Outbreak Week: Preventing Epidemics: Public Private Partnerships

Outbreak Week: Preventing Epidemics: Public Private Partnerships

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So, next. Panel, can. Be led expertly, by Ryan Moore Hart Ryan, has gotten, a couple shout outs already, he. Is really leading the effort on global health security for. The World Economic Forum, for those of you who don't know the World Economic Forum, it's, really a forum that brings together the leading business leaders, around the world it's, most famous manifestation. As its event in Switzerland. Every. Year in January but. It actually does a tremendous, amount of stuff throughout the year and I, would say the last couple, of years we've seen incredible, leadership from left on this, issue of global health security. Ryan. Thank you for that and thanks for leading us on. Well. Thank you for the introduction. Sheesh. And. Thank. You I should, say you know we noticed we're one of the last panels, so just to take a moment to thank all the organizers for outbreak, week it's really an incredible, undertaking. Really. Well done and really appreciate, the chance to be a part of it. And. Really a privilege to follow Ron, so thank you thank you Ron. But. It's a special especially. A privilege and an. Honor to introduce this panel and we. Appreciate that that public-private, cooperation can be on the agenda and we're looking forward to hearing from the, panel. But. When it comes to, public-private. Cooperation. Maybe. A week has set the stage by just sharing three, things. First. First. Thing on public-private cooperation with outbreaks is the private sector has every, reason to engage. In, outbreak. And, epidemics, and mitigating. The risk, and impact I. Think. We've discussed for a few reasons why but I'll tell you just a couple one. Is, these outbreaks and epidemics, are, incredibly. Costly. We. Heard a little bit earlier, from. Larry Summers on this, but, set the annual cost of outbreaks seems, to be maybe, 0.7. Percent of global income, which is on the, level potentially, of climate change and the risk of climate change. In fact, it is, actually. Striking. That. Broadly, speaking and really may be at risk of being speaking, too broadly. While. We continue to get better at managing the. Risk and the health risk of outbreaks and, of course important work remains in that regard but while we continue to get better at managing the health risk of outbreaks, we're. Seemingly getting worse at. Managing, the economic, consequences, of outbreaks. For. Example we saw in SARS in 2003. With. Only really, only 8,000, infections around the globe and 800, deaths. We, saw a global cost to the economy of 50 billion dollars. And. More. Recently. MERS. In South, Korea, with. 38. Cases. We. Saw a 41%, reduction. In travel and really. Dramatic, change as a consumer, behavior across the entire region. So. I think, it is safe to say that we're, past the point where. Businesses. Especially large, businesses, can. Afford, to neglect the risk of, outbreaks.

And Epidemics. The. Second, thing, to keep in mind when it comes to public-private cooperation is. There. Are several areas where, public. Private corporation, is essential. To effective global readiness, it's non optional, and we've, discussed today, throughout. The day and really throughout even yesterday. On vaccines. And and. If so of course medical. Countermeasures, development. And deployment is one obvious area, of essential, public private corporation, which has. Justifiably. Received, a lot, of attention from, this, esteemed. Group over the last couple. Days and really. It's. Been on the agenda but there are other areas as well where. Public-private. Cooperation is, is. Essential. And and. Non-optional. That's. In areas of pandemic, supply chain which will discuss more today. Also in areas of data and data innovations. Which we heard a little bit from, the. Prior panel on and in. Areas of communications. Which we'll hear some in just a moment, in, finance, again. Which we'll hear in just a moment and, also in travel. And mobility, which, ron has just mentioned a moment ago. I'll, just say a note because we don't have a panelist, on travel, and mobility, travel. Tourism. What. We've seen with the last couple responses, is the the easiest, thing to do has been to close your border or cancel your flight not that it's easy but that's sometimes the most politically, expedient thing to do. There. Are several ways that we can make that a little bit harder to do and you only do it when it's in the right in the right time in the right place and, and that's something I think would be worthy of the, the attention, of our community. Just think about how can we make that a little bit harder to do knowing. That that race to the bottom threatens, the response and communities and. Really the outbreak alike. Finally. On the third thing third. Item of public-private cooperation before we introduce the panel we've already said that businesses. Need to be engaged, out. Of their own interests of the economic interest that public-private, cooperation is required and finally. Maybe. Obviously, that. In these areas these five or six key areas of essential pub private corporation, some. Really, obvious and simple, challenges. Remain and. Even. Though there's simple challenges, good. Operationally. Integrated, public-private, cooperation is, really hard and so. This. Is where I'm, really. Happy to hand to the panel to talk about what are the things that we can be doing in these, spaces where. We can, find. That magic. Solution. For the operationally, integrated public of cooperation so with my pleasure. Introducing. A couple of the parents what I'll do is I'll introduce each of you and. Then and then Mike, maybe I'll put you on the spot and have you come up first but first let me introduce the entire panel and. Then we'll we'll hear from each panelist, and then. We'll have a dialogue together so first. Welcoming. Maggie, Farley, for the executive, vice president of global crisis and risk at Edelman, so, thank, you for being here Maggie Gerard. Mueller chief of global communications officer, at Henry Schein Thank You Gerard and, to. By this minute vice president, global uh global. Partnerships, at Swiss ray thank you for being here Tobias and finally. To come up to now, for some remarks doctor, Mike Ryan this isn't doctor general for emergencies that uh at, World Health Organization we've all heard from like a couple times and of course we hear here, Mike's name mentioned but if you weren't here yesterday you. Didn't hear Mike. Referred to as Indiana, Jones, so. He's, not asking us to call on that but it says it's starting to take. Good. Afternoon. Thanks. Ryan and. This. Is a Groundhog, Day for me I think I was here yesterday.

So. Yesterday, I spoke to the topic of vaccines, for outbreaks in the modern world and we have two excellent panel discussions. Moderated. After that one, spoke. On the end and issues, facing us from vaccine development and delivery and equity second. Probably. More important, panel two talked. About the challenges, creating. Community. Demand acceptance, and trust around vaccines, and it's, very interesting discussion, to be part of, today. I think again we remember, the pain the loss and the suffering of the. 1918. Pandemic, we. Again salute the heroes who worked in save lives and. I. Hope we, collectively. As a community can commit to do doing, everything possible to keep, the world safe from another high-impact. Epidemic, or pandemic. In. The last hundred years we've, made much progress in, this endeavor in terms of understanding disease, emergence, you saw that today developing. Better prevention, detection response, measures, and we, have recognized, as Ryan alluded to the broader societal. Economic and political impacts. Of these, diseases, so, as I said yesterday all. As well mm-hmm. Well. All, is not well. Because. Are. We ready for the next big one and for. Me the. Resounding answer is no. Sometimes. When you've got a problem in life you look in the mirror and you ask yourself some questions I, tend to do that a lot because I make a lot of mistakes in my life. And, so let's see if, we look on the mirror and can we answer the questions. Do. We have accurate forecasting. And prediction of, likely, pathogens, their origins spread and impact, do. We have sensitive, intelligence, and surveillance systems everywhere. In the world to rapidly detect and confirm, possible. Events, do. We have all the capacity, at all levels in all countries to, rapidly respond to outbreaks and, prevent larger scale spread. Do. We have the best countermeasures. Possible, in terms, of drugs and vaccines and do, we really understand. How to implement non-medical. Countermeasures. In confused. And panicked, communities. Do. We have the trust and confidence of our own communities, and, are they fully engaged, and empowered in. The fight against epidemics. The. Answer to all of these questions I think is as, with, all human answers it's kind of a yes and a no but. In my view it's mainly and no in. Relation to a lot of them and. One last question well, this is where we come up maybe to the public private sector to. Use the American vernacular as, I used yesterday have. We emptied the bench. In. Other words if we, accept that epidemics, and pandemics of, the greatest threat we face as a civilization. Have. We mobilized, all the ingenuity, the skill the passion, and commitment of, all parts, of our global village to. Protect preserve. And restore. Health. Economy. And society. Can. We answer that question when. We look on the MER I. Would. Argue that we have not and. There. Are two sectors that we need to mobilize urgently. In this regard, our. Our own communities. Everywhere. We. Have not been successful at building trust engagement, acceptance, and participation, of communities, this, argument is an argument of the experts and has been for a very very long time we. Also haven't mobilized, a vibrant private sector, everywhere. Some places yes most, places no, the. Private sector has a stake and the responsibility. To help answer all the questions I've asked in the last couple of minutes we're call countable, because. We serve our communities. Yes. It's clear we have pharmaceutical. Companies have a major role to play in pandemic, preparedness in terms, of the development of drugs and vaccines. But. As Mike osterholm, said yesterday we've. Yet to come up with a downstream, business models that worked for the development of epidemic, countermeasures, it's.

A Major challenge needs to be addressed urgently and, one, that wh I was working with partners on we do have one superb, global, public-private, partnership, which is the global influenza, surveillance, system, we produced global vaccines, every year for two hemispheres, based on the free exchange. Of risk data virus. Data and. Others. With industry. To come up with an. Effective vaccine although we, were arguing the effectiveness of that vaccine this morning when that vaccine happens because, of, a, 50-year public/private. Partnership. Our. Research. And development brood, prints lays, out roadmaps, for the products we need Sepe, and others are providing, upstream. Financing, but, again as we said yesterday governments. Need to take leadership and creating, the environmental, conditions, and incentives, where such innovation, and delivery, can occur, beyond. The obvious drugs, and vaccines we, think about because very often in our game when we think about public-private, partnership we take drugs or vaccines. There, are so many other areas where, public-private. Partnership, can be usually helpful, we already have our global, outbreak alert and response network we have hundreds, of institutions, working together to, deploy people and. Teams to, the frontline. Before. During. And after, epidemics. And. The, private sector site and this is a reflect imposter, was Ryan. Said and I know he won't blow his his, own trumpet but we've, been working very closely with with a number, of great foundations, UN, organizations. And many players from, the private sector including Henry Schein on. An epidemic, readiness accelerator, looking, at challenges. As diverse as you. Said supply, chain management. Data. And IT innovations. For forecasting, predictive, and visual analytics simulators, epidemic, intelligence innovative. Data capture, communications. Technologies, for risk communication, and community empowerment, policies. And solutions, for rapidly managing, regulatory, and liability, issues and working with the travel and tourism industry to. Deliver better risk information. Beyond. That and critically, and this is maybe the, main point I'd like to meet today, we. Have a massive challenge of building, core, preparedness. Capacities, around the world the. Capacity, to detect and respond to epidemics is, not evenly distributed we. Are only as strong as our weakest link a broad. Coalition is developing, around this challenge, and we're working closely with the World Bank with the GHSA, resolve. Many other foundations. And. The private sector to try and make the vital progress we need to make so.

All In all we have a massive, challenge. Even. If we are to respond to the outbreaks we face every day and in. Some senses these are there I think. Someone said it before in the previous thing there is no peace time anymore, there's. No peace time to, build the. Weapons to defend ourselves in wartime we're. At war, we. Have cholera we have we. Have monkey, pox we have Lassa fever we, have outbreaks at one point twelve. Weeks ago I think we had eight of the diseases on the on. The priority. Pathogens, list actively, causing outbreaks of one part of the world of the other the only thing we didn't have I think was disease X and. Was waiting for that one, so. There is if there is no peace time we're. Challenged every day we. Must use these challenges, we, must leverage these to develop the products the systems the networks and capacities, that will serve us well in. The future when the big one comes. I've. Said yesterday that I've been accused of being a, pathological optimist. Well my staff think I am anyway I wear. This badge would pride, but. I also contend I'm a pragmatic, realist. I just. Believed that we can achieve so much if we just recognize the scale of the challenge and work. Together relentlessly. To find the solutions, I called, a JFK, yesterday and. Today I bought, by him, my grandfather would've been very pleased great irish-american, I'm now going to quote Winston Churchill he's, as brave as we speak. But. He said a, pessimist. Is one. Who sees the difficulty, in every, opportunity. An. Optimist, is one who sees the opportunity in, every difficulty, thank you. Thank. You Mike. Please. Maggie. I'm. Actually going to take, a step back and look, at one of the work. Mike. Just mentioned so I'll drill down to one of the solutions, that's currently, underway through the World Economic Forum. When. Is the co-chair, of the communications, working group that you just saw up on Mike's slide and the, other I have, communication. Specialist and someone who leads a health, crisis, and issues, crisis. Team back at Edelman, and in, that team role I work with a lot of major on multinational corporations. So, hopefully I'll be bringing some insights from that work to, the discussion today. So. In terms of the communications, working group we've. Talked in the last probably hour a lot about how do we bring big businesses, into. The solution, and one. Of the things that we're working at on this working group is to. Find ways to really engage, big, businesses, big large employers, in. A capacity-building. Way where they. We. Recognized that large, employers, have. A lot of influence they have a lot of reach and they certainly have the means to quickly. And rapidly, reach. Out to all of their employees so. We want to work with them and I'll walk you through some of the strategies, that we're developing to make sure that they can readily and reliably.

Augment. Public messaging, and help manage, the rumors and misinformation, that, is, always, surrounding. A real, or perceived, epidemic. And, we want to make sure that we're using them well to amplify, credible. Information, and, I think that's where the start of some of the private. Public partnership, can come and, really how do we use big, businesses, with, great reach to, work with the public health officials, to make sure that, we're actually, pre-empting. Or minimizing. Or, correcting, all the misinformation that creates the fear, so. I think a lot of what I'm going to speak to right now we've already covered in the morning, sessions, but I want to talk about the challenges of bringing big businesses on and why it's so important we use them as. A communicator, and then also the opportunity. Both, from a public health perspective and, from the perspective of, a, company so the. Challenge, I think everyone agrees we, just heard from ron about the media and the media hype not knowing what's true or what's what's. False but, the information vacuum, itself, is what can create fear and so. We do recognize, that when, there is an epidemic or a rumor, of, epidemic. We need to find ways to close, that gap and get information out quickly but. It has to be reliable and I. Think everyone will agree that delivering. Information. When it's fragmented, is one. Of the greatest challenges, and sometimes. One of the things that we struggle with is well, the public health officials, are trying to get the accurate information as, we, heard earlier the media is looking for the headline and the story so. We're trying to find ways in which we can actually close that gap and. When you look at the ways big businesses, communicate, with their employees, they, do have channels to push out information really, quickly so, finding the accurate source to get the information out, I mean. This is probably one of the more important, points and I certainly don't want to go over all of the issues already shared but. During, an emergency, the current, lack of trust, can. Easily, create greater. Fear, greater. Misinformation, and, actually. Lead to dangerous, actions, so. When we think about trust, one of the, the. Insights, or stats that I'll share with you today, we. Do at Edelman, what we call the Trust Barometer for, 18 years we've been looking at trust. Across all the institutions. Worldwide. This. Year we surveyed, more than 30,000. People in 28, countries and, I, think when we look at the communications. Working group and trying to involve community, businesses, as communicators. Really important, to point out that, in this year's Trust Barometer, we. Found that 64%. Would. Trust a CEO, over the government, and that's, a big shift so. Right now I think the, the stat is 22. Out of 28, countries now. Say that they trust business more than they trust their government, so. We need to find ways to leverage that and use it in a way that is actually, helpful and progressives.

Or Advances, information. Sharing during epidemics. In. Terms. Of the opportunity. I've. Talked about the need to engage communication. Sorry businesses, as communicators, they, have the ability to cascade, out information, very, quickly and as I just mentioned, they're trusted so let's find a way to leverage them. More. Importantly, we can talk about the business reasons, the financial, reasons and incentives, for companies to become involved but, I also want to point out an important point where when, we talk about employees. Trusting CEOs, those, same employees are also saying in the car parameter, that they want their corporations, they want their CEOs they want their companies to stand, up and. Actually. Speak. To and represent, some of the bigger problems that we're facing as society, so. Corporate leaders can actually use this as an opportunity to show. Leadership and, I. Think in doing so if they were to get engaged and to think about how they could react, and be responsive, during an epidemic, not, only can they show leadership but they can certainly do a major job in making. This more about a mindset a shift, in mindset as well as practice, and by. Doing so public's, then can be appropriately, informed. I shouldn't, say singularly. Appropriately. Informed. But we could augment, what's already being shared, by the public health authorities to, make sure they're more fully informed. So. Some of the activities underway. We've. Identified these, four specific strategies. And. I'll give you just a little bit of information on each first. Learn from instructive, examples, of how. Public-private. Cooperation has. Supported pandemics, before, but. As a crisis, communicator, I'm also looking, at companies. That have actually, managed crises, in general, well, what, are the best practices in, terms of communications. That rapid, communication, on that's, necessary, when you're in an emergency situation so. We're looking at those types of analogs to determine, best. Practices that could be applied and actually. Turned into strategies, and toolkits, a very, very specific, corporate. Focused. Toolkit. That, canon's can, support, this integrated, partnership concept. So. If we think about best practices, just a couple of things that I want to share and I know this is very tactical, but, when we're looking at solutions, it's time now to start thinking, also about. What it is and how it will work and some of the tactical, aspects. Preparedness. Plans when we think at the highest, level, they. Really need to be supported, by the executive, leadership, to. Work any kind, of preparedness, effort, at the corporate, level has, to have the, support, and sponsorship, of the c-suite there. Needs to be that deep commitment to. Develop. Refine, fluid. And flexible, plans and those, plans could, be based on the economic, incentive, or as I mentioned earlier the, ephod the incentive, to really protect and, safeguard an, employee.

Base Not, only for economic, reasons but, for the social reasons that, companies. Are are, aiming to achieve. Really. Important, aspect to here is another. Point for public-private it's, any corporation, needs to have a multifunctional. Task, force with, very clear, roles and responsibilities. And jurisdiction. Of authority, but. What most companies don't have if they're forming a task force to deal with any crisis, but in particular an epidemic, or pandemic is. They, don't have unstaffed, the right subject. Matter experts, so, any. Public/private. Partnership. A task, force such form has, to have that. Liaison. Or that network and the ability, to pull in from the public health sector accurate. Information, no. We need epidemiologists. I have to do geologists. We need to know the. Severity should we be worried is this that rumor level is just really at a level that we need to act so that, multi. Like functional task force again needs, to find ways to develop relationships and, develop those relationships quickly. At the global regional, and certainly. At the local level we. Need policies and protocols these. Are already underway in many companies but, what do you do about travel, you. Know when you think about preparedness, how can we work with those who have lived through epidemics. And firsthand to, get those lessons, learned to decide monitored. Movement should companies have policies, on that should they be quarantined how. Do they handle absenteeism. So. So many different policies, that need to be taking into consideration some. Are legal and some are more along the the moral and ethical line but, these are the types of things that companies can be doing in advance and then. Finally, and I think this is where the toolkit, from the the west working group can come in is, during, the time of an incident or when there is an epidemic if. They have their procedures, and policies, in place we. Could tap together work together to really make sure companies, know how to interpret. What's. Happening, in terms of the case investigation. Knowing. Whether or not they, need to assign. A level of threat how, do they then internally, within the company, help. Prevent, the spread of any, kind of epidemic and then, more importantly how, do they again, serve as a channel, a communications, channel that can augment, all the, information, that they're getting from whether it be CDC, or w-h-o, so. Again going back to the goal to really work closely with, the. Public-private. Partnership, to establish, a network a very. Large employers, doesn't. Have to be private but, a large network of employers. Who can actually help push. Out accurate, information, in a way that's rapid. And also, actionable, and in. Doing that we really hope to cultivate, what we're calling this cross sexual, community. Of stakeholders so. Again. Businesses. Supply. Chains their partners, their employees, all that, would be committed to maintaining and, testing, and really refining, how we can approach emergency. Communications. During an epidemic. Okay. Thank. You Maggie. Thank. You so I am I'm, the finance guy on this panel mm-hmm, and um let. Me start by saying that um I don't, work in public health obviously I is. It working. We. Might need to get pretty close to it is.

This Okay better. Okay. Tell. Me if it's if you're not hearing me well so, I was saying um. Because. I don't work in public health um, but was actually trained, in public health the fact that I somehow and, never never worked in that field for a day in my life the fact that I somehow managed to claw my way back onto a panel, on this topic somehow, is. It is a personal, triumph for me that you don't. Even appreciate so. I work, for a company called Swiss, Re and like every, company. Whose name ends in re that. Is a reinsurance, company. I'm. Going to talk about something, that I suspect you've heard about which is the pandemic. Emergency, financing, facility the. Peph PEF. The. Pandemic emergency, financing, facility is a World Bank initiated. Implemented. And owned project. That. Is. A a. Set, of. Implementation. Guidelines. Government's, framework and different sources of financing, to provide surge funding. To. Better respond, to. Two, outbreaks. And that was initiated by the World Bank Group's president dr. Jim Kim, even, before the, Ebola, outbreak in West Africa was, fully was, fully over with and so. I'm going to talk about the the, transaction. That is the heart of the financing, for that facility which is a market, based insurance transaction. And which. I was involved in my in my capacity working. In the insurance industry. May, be I frankly. I I have, learned to assume that any information about insurance is too much for information, for most people and I I'm not here to convince you otherwise but I think we need to speak just a little bit about how this. Product, works and then, I'm going to focus my remarks on, how it contributes, to the ambitions, of the the, of, the peph and, what. What is most innovative about it and so. In. When. DUP when when the World Bank approached Swiss tree and another handful, of companies and said can you design an insurance, mechanism. That would trigger out that, would trigger and payout early, during an outbreak to, provide that surge funding to better contain, it which is one of the critical sort. Of in hindsight the the lessons learned from the from the Ebola outbreak in West Africa that funding, was late to arrive. It. Became apparent that there is a class of securities, that lends itself at, least in, principle, to that, ambition, that is called parametric insurance, and parametric, insurance, as opposed. To our car insurance where, you you, know you sign a policy, then you you bump. Into somebody and then you have to submit information. To your insurance company and yet sort of proof would happen you, know they talked you out of it and then if you're looking you get some money parametric.

Insurance, Is a product, where you define a. And. An objectively, observable. Parameter, called an index and as soon as that is observed. To have, reached the pre agreed threshold, it pays out so, obviously this is not insurance for you and I this is insurance that some, corporates by for. Natural risks. And. Governments, are increasingly. Using also to sort of stabilize, their financing, following. Following. Natural disasters so in other words you would say if, third-party. Agent. Meteorological. Agency a observes, seismic, activity, be in. Within. The boundaries of administrative. Area C then, this pays out okay so it's very quick, to pay out and it's very it's. Fairly transparent, and. So. The. World Bank's under, the World Bank's. Guidance. This eventually this, work will eventually led to a into, such, a transaction, whereby, the, World Bank as the insured, buys, four. Hundred and twenty five million, dollars of. Insurance. Against. A named, a finite. List of pathogens, which includes. Chromium. Congo. Hemorrhagic fever, Lassa. Fever. Viruses. Corona. Viruses you can tell I'm not the expert on this. Including. Ebola that's that's that's important, to know for the story because. That was really the event that triggered it and. This. Risk was structured, in such a way that investors. Can gauge, according, to a model the probability. Of a triggering, because the triggering, threshold, for each one of these is defined in terms, of number, of confirmed. Cases, by, w-h-o confirmed. Deaths there. Is a component of geographic, spread so freaking out for Ebola it has to has to be has to have been detected in two countries not only one and so, forth and then the model that underlines that underpins, this this, product basically, tells the investors what is the model probability. Of that, qualifying. Event that triggering, event happening. And when, you have that type of probability you can talk to financial markets because they say all right well if you're, telling me this has a probability of 5% of triggering every year and I agree with your model then. I'm gonna need a little bit of risk margin but I'm happy to take that risk in 8% and so this is an, enforced. Coverage it's the. The coverage is a three-year, term, coverage, it incepted, in july 2017. So we're about a good. Year into it. Obviously. The world bank pays, premium, to these risk takers which are sophisticated. Large. Investors. Who have specialized, you. Know investment. Units in this type of instrument and its type of security and, it's. Basically sitting there and waiting - waiting to be triggered if it, doesn't trigger at the end of the three-year period and the investors receive their, principal.

Back And they will have received the the. The. Regular coupon payments over the time of the term of the instrument, and. And. That will be the end of it now. That's. Enough in the product what I think it what I want to focus my remarks on, is how. This complements. The ambition, so the ambition, of the. Pandemic emergency, financing, facility from the beginning, was to secure. Funding, before an event happens, and to. Have it be as transparent. And is locked in if you will as possible, and by, placing, this risk in the market and paying. You. Know the premium that the market. Requires. For that you. You, have you you, were working with a level, of sort of in flexibility. If you will that. Is unprecedented in, donor funding, because. Now all of a sudden you know that, you, know if so, in so many cases, of Ebola are reported, by w-h-o over, this rolling period in a cording. To all the parameters, that are that are predefined, if that, happens, then the World Bank is going to receive this money and, knowing. This forces, them to think about well, first of all what are they going to do with that money okay. So there's, all this contingency, planning that is that it has been conducted, or it's actually still ongoing I think it's part of the dynamic. Emergency facility, in other words how. Are they going to use this money how is it going to reach who are the responding, agents who are eligible to receive the funds what are they gonna do with it how are you gonna get it there you know do you have their bank account number and all of this because. The the the product, is going to trigger and payout probably within about three weeks and. That. Really puts the onus down on planning how you're gonna use that money the second point, that this the, second, thing. That this forces you to think through is well, what if it's not triggered, what if I don't get money but I still have an outbreak that I want to respond, to and, so. You need to complement, such an instrument, with different, sources of financing, and that's exactly what they did so, there's a there's, a donor, and more traditional, I'm gonna call it donor funded, pot of money sitting underneath. The. Insured layer and that. Was triggered by for. The first time by, the Ebola. Outbreak in western. DRC, and that was officially, declared over in August. Or late July before, the the, ongoing one the current one then. Broke out in in, eastern Congo and. So the. Pandemic, emergency. Facility, you know I, suspect you've heard term is a set, of different financing, sources. Pre-agreed. And. Also pre agreed. Implementation. Rules and the government's framework there are people who have different you know there's a path coordinator, and so everyone kind of, it's it's it's all waiting there and sitting and this is a, as. Far as I understand that first certainly the first one that we've been involved in a, quite. A shift in emergency. Response an international. Emergency. Response. From. Waiting, for something to happen and sort, of having agreed on how, you're gonna react to it to, actually thinking it all through before, it has even occurred. And. I. Think, I'm going to leave it there perhaps, we'll get have time. To to, feel some questions on the details a little bit later thank you thank. You. Can. You all hear me good. Wonderful, good, afternoon my name is George Mueller as Ryan said on the chief communications officer, of a company called Henry Schein I have, to say it's quite, a humbling experience for, me to, be here you you could have doubled my high school SAT scores, and I still would not have gotten into Harvard so, the, idea that I'm speaking behind a podium that says Harvard Law School is really quite something I am. Here representing, the, private, sector and speaking. Specifically, about supply. Chain let, me tell, you briefly about Henry, Schein we are not a consumer, products company so I'm assuming most to you have not heard of us we're. Based just, outside New York City for, a fortune 500 company have, about 22,000. Team members about. 12 and a half billion in revenue and we are a very large provider. And distributor, of infection, control products, gowns, gloves, masks. All of, the things that doctors, need and, physicians, need to, respond, to a an, emergency, and we've. Had a long history of. Emergency. Preparedness but, the discussion, for us really changed, around the Ebola crisis. One. Day at my desk I got a phone call from the CDC, they called me directly and, it was actually the CDC, foundation and they said and. You donate, supplies to us because we have all these physicians who are going to West Africa but we don't have the equipment to give, them. And it's a whole separate, political issue, I won't go into about why the CDC itself, couldn't equip. These. Folks but, the CDC called us and so of course we donated everything they wanted they sent us a long list of products and we, made the donation but.

That. Again was in. 2014. But that began a discussion that, culminated, at the annual meeting of the World Economic Forum, in Davos the, following, January, and it. Was a meeting among, the, CEO of my company a fellow named Stan Bergman, who happens, to be from Africa which, is, relevant. To the. Discussion, and what. I would call the four w's the World Economic Forum, the World Health Organization. Mike Ryan's group the. World Food Programme which you may not be aware is the logistics. Arm of the United Nations and then the World Bank and Tobias mentioned, the work that the World Bank is doing and so. There was a meeting late on a Friday at the end of the annual meeting and. The. Director-general. Of, the WH o at the time Margaret, Chan said what. Can we do working with the private sector, and. So, my. CEO, said anything, you want us to do call us we will be there and that led, to what. Is now an organization called, the pandemic supply, chain Network, and the. Endemic. Supply chain network is a coalition, of organizations a. Companies. You would have heard of Johnson, & Johnson, is 1ups is, a company. Becton Dickinson is, another large. Participant. Henry, Schein serves, as the private-sector lead of the pandemic supply chain Network and our. Purpose, is to improve supply. Chain response. To. An outbreak at. A meeting in Geneva at the forms offices, a few years ago I had the privilege of sitting with the president of the World Bank who's, himself is a physician, dr. Jim Kim and we, had a long discussion about, the, challenges of getting basic, supplies into. The field and he, said hmm so now I realize, pandemic. Response is, fundamentally. A supply, chain exercise. And it is a supply, chain exercise. Ron. Klain spoke, earlier of the wonderful work that NGOs, do in send. Physicians. Into the field and these all heroic people but. We shouldn't make them suicidal. They shouldn't go into places without the proper equipment they need to protect themselves and the gloves and the gowns and the masks right because if they don't have that basic, equipment they're, much less likely to volunteer to go into. The field and we shouldn't, put them, in. That place so. So. The Ebola crisis, taught, us one enormous. Lesson, which is that we have failed to learn the lesson from all of the other outbreaks, that have preceded. It, a perfect. Example and. During the Ebola crisis, The Wall Street Journal, wrote what is in our community. A rather famous front-page, story about how hospitals. All around the United States were attempting, to gobble, up all of the personal, protective equipment as, we call it the gloves. Gowns and masks, because, of the Ebola outbreak. Now. The chances at a community, hospital in, Des Moines was likely to have anabolic agent was. Extremely. Rare but. America. Being America, every hospital gobbled. Up what they could right when, in fact the best way to protect, the. Spread. Of the disease was, to send that equipment. Where it was needed which is West Africa, so it. Dawned. On us that we have this enormous supply chain imbalance, where in these moments we're, not getting the supplies to the places it needs to be and rather those countries.

That Are wealthy and have the ability to. To. Absorb the supplies, and. To act in in their self-interest so Ron, Klain also, threw. Out the challenge which were. Happy to address that the private sector needs to do more and we absolutely need, to do more every. Sector, of society needs, to do more and specific, to supply, chain I can tell you that Henry, Schein and the companies that are involved in this network absolutely. Will, want to do more which leads to another interesting, development and. I'll speak frankly here in Mike Ryan have had this discussion, historically. There has been a. Level. Of perhaps. Misunderstanding. And distrust, between the World Health Organization. And the prior sector, and it's, pointless, to belabor. Why that is but. The good news is we have been using this period of time since the Ebola crisis, to get to know each other really, really well and this. Is enormous ly useful because you. Don't want to start exchanging, business cards in a crisis, you need to know who all the players are, and in. A meeting in. Geneva at the World Health Organization. A few years back I saw, it right beside the. Margaret. Chan who said to me we, want to work with the private sector we need to work with the private sector you, guys have the products, you ship the products without, you we can't address the. The outbreak, by the same token we in the private sector absolutely. Understand, the vital role that government plays at international, organizations. Play that NGOs play we. Have product, we have shipping we have transportation. What we don't have is expertise. On the ground to deal with an. Outbreak so, complex. Of problems, will not be resolved, individually. They will only be resolved, working in. Partnership, and so, the. Private sector supply chain work now has a wonderful, relationship with the. W-h-o, and the, real beauty of it is that the relationships, were forming, are out, lasting, changes, in personnel, this can't be the kind of thing where you get to know someone you. Have a nice meal together and then they both leave the organization. And that's the, end of the work so there's, a new DG, dr., Ted Rose who again remains, committed, to, working. With the private sector to advance. This. Work so. Just to a few more points. The. There's. The. Timing, of this. Of. This event is auspicious, just. This week and, I'm going to sing the praises of Mike Ryan and the w-h-o, they. Released, a. Document. Known. As the disease, commodity, packages, and it's something that we in the private sector are just so excited to receive so, Mike. And his team have done the really hard work of identifying, across, a range of passage ins what are the specific, products, that would be needed in an outbreak. And giving. Us a sense of the kinds of quantities, that would, be involved and now they made that public I think it was Thursday Wednesday. Thursday Mike. And, so now that we have it we in the private sector can take those disease commodity, packages, or DCPS, as we call them and begin, mapping against, it we can say okay this supplier, has. Volumes, of this particular product and that supplier has volumes, of this product, we, can also work with ups because again UPS is a huge. Freight company, we can say okay here are the kinds of volumes, that would, be shipped in this kind of event and you, ups need to begin thinking about how you. Would make space available in. Your. System, to make sure that this product gets from wherever. It's manufactured. To. Other parts of the world so we're really really excited about the. Arrival. Of these disease commodity, packages, that. Said. This. Is far more complicated, and I think people appreciate so. One of the other W, organizations. We are involving. In our work is the World Customs organization, because. One might think it might make sense in terms, of or rather in times of an outbreak that product. Would be shipped and it would be expedited. Into the field one might think that but that's not quite the case right because every country has his own, customs. Regimen. Oftentimes. They. Are not consistent, from country to country too, often, basic. Materials, will sit in a warehouse or, sit on a dock and their, movement into the field is delayed because of some. Customs, issues so we're, having what, we think are fruitful conversations. With the World Customs organization to. Say can we create. Kind. Of a roster. A basic, product, that would have pre-approval, so that in the event of an outbreak all. Of the wonderful heroic physicians. Who are going into the field don't have to wait for the supplies to get there because it's hung up and some, loading dock in some port because of some bureaucratic, issue.

So, There. Are lots of things that have to be done to. Make. This. Pandemic. Supply chain network operational. The good news is we have commitment, from all of the relevant parties and it's as the seer interest. In in doing that. Just. A closing, comment there's, oftentimes this, view that, well, why. Is the private sector involved, well I can, tell you speaking, for my company but even the companies that are part of the network we're, involved for two reasons one its absolutely. Morally, the right thing to do right we all share this earth with everyone I mean, so we have the same values, and the same interests as you do but, from a business perspective it's, also enlightened, self-interest right, a. Business. Cannot succeed in failed societies. And we have every interest in making sure that every society is, prosperous. It's good for the people it's. Good for their economy, it's good for the world and so. The. Motto of the World Economic Forum, is committed, to improving the state of the world and that is the animating. Driving, force and not only of the forum but of the pandemic supply chain Network and those of us who are involved so with, that I'll close and look, forward to your questions and, thank you for your time and attention. Wow. Micah. You, thought I wasn't gonna toot my own horn and you were right but I think I accidentally, had, you. And Gerard and, to. Do it for us and then of course, then to hear from the really the innovative stuff that that. That device described, is really, thanks to thanks for the panel and I want. To hear from we wanna hear from the room I do want to start with just one question. We. Just heard that maybe the, the. Response, is a is, a finance, challenge, it's a communications, challenge and it's a supply chain challenge. So the question. Mike. For you is is a response, also. A public-private, cooperation challenge. But so what what, is so hard about. Public-private, cooperation what makes it so hard and and what, is your kind of from, do you chill perspectives, and based, on your experience what is your approach to getting it right and maybe. Shine a light on why it's so hard to get right. You'll. Be here all night. Yeah. Well, beyond. Finance communication, to supply chain people often ask me what's. The most important, thing in public, health and surveillance, or fight and pandemics, and I often give them an answer three things, governance. Governance, and governance. I think, we do forget that at the center of all this our. Governments. And people. Who. Are mandated, to protect, populations, the, ultimate accountability in, any society, for the care and welfare of population, is an elected, government. Well. Within that framework. The. Private sector the public sector interact. I, don't. See the difference I mean I go back to the mid 90s, when huge. Amounts of our we share heritage yesterday, of fighting, meningitis, and yellow fever in Africa involved, private. Sector providing proprietary. Information on the vaccine production across multiple, companies, to us so we could, effectively. By all the vaccine on the market at a preferred, price and distributed. To all countries, on the basis of epidemiologic. Need at. That time any one of those companies could have probably sold that vaccine, on the open market for 10, to 20 times what, they were ultimately paid, for so I've seen through my career, wonderful. Examples, of. People in, the private sector doing, incredible, amounts of good work and equally I've seen plenty examples of my time of people in the. Public sector running, away from the responsibilities. And and. Doing bad things so this, isn't also. Them. For. Me some, of you said, we're all one family we're, all one society I liked what you said business, kind of succeed. In a failed Society so, I think there's a mutual interest here. And. We. All have, kids we all want to go home and, see them in the evening we all we, all wanted them to think of us as heroes as, people who do the right thing we, do different, things to do the right thing oh, yeah.

You're Right I think wh Oh historically. Has. Been very. Nervous of a private sector engagement and understandably, in many levels because there's there are huge pitfalls, especially. When it comes to pharmaceutical. Products there are huge potential conflicts, of interest or issue huge swamps. That can. Swallow you very quickly, in. That but. You. Know knowing that there are areas, where we have to be careful in the engagement doesn't mean we can't operate and the 95 percent of the territory that is safe to operate. And. I think that's uncommon upon us all to do that I think and, I thank you for the comments everyone made I think w-h-o. On, governments in general it's. Not just W Jo are, really beginning to realize the pandemic preparedness, is a shared societal, objective, and the private sector is an intimacy, important, and essential part of that preparedness, some, of the data presented by, its afar kirtan, who. Trust who and. That's. You. Know that have been a shocking, statistic ten, years ago mmm no one is shocked by it anymore. And. I've seen that. Pastoral. Leaders community. Leaders business. Leaders in. Many countries, are. Often trusted, more so, I think, we. Have as, I said in my my, talk there's. A massive challenge yeah. There's. A real, major. Project, that needs to be achieved, I think reinsurance, companies, were, the ones who led the way I know Jim Kim had a survey done with you a couple, of years ago that looked at what were the greatest risks to society over, the next 20 years and I think epidemics. And pandemics came. Right to the top of that list so, if we accept the collective risk then. We accept the collective challenge of managing us, turning. That end on this is the thing. Transforming. That. Common. Purpose into, real, solutions, real. Funded. Sustainable. Solutions, that, aren't just flags to be waived. By. Others that, don't just turn into pork, barrel funding, of stuff that looks nice but, doesn't deliver that, ability to be disciplined and truly. Cooperate, not just deliver, what we think you need and I've had situations in, the field clearly, and I have to say it with, private. Sector, people. Arriving, with boatloads. Of donations, that, were utterly, useless to what was needed and what, was being. Looked. For was a yellow ribbon moment, couple. Yellow ribbon get, the photo get. Out of Dodge, I think, it's much more sophisticated much, more mature now so this idea of a sustained. Coordinated. Investment, where. We all leave our guns at the door and. And. Try and do something practical with some serious, practical, outcomes and you know I'd love to see that's why and you're asked why we've very. Much engaged, with your. Process there by yourself Ryan is, that we see practical, things coming out of the readiness. Accelerator, they're, not, earth-shatteringly. Important. In the great scheme of things potentially but they're real stuff. That can be delivered in a time frame, that's. Doable and with not tremendous. Amounts of funding either needed to make them happen so, and, I hope we'll have a few announcements for, next year that. Bus as well so some innovative, stuff we're gonna do together. Thank. You Mike I do have, questions. For the panel but we do want to hear from from the group and so, let's. Let's go to the floor yes. Thank. You Ryan um thank, you all for being here as well it's it's, good to sort of see private sector representation, I don't mean like this you. Know we talk often about the lives impact, of outbreaks, but there's also the livelihoods impact, as well which is substantial. And. What, people often forget actually, miss is that much of the economic damage that's done by these outbreaks, disproportionately. Affects the already, most vulnerable, groups. Around the world so they're already marginalized. So. It's great to see that we're now being more collaborative about this, Tobias. It's great to hear you speak financing. And solving. Some these financing, challenges, clearly. A really big part of it and and the peph is a useful adjunct in, that, landscape, you. Talk about sort of other types of funding that might be available as well and and, one of the things that I've been thinking, about recently is, whether there. Might be other. Insurance. Type interventions. That might work below. The country level you. Know the great thing about the peph is that it's a it's. A world bank backed, initiative, that, provides funding for countries, who aren't necessarily, choosing. To pay the premium it's the collective community choosing to pay the premium but. We know that historically when it comes to things like insurance. Governments. Companies. Individuals, tend to under insurer, and that drives one of these cycles of panic and neglects in terms of financing and flows, could.

You Share any thoughts that you have had about sort of how we might address that and, whether there's a scope for financial innovation, sort, of targeted. At things other than countries. Thank, you very good question. It also allows, me to react to the, your, first question about some of the challenges so I guess. The, you. Know wearing. My salesman, hat I would, say look, if somebody wants to buy insurance, say. Instead, of at their super, national level like the World Bank bid but at the national level then they could. The. Pandemic emergency, financing, facility shows, that you can tailor such a product, and. You certainly could for, example initially, there was thinking you know does a country or, does a does. A does a donor, let's, say want to buy, top-up. Insurance, for a specific, country that they you. Know because, it fits into their collaboration. Or because that country is primarily. Exposed and so forth and so. The, the, major challenge, to that that I see and you know you could a country could buy that at a a for. A certain district. Or first for, a region, within its territory or, something like that the. Major challenge that I see is that the. The proposition, of buying, market. Based financing, is, really, alien. To the public sector and I, get. It I understand, it so this idea, that. As. I and again I want to just make sure it so I we provided, the service to the World Bank where the buyer of this insurance and they were able to afford, it with with. Assistance. From a, few, donors including, from the IDA fund by the way they so fun, for, the. The poorest country within the World Bank and as. I, observed that debate, should it be renewed should we start preparing for when you know when this policy runs out and in 2020. Do we need to start working on you know the next coverage and so forth I observed. That the the. Challenges, that are being worked through are not on the technical, side not on designing. Coverages. You know better indexes, to capture the risk and so forth certainly, there's a ton of work to be made in that but it's more about does, this provide value for money for public, sector because. The idea, that, you will have paid premium, -, let's, face it big, finance right so the so the risk takers, here these investment, funds that invest in this this is you, know this is Wall Street. The. Idea, that public donor, funds end up, in their pockets and there, is no triggering, event over. The period of that just scares. Public. Officials like crazy and. You. Can you can look at that a number of ways I mean think about our health of your health insurance right in, the in a sense the best the, best outcome, is that you pay premium every year and you never use it because that means you never got sick but, people. Have different views of that certainly, in the public sector I think the idea that there is no triggering event they, what they really hope for is it a triggering, event that doesn't really hurt anyone but you know that they get, as much back as they paid premium, which is a little, bit absurd but. You, know I don't mean I don't mean to belittle this conversation, at all but I think it illustrates to, how, innovative. This really is largely. From their perspective, this, idea that you would pay capital even if the. Even. If the benefits. At least the potential benefits of an early trigger of having this leverage where you pay a certain amount of premium but if it ever triggers you get a much larger. Benefit. Out of it even, if that is recognized, I think, the the main obstacle, was kind of this idea that public. Funds end up in private pockets. What. If there are too many triggering, events what. Does that do to private sector appetite, to provide that so. Right, so we're back to the, intricacies. Of the product a little bit. So. There's, a there's a model that was divided, and that. Was designed, by a third-party vendor modeling. Agency and that does this type of stuff for the insurance industry and you, know it works with flights. And, passenger, movements. And seasonality. Zand gazillion. Different factors and then it comes, up with a. Curve. That essentially. Puts. A relate puts in a relationship, the probability, and, the severity of the outbreak sort. Of a lost frequency, curve we call that and then, whoever, wants to buy such a product basically decides well what is the attachment level, at which you want to buy your insurance and so. If you buy something, that the, model predicts will trigger once and you know every, five years then. Whoever takes, this risk is gonna say well I'm gonna need a lot of premium to cover that if you, get something that has, a probability of one of triggering once in every, hundred years then.

Every Minister of health can say well I got tons of stuff to do until this thing triggers so this is not a priority anymore and so, that's where you, have this trade-off, between how urgent, or how often do you want it to trigger how much premium are you willing to pay for something like this and how. High. Up on the list of priorities is, this really and you're among, all the different you know things that you need to consider and so. I would, say from it it's, a price question, if, you wanted to trigger every year then we're swapping money right you pay you're gonna I'm gonna ask you so much premium, as I. Expect, to pay out to you so that's not an interest anyone this. I. Can, I can share that the the peph has different tranches and so forth but it's basically designed to trigger about as, a five to, ten percent probability, of triggering every year, so. That one but that was essentially, that's the buyer who decides that right it's bit like you're choosing your deductible, your copay I, have. A closely. Correlated question, sort of the other side of that question which is you have a room full of people who are interested in mitigating, those triggering, events so. When you think about these public-private, partnerships, or. Collaborations. How. Can these. Organizations. Collaborate. To reduce, the premium, so, that the. Organization's. Purchasing. The insurance, actually pay, less cuz. That's something that all want to do. I. Just noticed, the time I thought maybe think take the next two questions as well and then we'll take them all together if that's okay. Thank, you for panel my, question is the. Internal, process, of, the gates get, together, a smirky inside. With a derecho in the, case of multi. Drug-resistant, versus, the. Ritual wind or silver. In our interaction. Sweetie, t-test this. Is a. Produced. By private. Profit. Public partnerships. In Europe in, Paris a Britain, it. Is neither lunge and each. Series were quite great, it is I, think it's great but. I under. What, was the internal, process. Tinka, Narasimha, since idly and the ratio and I wonder, it is because. I verify the way. High. So, this. Ensure I'm very interesting this insurance, thing because you, know that hinges, on thresholds. Where you have to believe your probability. 5%. Ability in. In my world that doesn't mean anything because. Infectious, disease outbreaks. You, know defining, what that means yeah you can throw in airline. Data you can throw in all this stuff the models are not very good and the uncertainty, is huge, and these are rare events that. Start small and can look mild and whatever else and so I wonder. You know you said in your talk you know if you believe the model then you're willing to buy. The insurance but. Like I don't believe the model at.

All Right. And and I think a lot of infectious, disease epidemiologists. Would look at these giant simulation. Models and say like this is nonsense, we. Don't we don't know how people are moving around Sierra Leone and we don't know you. Know any of the underlying parameters, of the model so, your your confidence, intervals are enormous around, that probability and for any trigger, that's. A no go no-go decision I, just, I wonder, how, governments. And how we as, a community interested. In doing, this better can. Can, think about communication. Of those uncertainties in, an honest way so, that what, happens is people lose, trust in the whole the, whole concept. Right. Maybe, address part, of that because your, point is well made if, you look at the cash window of the path it's, not triggered by the model it's. Actually triggered within a group within w-h-o, scientific. Technical advisory, committee with people like David Heyman and I suggest, triggers and data, is presented, to a learning group when it's a hive mind and the decision, is made regarding, the public health importance, of the event and the, need for a response so I think over. Time I think, them as. The instruments, develop, there's going to be different layers within us which are absolutely correct but you have to start somewhere and the issue here, has been how. Do we get the, private sector to participate, in. Indemnifying. The, risk associated with natural, disasters. As such and within, that there, may also be ways to, have incentives. In that for preparedness because. If countries, for example already, within the within, the path there. Is this concept. Being developed, that, countries who engage for example in implementing, five-year national action plans for strengthening their own capacity, across the thirteen different, core capacities, that if countries invest in those capacities, that. There are donor countries willing to pay premiums, and willing. To, reward, those countries, within the peph for, having done so so there is a way I don't think we're there yet I don't think we've reached the, best instrument, and I don't an affray example. While. It may be a very large fund in, a true pandemic, it'll. Be gone in five days that's. Just the reality so, this is the first attempt, to create an instrument that in some way tries, to manage risk, with. A pair tries. To incentivize, preparedness. And having government's think through the issues as you were saying to, us and we. I think can begin with you and others to see can we come up with better models can we come up a better predictive. Analytics, to look at impacts and everything else but, like, everything else in, Ireland when you ask for directions usually, people say well you know what if I was going there I wouldn't start from here. And. We. Have to be very careful because it's, very easy to say well if I was doing that I wouldn't start from there it, has started it, exists, we. Have seen it the cash window triggered for the last of all outbreak race successfully, there, are issues through the whole system but I'm. Not here to defend us. Where, we're advisers to it but I think it's important to recognize that it's a good first step but your points are well well made it's a we, have an awful, lot more work to do to adapt these instruments both for the private sector investors. And for the public sector users. Of those funds when they when they get triggered I. Think. You so. A couple couple comments you raise excellent, points don't trust the model I would, be my advice but one. Of the benefits does it done that, it does have is that you how obvious Lee have historical, records of outbreaks, and so once you have that model you kind of back test.

That You apply, it and then. You can sort of determine, when would it have triggered, in the past and. So, for the path I am as. Far as I know for some of the pathogens they went back you know hundreds, of years obviously, the w-h-o was in reporting, uh you. Know didn't produce sitreps, and Don's and stuff at the time but nonetheless, so that's a bit of an assumption when those would have been reported, other. Than that you&#

2018-10-11 04:13

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