Welcome to edit HTML viral season 3, a podcast, exploring the science behind Global and public health.

I'm Amy Thomas, I'm Carl burn, and I'm Naomi Stewart.

And every Fortnight will explore the latest developments in covid-19.

Pandemic and take a deep dive into vaccines and vaccinations.

As of today, there are 171 million reported cases of covid-19 worldwide as global leaders grapple.

With the scale of this pandemic, they are tasked with supplying vaccines to their own people and at the same time preventing further Devastation from the disease worldwide but the Colossal task of Distributing vaccines to the world's countries has revealed deep cracks in our geopolitical infrastructure.

Although 1.9 billion doses have been given across the world, many developing countries are yet to receive a single dose.

We are now witnessing an alarming and explosive covid-19 outbreak in India.

The warring situation has forced India.

The pharmacy of the world to Halt, vaccine exports, severely affecting Africa, and developing countries, who are heavily relying on those supplies.

In this episode, I'm joined by two leaders in global Health, to discuss the critical issue of vaccine rollouts in low-income countries.

Today, I'm thrilled to be joined by Professor Peter Piazza and dr.

Yo, di Alec eger Professor.

Peter piot is the director of the London, School of hygiene and tropical medicine.

And professor of global Health, Peter began his career as a microbiologist and was part of the team that discovered Ebola later as a pioneering researcher.

Iran under the secretary-general of the United Nations.

He led the global fight against AIDS work, that has helped to save millions of lives.

He was a Time Magazine person of the year in 2014 and alongside running a sh T m--.

He is currently special adviser to the European Commission on covid-19 our second guest is dr.

Yo di Alec eger, yo, D is the founder of the Nexus Hub and Innovation, Center research, Social Development.

And You see Response Unit for the West Africa Sahara region.

She is currently co-chair of the Africa.

Union Africa, vaccine delivery Alliance for covid-19 and serves on the global Advisory Board of women lift health.

She's Chief strategist for convinced Africa and also the former Chief humanitarian coordinator for the government of Nigeria first.

If I may direct a question to you yo D, can you tell us where we are right now with vaccine delivery in different countries in Africa?

Thank you Amy.

We are stalled is where we are.

We have ground to a halt so there's two things vaccine deliveries within the continent and vaccine.

Deliveries from manufacturers, both those have been purchased by Africa and the Africa Union for the 55 nations of the continent.

And those that have been supplied through, the multilateral Gabby UNICEF and who back Kovacs facility.

The I'll answer to your question is that there are no vaccines in a continent of 1.2 billion.

People, we have to date as of the data, I had this morning.

We are vaccinated 24 million people, it is unacceptable and we have a problem and how will be rapidly.

Progressing covid-19 cases in some African countries, for example, Nigeria be affecting this rollout.

Let's interesting question because you say rapidly progressing covid-19 cases.

But the issue we have is not just with vaccines, it is also with Diagnostics so we don't the pieces.

I'm sure are rapidly progressing but we don't know that they rapidly progressing.

I had a conversation just yesterday with the minister of Health from Nigeria, who announced to me that, as of Nigeria.

As of yesterday, Nigeria had done, two million tests, conducted two million covid tests for a pop, it in total over.

The entire pandemic, for pop total population of over two hundred and ten million people.

That is simply unacceptable that that should be considered an achievement in this day and age.

So part of the issue we have is, you know, not South Africa recorded.

I think about two and a half thousand cases daily in the last few days and they're seeing an uptick, but their Diagnostics capacity is quite a bit more sophisticated than the other countries.

We have a hidden pandemic, Amy we have a hidden pandemic in Africa where we are not She measuring the cases and the concern is as we were seeing, so we have two things going on, vaccines are not been delivered.

We have no vaccines and we have cases rising and the the virus seeding and I will let you that conversation to Peter but the virus really embedding itself in our countries.

And we're waiting with bated breath.

And unfortunately, rather nervously for the India situation to become a reality on the African continent.

Thank you.

Dear.

It's quite worrying situation.

And Peter.

What are your thoughts on this on Africa?

And where we are with those vaccines?

Well first I totally agree with Jody about the analysis of where we are and I would add also that on the therapeutic side, we are also in trouble.

I mean with oxygen and people talked a lot about ventilators and so on but it's oxygen.

That is the Bedrock of treatment for people with severe covet as I experience myself, actually.

So it is really at the moment.

I would say we're getting a ready for a perfect storm.

Erm.

Like a fairly silent epidemic in some countries.

Fairly steady progress in terms of the spread of the virus now, and then outbreaks and players and then the lack of vaccination.

And I think what's going on in India is for me, a preview of what may happen in Africa and also in the southern hemisphere, the colder season is coming up, which is traditionally and increase results in increase in In respiratory infection.

So it is really bad news.

On the other hand, I must say that a year ago I thought that Africa would have a massive epidemic which hasn't happened and we still don't fully understand what is going on.

There may be some factors that are in Africa's favor, for example, a very young population.

We know that in terms not in terms of transmission, but in terms of disease, mortality that Your people are less vulnerable than older people.

But let's not forget that in Africa.

Life expectancy today has gone up tremendously as well as a success story that's bit hidden.

And particularly, if you make it 25 years, you have a really very decent life expectancy, that's getting closer and closer to the world.

So I think there's nothing that we can say that should lead us to complacency and I'm not even mentioning the incredible economic and social image that is epidemic has already imposed on Africa.

Thank you Pisa and you both mentioned, they're sort of hidden unknowns and diagnostic issues that are happening in Africa.

Is there more that we can do to understand the epidemiology that might help us fight the disease?

I think it's been too, it's too soon.

You know, this has been such a rapid progression of this disease I think we just haven't had time to understand it.

Everything Peter said about India or about Africa in terms of the young population and various factors.

Those were the things we all said in Africa.

Last year we have very similar indices with with India, for instance.

And the other thing is that we're not counting, we're not, there's no data the difference between other countries, South Africa in Africa, and the rest of Africa.

And then India is that they have data.

And so epidemiologically, you're able to dig in and see what's going on.

We're using anecdotal evidence, I mean, in one week, about two months ago, my husband lost, three of his friends, who are all in their 50s, three frames in one week, one day after another, at that point in time, Time.

This was in Nigeria at that point in time we were seen 50, 50, 52, 54 56.

Sort of that age range between 50 55 and 58 dying.

It was every week and yet everyone said it was malaria.

So I don't think we're doing the research.

I just had actually really castigated our Centers for Disease Control in Nigeria.

Because I mean, they keep putting out data every day that they have 39 and 40 cases a day, which is absolutely not, right.

We are not measuring.

So if you don't measure you, Diagnostics is prevention.

If you don't measure, you don't know what's going on and there's no deep research going on anywhere in most of the African countries Tanzania.

For instance, if you look at that, they completely said, covid didn't exist.

So of course, they're not researching.

So, if you look at our behavior in Africa, the fact that in rural areas people bury almost immediately.

I mean, your, we haven't even talked about humanitarian settings.

I think we don't understand yet.

From epidemiological perspective, what is going on?

With covid.

It also presents slightly differently.

And I've said this Peter, you've heard me say this before, that one of my concerns with the lack of inclusivity in the description of this disease.

When it first came out was that it was described from you know, China who sort of high-income areas exactly like malaria exactly.

Like Denny.

Now I would have done that differently.

I would have, you know, characterized it as said yes, it has these features.

However, it could look like malaria.

But watch out for this.

So in all of the countries in most of those countries, we're talking about people are saying it's malaria lingering, malaria or Dengue.

We don't understand what's going on, epidemiologically.

I think it's just still too soon.

Yeah, I think we need to really agree with that.

And frankly, a lot looks like malaria, I mean, that's probably the most over diagnose disease, but I think that on the other hand, there is research going on now.

Starting and like, in the You know the MRC units in The Gambia and in the in Uganda the affiliated with the London school doing even sequencing.

So I would say that compared to the last big scare in Africa with Ebola in West Africa.

In we're actually Nigeria you did very well.

But since then, we have the Africa Center for Disease Control, there is there is really progress but it's an incredibly unequal among countries and at.

That's also In terms of vaccine confidence vaccine deployment.

When you consider that the DRC Democratic Republic of Congo, send away millions of vaccines that they had that is just mind-blowing you know in a times of the extreme scarcity.

There's so many factors you know to consider during this pandemic in obviously you know what we're talking about today in terms of developing countries and how we get how we get vaccines to those people that really need them.

You both mentioned the situation in India so it'd be great to touch on that a little bit further.

How are other countries like Africa being affected by the covid-19 crisis in India, and the halting of vaccine exports from the country.

Yeah, so first of all, okay, there's the situation in India is an old example of what you're They said that the Under reporting is dramatic.

I mean, the, the most reliable figure in terms of deaths are the commission's, because in those are cremated.

And so the commission's for covid Exceed by up to a factor of 100, the official death certification, but what is important for?

The world are two things.

One is that when you have millions of people, infected that is a fertile breeding ground for new variants and so new variants.

Mock that may be more transmissible because viruses do mutate, that's what they do and maybe less inactivated by vaccines.

And that's there's some coming out of India and that's in some African countries like the specials, for example, which had been doing very well in terms of vaccination there we in flooded with that, you know, that variant.

But most important I think for the rest of the world is that Prime Minister Modi has banned the export Of vaccines do the rest of the world.

And, you know, India happens to be the number one producer of vaccines in general.

Not just for profit because we know a lot of our colleagues really are not very precise.

When they say, oh we need to manufacture vaccines, in Low Middle income countries, you overwhelming.

Majority of vaccines are produced in middle-income countries, but in Asia in India, in China, not in Africa.

Come back to that.

I'm sure.

Because Yoda has been really nice, so that means that you have this Chain Reaction, a domino effect.

United States is Banning export of ingredients of raw materials of Commodities like Plastics and filters to the rest of the world that are essential to make vaccines.

Hence, the production in India was already suffering.

And now India says, okay we need to vaccinate our own population which I can And only one to two percent of Indians are vaccinated.

And let's not forget, we're talking about 1.4 billion people which is slightly bigger than the all African population.

But the similar size.

So you see this, how in today's world, whether we liked it or not, we're all related with.

Once part of the chain is stopped, then we're all in trouble and that's why what's going on in India is so important for for African affairs.

This place because the deal for by Kovacs and also for other bilateral deals for Africa vaccine Supply at that were India, was really the foundation of the strategy, but you're the you're being really involved in and you are so active in getting vaccines to the people.

How do you see it from where you are?

Well, I think you're absolutely correct.

I mean, the India situation.

First of all, it is absolutely tragic.

It is heartbreaking and Watching those funeral pyres burn across the country of India for me, was really, I mean, I think a lot in pictures, it was really evocative, it was it really felt like the virus burning its way around the world.

That's what it felt like.

I felt like, literally a world on fire when I saw those but even as I watched that, it was clear to me as that was happening.

And you've read some of the pieces Peter.

It was clear to me that this was a march across the world that this was going to affect other Nation.

So it's our Nepal, it's affecting Bangladesh.

It's, you know, we hear it's going into Indonesia, my other home, which is the Fiji islands.

So I always try to make sure that I make these things Global.

You know, Fiji was completely virus, free until three weeks ago.

And one of the be 1617 to bury and got in and obviously transmissible because it got past all their Protocols of Border guard, got it.

And now the entire country is shut down.

It is shut down that economy they have no vaccines there, people.

People with lots of comorbidities ncds, heart disease, diabetes.

It is a disaster waiting to happen.

So if we look at the impact on, not just on big Nations on small Nations.

But let me go back to Africa and also the vaccine Equity issue.

Future for instance was begging for vaccines and their small.

I was saying this, you know, yesterday with with my husband that you know what is going to happen to Fiji when I saw this announcement from from India because now they have banned exports to Kovacs till the end of the year.

So that means that the entire world supply has crashed to a halt, its countries like Fiji because small Australia, New Zealand, descending them, 10,000 doses, you know, they sent them 10,000 doses.

Yesterday.

I think they're sending them and thousand doses today.

You can't do that for Africa.

Africa is 1.2 billion people.

There are some countries in Africa that are yet to receive a single dose of the vaccine Tanzania, which is one of the large ones, being one in particular, Kovacs was supposed to supply the world.

As Peter said, India's the pharmacy of the world.

The geopolitical implications of this virus cannot be understated.

It is not just Global Health anymore.

It is not just a global Health crisis.

What we have developing is available humanitarian crisis because when what and I'm not, if but when what is going on in India, hits other parts of the world, it is going to affect way more than health it is.

It's going to affect the economy.

It is going to affect social structure.

They will begin to be social unrest in some places.

Because, you know, it's happening already, there's no food, there's lockdowns, and yet, how do we as a world avoid this Africa?

For instance, we went out at the very beginning and said, we want to purchase our own vaccines.

We don't want to sit back and wait for Kovacs.

But there was significant pushback from the world because there is this paternalistic attitude that.

Well, Africa, we Supply you with vaccine.

So, you need to sit there and accept what we give you, you know, and and don't complain you.

It's that whole, you know, I know you're giving that your A child you lunch, or, or tea or something, you know, you say, no, darling.

You take what you're given and you say, thank you Mommy.

That was the, that was the attitude from Kovacs and from the world towards Africa, and when we said no, you know, Mommy I have grown up and I have left home now and I want to cook my own meal.

The attitude was no, you can't do that.

We will give you what you support, what you need.

Now had we sat back and allowed them to do that and had we not pushed back at that and with the help of very many people across the world, To support it as including Peter, PR Professor pgp Ultra, I'm looking at right now and the EU and others who very quietly in the background really supported this, we would not be in a position right now where we have hope because we have ordered about 400 million vaccines or have have have an option on 400 million vaccines through Johnson, & Johnson.

Africa, would be completely, and totally done for, in this moment because India has stopped export not because They're being mean they've stopped export because they're people are die and because they are the pharmacy of the world.

So when the virus variant is Peter said I call this a race between vaccine virus and variance.

It's a three-way race about two months ago.

I used to say the virus was ahead and now the variants are ahead quite clearly.

So when this variate hits Africa, we are going to need to be in a position to start vaccinating as quickly as possible.

But we're not in that position because we have no vaccines in view even with our orders.

For the next few months.

I also advise a few African governments and I can tell you.

My phone is ringing hot at the moment because I have ministers, and and presidential aides.

Ringing me all the time, saying doctor uid.

What gives what are we going to do?

What we need to do is to prepare, we need to prepare for Therapeutics oxygen.

We need to prepare mobile hospitals and we need to sadly, prepare gravesites.

Thank you so much.

Jody that was extremely extremely interesting.

The who had stated several times that countries need to share vaccines in order for there to be enough Supply, what are our options for sharing vaccines from high-income countries to low-income countries?

I think that first of all, what Yuri says is a Kovacs and covid really reveal how to save fault lines in the international architecture it when you Say the world didn't accept.

It's the Western countries that not accept and are still trying to tell particularly for Africa.

What's good?

So the multinationals, you know, the multilateral organizations and so on.

And so I think we need to take this crisis on to change that system because that's what I always say.

Never miss a good crisis in a sense that if the next Crisis we're in the same situation then we haven't done.

Joke, we need to fix this crisis, no doubt about it, but at the same time, we need to make sure that we better prepared.

That means that a different type of International System where those who are less well-off are at a table and take part in the decisions not to be the recipients and say thank you very much for this vaccine or whatever and secondly Manufacturing in Africa will come back to that but only sharing at the moment that's probably the only Option for immediate some immediate impact.

I hope at the global Health Summit in Rome that there will be some commitments.

Some countries have already committed in Europe, the u.s.

also it's still not enough and for example we have a whole discussion now in Europe, whether to vaccinate children now that makes good sense from you know if you want to end the epidemic in your country but children are hardly being affected in, you know, by disease they they Infected and vaccinating children is really to protect the elderly.

That means it's a ero-sum game at the moment.

Every vaccine you give to person a, you cannot give to a person B.

And if we start vaccinating children, let's say in the UK in Europe in the US who that means millions and millions of vaccines are being denied to people who are far more vulnerable and where it could make a huge difference.

So these are some policy options that will Make good sense from the perspective of an individual country.

But they don't from a, you know, from a Global Perspective, this is not only a moral issue, it's also in the interest of everybody and we could start with sharing vaccines to vaccinate.

Let's say, those are most vulnerable those who are on the front line.

I bet that in Africa as well, just as elsewhere already.

Thousands and thousands of healthcare workers and care worker.

Have died from covid.

If the front line is not protected, then that makes it even worse.

But for the medium term we need also Manufacturing in in Africa.

This a matter of national or Regional security because frankly I mean I've spoken against a vaccine nationalism but I to be honest, I understand it leaders are elected in democracies by the citizens of their country, and to protect them and to do everything for them.

So there is this I had underestimated that because I think a bit too Global, it is a kind of a normal reflex and then those with the most money, they will be best served and so on.

So that means then I'm not, I don't think we're going to change that.

That means that one has to prepare and to be ready.

And I think for by next year it should be possible to have lots of local manufacturing, all over the world including in sub-Saharan Africa, there are already a number of countries, not many but Uh producing vaccines, do you can buy a yellow fever vaccine from as to pasture in that car that is internationally recognized.

So they have the know-how.

So the Africa also they do fill in finish.

So this is really a top priority but it won't solve the problem now and we need vaccines now and this is where I think that the you know, you do this work and with the task force and everything that's being done, under the ages of the African Union is so important.

And what's important, there also is That for the first time as far as I know, the African Union is taking things in hand and trying to make a difference and not just waiting for the outside to send, whatever to Africa over to you.

You're ready because this is what keeps you busy day and night.

No, it keeps me awake and yes, you're right.

I mean, sharing, I can't stress it more.

You know, I did a TV interview the other day in which I said that.

Look, we teach our children to share.

You know that, when you've taken your fare, your fair share you give you open your hands and you share.

What Peter has said about the need for manufacturing and the stages, we can walk and chew gum at the same time.

I had the privilege of chairing.

The vaccine meeting at Kovacs or Kovacs meeting actually at the ACT accelerator Council last week, and I had the privilege of chairing the session where we had Seth Berkeley.

And Richard Hatchett and sue me of Who Doctor ERM Garcia gone, Joella the director general of the World Trade Organization and there was some suggestion, for instance from gavi you know Seth Seth of gavi.

Who said the well maybe we need to do this in three stages.

In terms of manufacturing, we need to get supply chains in place and for those who already manufacturing, which would be those in yes, maybe India, China and in the high income countries America in Europe, Etc.

And then, the second stage would be to begin to look at other manufacturing plants in other parts of the world.

Also, the high income countries, That are already set up and that the long-term view would be doing manufacturing across looking at Manufacturing in other parts of the world IES, you know, the low-income countries of the world and what I said to him at the time I will repeat, I said that, you know, this is why we ask the world to let women lead, you know, dr.

On Gaza was there, she's written the book on women in leadership.

I said this way we ask the world to let women leave.

I said because women could talk and chew gum at the same time.

We don't need to do it sequentially.

I said I can hold her baby sister apart.

Hold the The phone and type on my, on my laptop, all at once.

And so, if you had to give Gabby feel that we need to wait and wait, three years to do this thing sequentially.

Then you are probably in the wrong job.

You should let a woman step step into place and Lead this thing because we can do it all at once.

And you know, there was everyone smiled and he nodded and said, okay, you're right, perhaps we can do it all at once but we did.

This is a pandemic.

It's a Once in 100 Year event, which requires a once in 100 Year level of global Corporation solidarity and action, the urgency of the moment cannot be understated.

You know, Peter has said quite rightly that look at the global it Health System architecture has failed us.

It hasn't delivered for high-income countries.

Look at, you know, 600,000 going on dead in America in England.

I mean, the numbers are still active my mind under undercounted and Etc.

All over the world.

Over three million people, dead low-income countries were, literally Watching people on television doesn't gasping on television dying for lack of the most basic of oxygen in front of us, in these horrible images and that is marching on across the world.

The global Health infrastructure needs to shift and change.

It needs to be more inclusive, but that inclusivity also means that I shouldn't need to ring, which is what I'm doing at the moment, people at the highest level in the US government or in various governments around the world to plead with their better nature to say, please, you need to Share vaccine.

And the, the u.s.

announced yesterday that they were going to give 80 million vaccines to the countries of the world 80 million.

It's a lovely gesture but that's what it is.

It is a gesture.

I mean, India alone need they need a few hundred million like yesterday, you know my home country Nigeria needs 100 million like yesterday?

My adopted country of Fiji.

Now they could benefit from that, because at least if you gave them 1 million, they could vaccinate that entire Population and I actually think that's what we should be doing.

Now vaccinate places like Fiji vaccinate, those really fragile parts of the world that we might all have to run to once we've destroyed these other parts but we all live in at the moment and make sure that that we preserve some indigenous cultures and traditions.

So nations of the world need to share, I mean it's and now with the announcement from India.

It is it.

I'm glad to hear that.

The global Health Summit will.

Hopefully see some announcement around The sharing immediate sharing and vaccines.

But then how is that an equitable sharing?

You know, the most fascinating thing for me, you know?

I mean I'm Peter, of course help has been my sort of global Health hero figure for most of my, my career.

And so to be doing the doing this podcast with him right now.

And I'd love to hear his thoughts on this because for me this year, this past year has been the place where you No, my sort of training and public health, Global Health at the London School of hygiene and tropical medicine.

My work and humanitarian crises around the world from Haiti.

We wonder Nigeria Lake, Chad region my work and development.

In the Pacific over these years, all of it has collided in this moment.

And I've realized that this is a geopolitical global health is geopolitics.

It is diplomacy, it is donor relations, and we have simplified it to you.

I mean, maybe this is a moment to call for the faculty at the London school to perhaps, you know, have a practical aspect to some of the teaching because we have siloed things too much.

And we're going to need to evolve as a global Health Community.

We're going to have to get more practical feature and I have talked about this before.

There's too many people having high-level conversations.

You don't understand what it's like to work on the ground to advise ministers to deliver vaccines to work with.

Unity's.

And yeah.

So yeah, we talked about, we talked about sharing, but I think part of the issue is that those who are having those conversations, in many ways are not understanding the moment that we're in.

They're not understanding, not just the gravity and the urgency, but they're not understanding the complexity and the multi-faceted nature of the moment that we're in, it's not oh, please sir, give me some vaccines.

No it is it is in your enlightened self-interest as a global Community to share vaccines.

Now because Yes, we might have a nice summer in the US or in Europe, but I believe you need by next January, it will be shut down again when the be 1612 Varian multiplies and then has more grandbabies.

I think that this conversation reminds me of, you know, what your Garvey conversation is that when I was trying to bring antiretroviral therapy, you know, to access to in Africa, where millions of people were dying from AIDS in.

This was in the 90s and early 2000, they fit the development, you know, agency in the UK said, oh no, first, we need to build Health Systems and we need to provide healthcare for all and all That and then we can start thinking about, you know, providing HIV treatment.

And so I wouldn't I never accepted that and it was a similar conversation.

It's so disheartening actually that people haven't learned.

I always told him in the meantime people die.

Okay.

It's as simple as that.

And and so here we also need to work at multiple levels.

I mean sharing is only one aspect of it and and we'll go to certain degree.

I mean something that's not Well, known Miss pett in Europe in the EU.

Half of all vaccines produced their exported.

It's the only vaccine producing entity in the world to explore the country but where you know, half are exported, but where are they exported to to the UK to Japan to Australia to the u.s.

even, not yet to lower middle-income countries because we were counting on India.

So I think it is really the minimum What we can do now is sharing and commitments have been made.

Prime minister Boris Johnson said but without the timeline, this requires the say sharing now and and that's possible.

Thank you so much, Peter and Jodi for that.

Really enlightening chat.

I mean, just trying to understand, you know, the broad scale of factors are affecting this.

It's almost hard to get your head around at times.

So we're kind of coming towards the end of the chat, but I would like to ask each of you for some closing remarks.

Perhaps Reflections, you know, what do you see for tackling this disease in the short term and then the long-term, what are we most concerned about right now?

Perhaps Peter, I Write to you.

And then, you know you can give some closing statements.

You see me, well, I think that in those countries where there are lucky to have brought vaccination, like, in Europe in the high income countries will going probably to some kind of low endemicity as we would say so that it will be fairly under control with now.

And then outbreaks caused by new variants or people coming in or who refuse vaccination because that's also another topic, of course, but it's going to make the world even more unequal because of what we just Just discussed.

It's not those who have.

And those who have not, it's those who have a vaccination.

And those who have no vaccine, and that's not only tragic for those who have no vaccination.

But is really mean that this epidemic is not over until it's over everywhere.

And that is something we should Hammer to all those who say, okay, my people first, yes, I understand that but we need to share and then we need to invest in the future in every country better systems for data for know.

Knowing what's going on but in the first place now also manufacturing offer vaccines and there I'm optimistic that it will happen but it will require a major major effort at the political level but also business this will involve a need to involve those who actually produce the vaccines.

What do I see in the short term?

I, I see a two-tiered wild.

I see a very divided future.

I'm very, very concerned for Africa and very, very concerned with the Asia.

And for the Pacific Islands, I see a two-tiered wild one in which those of us who have no vaccines are actually physically separate from those who are vaccinated.

So, I'm going to go beyond the sort of, you know, the ethical issues and even just speak to the emotion of the moment.

You know, for me, as somebody who has a home in Fiji, and has a home in Nigeria, and now have a situation in my life where it's actually the pandemic as effectively moved to me.

It's completely moved me geographically, because I'm not going to be able to get home to Fiji for the next couple of years, almost certainly, because Africa can't get vaccinated the Pacific.

Can't get vaccinated.

You can't travel, so that, that alone.

I have a daughter who's a university, whose finishing a law or bar chords, she is actually a barrister.

In London and I'm terrified that I won't be able to get to her if I'm in Nigeria and we're put on a red Bliss.

These are real life issues for real life people.

So that is what I see in the immediate future.

There are a lot of people now than Society with fear.

I mean and that is for those who have privilege in the medium term, I see economy's crumbling, it is not just a global Health crisis, it is a humanitarian crisis, I see food insecurity.

I see increasing gender based.

Violence issues, increasing children out of school, for many of these countries who are going to have to drop out of school because they have to care for sick, parents or sick, grandparents and relatives.

I see all the gains that we have made in the last 20 or so years you know Peter talked about increasing life expectancy in Africa.

I see those gains being rolled back.

I see us not meeting the sdgs I seen millions and millions.

Hundreds of millions of people literally being left behind because of this microbe and Fact that we failed in this moment if we don't act now and act with urgency we failed in this moment to understand that this is the geopolitical crisis of our time and that it is imperative upon all of us to understand that we must act as one.

This is no time for nationalism.

This is no time for, for me, first me first.

This is no time for beating of chest, I made vaccines better than yours.

This is a time to act in the interest of global solidarity, and in the interest of everybody, Be in the world.

Thank you so much.

Joe D that almost gave me shivers talking.

You talking, they're really, really powerful.

And just so important at this time and it's been so great to talk to you.

Both about this highly highly critical issue that we're facing at the moment.

So thank you so much for your time on the podcast of giving up the time to talk about this.

And yeah, thank you so much again.

Thank you and thank you for listening to the podcast being with us on this journey as we explore Global Healthcare.

The pandemic vaccines and finding ways to a more Equitable world, you can leave us a review on Apple podcast would be hugely grateful.

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And until next time, goodbye