNTABILITY FOR SUSTAINED ACTION AND NOT JUST RESPONSE.

00:44:21
Michael Specter
SO, LET'S TALK ABOUT THE SCIENCE A LITTLE BIT MORE. CRAIG VENTER, WHO IS A CONTROVERSIAL PERSON, BUT INTERESTING TO ME... HAS WRITTEN THAT, HE THINKS WE OUGHT TO HAVE A VACCINE SUCH THAT, IF YOU TAKE OFF IN A PLANE FROM HONG KONG, AND ARE INFECTED:]
[To here: The above portion in brackets, was missing from the original transcript.]

BY THE TIME YOUR PLANE LANDS IN NEW YORK, THERE OUGHT TO BE A VACCINE ASSEMBLED UNDELIVERABLE TO YOU.
HOW CRAZY IS THAT?
HOW FAR ARE WE FROM THAT?
ARE WE EVER GONNA GET THERE?

*******************PAY ATTENTION TO THIS********************
00:44:50
Rick Bright
I'M NOT GOING TO SAY WE ARE FAR AWAY BUT I DON'T THINK IT'S TOO CRAZY. IF WE WENT TOWARDS THE AREA OF SYNTHETIC-BASED VACCINES
(mRNA)
AND REMOVE THE DEPENDENCY OF MAKING THE VACCINE HAS TO BE SOMETHING THAT WE HAVE TO GROW INTO SOMETHING ELSE AND EGG OR SELL OR AN INSECT CELL OR ANY DEPENDENCY ON GROWTH IF WE CAN MOVE INTO A MORE NUCLEIC ACID BASE OR

SYNTHETIC MESSENGER RNA BASE. !!!

THOSE SEQUENCES CAN BE GRAPHICALLY SHARED AROUND THE WORLD. ENZYMES THAT CAN SYNTHESIZE THE SMALL FRAGMENTS OF MESSENGER RNA NECESSARY TO GO INTO A VACCINE, CAN BE MADE IN A SHOEBOX SIZED SYSTEM, UH, RIGHT NOW. WHICH IS TRANSLATABLE INTO A 3-D PRINTER OR INKJET PRINTER LIKE THING. NOW, PUTTING THOSE IN A SYSTEM TO PRINT THOSE ON A PATCH, THEN A SELF ADMINISTERED VACCINE COULD HAPPEN. THE TECHNOLOGIES ARE OUT THERE. WE HAVEN'T DEMONSTRATED THE TRUE EFFECTIVENESS AND ABILITY OF THE VACCINE...

************THIS***************** (Still Rick Bright)
BUT IT IS NOT TOO CRAZY TO THINK, THAT AN OUTBREAK OF NOVEL AVIAN VIRUS COULD OCCUR IN CHINA SOMEWHERE, WE COULD GET THE RNA SEQUENCE FROM THAT, BEAM IT TO A NUMBER OF REGIONAL CENTERS - IF NOT LOCAL; IF NOT EVEN IN YOUR HOME AT SOME POINT. AND PRINT THOSE VACCINES ON A PATCH AND SELF ADMINISTER. WE'RE A WAYS OUT, BUT THE TECHNOLOGY IS THERE TO BE ADAPTED AND ASSEMBLED AND

PUT INTO THAT FUTURISTIC VIEW OF RAPID RESPONSE TO AN EMERGING NOVEL THREAT.

(And the technology was adapted and assembled by the end of 2020!)

00:46:23
Michael Specter
HOW MUCH MORE DO WE NEED TO KNOW ABOUT IMMUNOLOGY TO GET THIS RIGHT?

00:46:33
Anthony S. Fauci M.D.
NOT IMMUNOLOGY IN GENERAL, BUT IMMUNOLOGY ASSOCIATED WITH PROTECTION AGAINST THE FLU. WE DIDN'T MENTION IT, BUT I WILL BRIEFLY MENTION IT NOW BECAUSE IT IS IMPORTANT... IS THAT ONE OF THE OTHER COMPLICATING ISSUES WITH THE FLU IS THAT AS THE HUMAN SPECIES EVOLVES AND DEVELOPS AN ADAPTIVE IMMUNE SYSTEM WHICH MEANS IF YOU GET EXPOSED TO SOMETHING AND LATER ON YOU GET EXPOSED TO THE SAME OR SIMILAR THING YOUR BODY WILL REMEMBER IT AND MAKE A GOOD IMMUNE RESPONSE. THAT REALLY HELPS YOU AND SAVES CIVILIZATION AND IT'S VERY GOOD FOR THE IMMUNE SYSTEM. THE TROUBLE WITH INFLUENZA SINCE IT CHANGES A LITTLE BIT YOUR BODY FOR THE FIRST INFLUENCE OR YOU GET EXPOSED TO EVERY TIME YOU GET EXPOSED TO SUBSEQUENT THINGS THAT ARE A LITTLE BIT DIFFERENT - BECAUSE IF I GET EXPOSED TO THE MEASLES AND GET THE MEASLES AND A YEAR OR TWO OR THREE OR FOUR FROM NOW I GET EXPOSED TO MEASLES AGAIN I'M PROTECTED BECAUSE MY BODY SEES THAT THE MEASLES WILL MAKE A GOOD RESPONSE AGAIN TO THE VIRUS. WITH INFLUENCE I HAVE A THING CALLED IMPRINTING THE PEOPLE REFERRED TO IT SOMEWHAT INAPPROPRIATELY AS "ORIGINAL ANTIGENIC SIN." IF YOU GET EXPOSED TO AN H1N1 WHEN YOU WERE AN INFANT EVERY TIME YOU SEE ANY INFLUENZA, BE IT H3N2 OR H2N2, YOUR BODY IS GOING TO MAKE A RESPONSE AGAINST THAT, BUT IT'S GONNA BE VERY DISTRACTED AND IT'S GOING TO BACK AND MAKE H1N1. I WAS BORN IN H1N1 YEAR AND WHEN I'M EXPOSED TO H3N2 MY BODY WILL WANT TO MAKE A RESPONSE TO H1N1 AS WELL AS H3N2. SO, IT GETS DISTRACTED.

SO GETTING BACK TO WHAT YOU ULTIMATELY WANT TO DO, AND I THIK CASEY MENTIONED IT, WHEN YOU DO GET A UNIVERSAL FLU VACCINE YOU'RE GOING TO WANT TO GIVE IT TO 6-MONTH-YEAR-OLD KIDS BECAUSE THE UNIVERSAL FLU VACCINE, EVEN FOR ME AT MY AGE, IS NOT GOING TO BE UNIVERSAL. IT'S GOING TO CALL UP OTHER THINGS I'VE BEEN EXPOSED TO. SO, THE ANSWER TO YOUR QUESTION, MICHAEL, WE KNOW A LOT ABOUT THE IMMUNE SYSTEM, BUT INFLUENZA, BY THE WAY IT INDUCES A RESPONSE, REALLY COMPLICATES THE IMMUNOLOGICAL RESPONSE TO IT.

00:48:49
Rick Bright
ONE OF THE INTERESTING THINGS ABOUT THAT AND WHERE TECHNOLOGY IS GOING WHEN YOU THINK ABOUT SYNTHETIC BACED VACCINES, WE ARE DRIVING SYNTHETIC-BASED MONOCLONAL ANTIBODY PRODUCTION IN VIVO. SO AT THE SAME TIME YOU COULD, OR SOMEONE COULD PUT THAT VACCINE DOSE, MESSENGER RNA, INTO A PATCH, OR SOME WAY TO ADMINISTER IT INTO YOUR BODY.

THEY CAN ALSO DELIVER MESSENGER SEQUENCE FOR MONOCLONAL ANTIBODY. SO YOU COULD ACTUALLY HELP THE IMMUNE SYSTEM WHILE IT'S MAKING THAT IMMUNE RESPONSE OF THE VACCINE, BY DELIVERING AN ENCODED MONOCLONAL ANTIBODY. YOU CAN HAVE AN ANTIBODY RESPONSE COME UP WITHIN A PERIOD OF HOURS, THAT WOULD BRIDGE YOUR BODY WHILE YOU ARE MAKING AN IMMUNE RESPONSE TO THE PARTIAL IMMUNE RESPONSE TO THE VACCINE STRAIN.

MIC CRACKLE - INAUDIBLE

00:49:39
Rick Bright
THE COMBINATION OF THE HELPING VACCINES IN THE IMMUNE RESPONSE BY COUPLING IT WITH SYNTHETIC DELIVRY, RAPID DELIVERY OF A MONCLONAL ANTIBODY OR OTHER SORT OF PASSIVE IMMUNITY MIGHT BE AN APPROACH TO SORT OF GIVE US THAT PROTECTIVE IMMUNE RESPONSE.

00:49:59
Michael Specter
I DON'T WANT TO BEAT UP ON INDUSTRY TOO MUCH, WELL I DON'T MIND BEATING UP ON INDUSTRY, BUT PRESUMABLY THERE WOULD BE A PROFIT INCENTIVE EVEN FOR UNIVERSAL VACCINE FOR A LOT OF PEOPLE WHO WOULD NEED IT...
HOW EAGER ARE INDUSTRY PLAYERS IN YOUR EXPERIENCE? MAYBE PEGGY WOULD BE THE FIRST TO ANSWER THIS... TO EMBRACE SOMETHING NEW LIKE THAT?

00:50:289
Margaret "Peggy" A. Hamburg M.D.
YOU KNOW, I THINK THERE ARE CERTAINLY COMPANIES, BIG AND SMALL THAT ABSOLUTELY WOULD. I THINK WE HAVE SEEN, YOU KNOW TONY WAS MENTIONING THE EBOLA OUTBREAK. WE YA KNOW, WE HAVE SEEN SEVERAL MAJOR COMPANIES AND SMALLER ONES, STEP UP TO THE PLATE IN WAYS THAT AREN'T REALLY BENEFITING THEIR BOTTOM LINE, BUT ARE IMPORTANT IN TERMS OF PUBLIC HEALTH. BUT I THINK WE DO HAVE TO TRY TO CREATE A CONTEXT FOR THEM TO DO THIS, WHICH THEY WILL GET REWARDED. SOME OF IT IS APPRECIATION. SOME OF IT IS, YA KNOW, THE SENSE OF CONTRIBUTING AND REALLY HARNESSING SCIENCE FOR THE BENEFIT OF HUMANITY. AND SOME OF IT IS HOPING TO DECREASE SOME OF THE BARRIERS AND THE UNCERTAINTY IN THE PROCESS. AND, I THINK THAT GOES BACK TO THE COLLABORATION. I THINK WHAT WE REALLY HAVE TO THINK ABOUT IT IS HOW TO ALIGN THE DIFFERENT CAPABILITIES - THE DIFFERENT FUNDING STREAMS, THE DIFFERENT INCENTIVES TOWARD A COMMON GOAL.
FOR AN INDUSTRY I THINK IT IS REALLY IMPORTANT FOR THEM, TO NOT FEEL THAT THEY ARE JUST GOING TO SORT OF WALK OFF A CLIFF WITH A COMPLETELY NEW APPROACH WITHOUT ANY IDEA WHETHER IT'LL BE SUCCESSFUL. WHAT WE HAVE SEEN IN VARIOUS AREAS, AND CERTAINLY SOMETHING I LEARNED WHEN I WAS COMMISSIONER OF THE FOOD AND DRUG ADMINISTRATION IS THAT THE SOONER EVERYBODY CAN SIT AT THE TABLE: GOVERNMENT, INDUSTRY, ACADEMICS, RESEARCHERS... AND IN MANY CASES THE PEOPLE WHO ARE GOING TO HAVE TO EITHER CONSUME OR DELIVER THE PRODUCT AS WELL. AND REALLY TOGETHER MAP OUT A PLAN AND SORT OF IDENTIFY, WHAT ARE THE CRITICAL QUESTIONS TO ASK AND ANSWER? WHAT ARE THE UNKNOWNS SCIENTIFICALLY AND WHAT ARE THE UNKNOWNS, IN TERMS OF THE REGULATORY PROCESS? AND WHAT IS THE LEVEL OF RISK THAT PEOPLE ARE WILLING TO ACCEPT? AND HOW CAN WE REDUCE SOME OF THAT, EITHER THROUGH FINANCIAL INCENTIVES OR GUARANTEED PURCHASE? OR, YOU KNOW REALLY CLARIFYING AND MAKING MORE PREDICTABLE, THE REGULATORY QUESTIONS AS WELL.

00:52:48
Casey Wright
I THINK TO ADD TO THAT, PEGGY, UM, SORT OF PART OF IT, GETTING EVERYBODY AROUND THE TABLE, ACKNOWLEDGING WHAT EVERYONE'S STRENGTHS ARE AT THAT TABLE, AND WHAT IS REALLY HARD FOR THOSE INDIVIDUAL ORGANIZATIONS TO DO AND TAKE ON. AND I THINK THERE'S A POTENTIAL ROLE FOR PHILANTHROPY TO PLAY THERE TOO AND HAVE A ROLE AT THAT TABLE. I THINK, WE ARE IN A POSITION TO TAKE ON A LITTLE BIT MORE RISK. TO BE OPEN TO A LITTLE BIT MORE EXPERIMENTATION WITH METHODS AND HOW WE DO THINGS. THAT'S WHAT I THINK IS UNIQUE ABOUT FLU-LAB AND I THINK ABOUT OTHER PHILANTHROPIES AND I THINK THEY COULD PLAY A REALLY IMPORTANT ROLE THERE AND FUND A SET OF SORT OF BOLDER, MAYBE EARLIER PROMISING CONCEPTS. BUT ALSO TAKE ON SMALLER CREATIVE INITIATIVES THAT MIGHT HAVE AN OUTSIZED IMPACT.

00:53:43
Bruce Gellin
SO, WHAT PEGGY AND CASEY JUST DESCRIBED, IS THE RATIONALE FOR THAT CALL TO AN ENTITY. IT WASN'T NECESSARILY A BUILDING WITH A LOGO, BUT JUST PUTTING IT ALL TOGETHER. AND I THINK IT'S IMPORTANT WHEN THE GROUPS LOOK AT THIS THEY RECOGNIZE THAT CALLING FOR SOME OF THIS WASN'T EASY:
DO WE NEED ANOTHER "GLOBAL THIS OR THAT?" BUT THE RECOGNITION OF, GIVEN THE URGENCY, AND GIVEN THE IMPORTANCE OF THIS. AND AGAIN, WE HEARD ABOUT, GIVEN THE RISK, IT WAS REALLY WORTH PURSUING THAT TO FIGURE OUT HOW BEST TO ALIGN ALL THOSE DIFFERENT THINGS THAT PEGGY LAID OUT, TO MAKE SURE EVERYONE ISAROUND THE TABLE AND WOULD ADVANCE THINGS, RATHER THAN KEEPING THINGS IN THEIR OWN LANES.

00:54:16
Michael Specter
SO THAT REPORT'S BEEN OUT FOR A LITTLE WHILE NOW; ARE YOU FINDING THAT IT'S CATCHING ON?

00:54:18
Bruce Gellin
WHAT DOES CATCHING ON MEAN? IT WAS RELEASED IN JULY. WE TALKED ABOUT IT A LOT. IT'S GOTTEN A LOT OF ATTENTION... I THINK THE GROUP WAS WISE IN PRIORITIZING WHAT THEY CALLED FOR. BUT THEY CALLED FOR THIS ENTITY, WHICH AGAIN, IS THIS COLLABORATION WE TALKED ABOUT. THEY CALLED FOR THE NEED TO INFUSE INNOVATION; TO FIND SOME OF THESE PEOPLE WHO WE DON'T KNOW, MIGHT BE PART OF THE PROBLEM, AND TO TRY TO THINK ABOUT HOW WE TALK ABOUT THIS DIFFERENTLY, SO YOUR STOMACH FLU DOESN'T KEEP US FROM MAKING PROGRESS. (LAUGHTER)

00:54:50
Michael Specter
WE ONLY HAVE A COUPLE OF MINUTES. I WAS WONDERING WHAT IS THE BIGGEST OBSTACLE?
IS IT MONEY?
WE JUST HAD A TON OF MONEY FOCUSED ON THIS PROBLEM; WOULD THAT MAKE IT GO AWAY?

00:55:08
Anthony S. Fauci M.D.
IT WOULD MAKE IT GO AWAY BUT INFUSION OF MORE RESOURCES DURING PEOPLE INTO THE FIELD THAT WOULD NORMALLY BE INTO THE FIELD. SCIENTIST DO THAT. THEY DO THINK IT'S INTERESTING THAT THEY ALSO FOLLOW THE MONEY AND AN INFUSION OF RESOURCES IS GOING TO BRING SOME PEOPLE WHO ARE INTERESTED IN OTHER FIELDS TO ADD A FRESH NEW LOOK. SO, I THINK IT WOULD MAKE A DIFFERENCE.

00:55:36
Michael Specter
AND DOES THAT HAVE TO BE SOMETHING THAT COMES FROM
PHILANTHROPY?
DOES THIS HAVE TO BE SOMETHING THAT COMES FROM THE UNITED STATES CONGRESS OR BOTH?
WHERE DO WE GET THE FINANCIAL FIREPOWER TO DO SOMETHING LIKE THAT?

00:55:53
Anthony S. Fauci M.D.
I THINK BOTH, I MEAN IT'S NOT JUST UNIDIMENSIONAL. I MEAN, CLEARLY THERE'S A MOVEMENT OF DISCUSSION IN THE CONGRESS. WE HAVE FISCAL CONSTRAINTS NOW, BUT PEOPLE LIKE ED MARKEY & ROSA DeLAURO HAVE BEEN TALKING ABOUT THE NEED TO MAKE A SUBSTANTIAL INFUSION OF RESOURCES INTO THE ENTIRE FIELD; NOT ONLY THE FIELD OF SCIENCE TO GET DISCOVERY AND INNOVATION AT DEVELOPING BETTER PROCESSES TO MAKE THAT VACCINE. AND, THE PRESIDENT'S EXECUTIVE ORDER SPECIFICALLY TALKS ABOUT THE KINDS OF THINGS THAT NEED TO BE DONE. IT DOESN'T MENTION RESOURCES BUT IT CLEARLY DELINEATES THE KINDS OF THINGS WE'RE TALKING ABOUT.

00:56:35
Michael Specter
DO ORDERS LIKE THAT SPUR RESOURCES TO GET ALLOCATED?

00:56:40
Anthony S. Fauci M.D.
ANYTHING THAT CALLS ATTENTION TO THE KINDS OF THINGS THAT ARE GOING ON INTO THE PROBEM, WOULD EITHER DIRECTLY OR INDIRECTLY, AT LEAST BRING ATTENTION TO THE NEED FOR RESOURCES.

00:56:48
Margaret "Peggy" A. Hamburg M.D.
AND I THINK WE REALLY DO NEED TO HAVE SOME ACCOUNTABILITY. WE CAN'T JUST KEEP TALKING. WE HAVE TO REALLY DEMONSTRATE PROGRESS WITH GOALS. THAT'S PART OF WHAT THE ASPEN SAVEN GROUP TRIED TO DO, TO DEFINE SOME THINGS THAT NEED TO GET DONE AND CREATE A SYSTEM OF ACCOUNTABILITY.

00:57:12
Rick Bright
I KNOW WHERE THE TIME BUT I THINK WE NEED THIS MOMENT OF ENERGY THIS BURST - THAT COMPLEMENTS EVERYTHING WE HAVE BEEN DOING FOR YEARS AND COLLECTING LOTS OF INFORMATION. THIS ADVOCACY GROUP THE SINGLE FOCUSSED, THAT GOES TO CONGRESS, THAT GOES AROUND THE WORLD - PEOPLE ARE DYING. THE URGENCY, THE TIME IS NOW IN THIS GROUP IS FOCUSED ON IT. IT IS THE LOBBY GROUP AND IT IS WHATEVER GROUP DOES, BUT IT'S GOT TO GET MONEY FROM PHILANTHROPY. IT'S GOT TO GET MONEY FROM GOVERNMENT. IT'S GOTTA NOT BE DISTRACTED BY THESE CYCLES AND UH, BUREAUCRACY TO GET THE JOB DONE.

00:57:51
Michael Specter
WE ARE OUT OF TIME. THINGS ARE FLASHING AT ME. I'D JUST LIKE TO THANK YOU VERY MUCH FOR HER PROVOCATIVE CONVERSATION.

00:57:58

THANK YOU MICHAEL.

APPLAUSE INAUDIBLE CONVERSATIONS

*This text was compiled from uncorrected Closed Captioning. However, fixing of the punctuation was attempted.

Original Video Posted on C-Span: https://www.c-span.org/program/public-affairs-event/universal-flu-vaccine/535344