But I was really struck how different it was from the last time we talked about goalkeepers in 2018 and that was so much of a more positive report, you know, all of the indicators were going in the right way and co vid really has really just put the brakes on that.

I think your report puts it really well.

It said in the blink of an eye, health crisis became an economic crisis.

Food crisis, housing crisis, Ah, political crisis.

Everything collided with everything else.

So what about all of these results?

Do you think is the most important one that we you know?

Where would you love to start to talk about this?

Well, as you say in most years, the reduction in malnutrition, the reduction in childhood death three increase in literacy rates there's this gradual progress that human life is getting better.

People are living longer and it's amazing that this is so widespread in its negative effects.

And the actual direct effects of killing people in poor countries is a very small part of the overall damage that's been done big part is that their health systems that are very fragile have been disrupted, so vaccinations aren't taking place.

Malaria bed nets are not getting out.

HIV medicines are not getting out.

And so Africa, we'll have dramatically more deaths from these indirect effects, then from the direct effects.

So the imperative is, let's bring the epidemic to an end.

And that, um, takes us to a discussion about vaccines, which is the only tool to do that, and then make sure that we do restore the services, even some ketchup for the kids to miss those vaccinations.

And even if we do our best on all those things the vaccine, the restoration, the rich country generosity, it'll take 2 to 3 years just to get back to the beginning of 2020.

Well, and it has happened also quickly.

One of the things that the report talks about that I found really startling, um, was when it came to vaccine distribution and how key this is going to be, uh, in terms of survivability, uh, this model from Northeastern University.

I was really shocked.

That said that 33% of the deaths will be averted if vaccines are distributed the high income countries first, but 61% could be averted if the vaccines are distributed toe all countries proportionally to their population.

Can you talk about why that is?

Well, they, um there's deaths, uh, all over.

And now no one is saying that the distribution album will be totally based on, uh, equity.

Uh, you know, there'll be some tilt towards the countries that helped fund fund the R and D.

Uh, but we need to have some bathrooms here.

Both the generosity to buy the vaccines for those countries, uh, to increase the manufacturing capacity because this is mawr units of the vaccine in the world has ever needed.

And then to help fund that availability without, uh, the rich countries taking all of the capacity.

Do you think so?

That if if countries say the United States or other wealthy countries don't, you know, take this equitable approach that we will be morally culpable form or deaths?

Well, the foundation's motto is, all lives have equal value, and, uh, the foreign aid that rich countries give has saved tens of millions of lives.

Things like Global fund for HIV and Gabi, which helps buys vaccines for things like diarrhea, pneumonia on DSO there is some equity in the world.

But the very fact that you know, our foundation is saving a life for every $1000 we spend.

It does show that we do treat lives outside the U.

S.

As not being as valuable.

Aziz those lives and you know, it's it's pretty extreme.

This would be a double mistake because not only would you be sacrificing those lives as long as you let the disease exist outside the United States are, uh, anywhere in the world it's going to come back.

And so you can't resume your normal activity.

And so, of all the health crises, this is one where the world really is in it together, Uh, even countries that did a good job on the epidemic like South Korea, Australia and found it difficult for there not to be re infections.

And so they're having thio continue preventative measures where they have very few cases with big disruption and economic costs.

And so here we've got to solve it.

For all of humanity and eso, it's both just and even from a selfish point of view, it's the smart thing to do Well, I mean, the report does make that point repeatedly that you can't solve a global problem with a national solution.

But it sounds to me like you're also worried that this might not really this This might not really happen, that there won't be that global solution, because, I mean, that report comes back to this point over and over again.

Well, so far, the US although it is exemplary and funding the R and D for the six vaccines of the most likely Thio get, uh, really strong regulatory approval by early next year, the US has been absent in the discussion about creating the capacity and the aid money toe by those vaccines.

Now, I'm hopeful, You know, the Congress historically has been great on global health.

Uh, you know, very generous on things like HIV, malaria on dso.

The fact it's been overlooked.

I hope that gets remedied and very quickly, because every month that this epidemic stays out there literally cost trillions of dollars.

And yet the billions needed for the vaccine are what the Onley thing that will bring it to an end.

You know, one of the one of those figures in there that really struck me was the increase in poverty.

I mean, here there had been this horrific streak of less and less poverty, I think has gone on for about 20 years.

And now all of a sudden, you know, tens of millions of more people are pushed into poverty because of what's happened here.

And the report talked a little bit about, you know, women really taking the brunt of some of that.

Could you talk about that?

Yeah, there's no doubt import countries, uh, things were tough for everyone, but women bear the brunt of that.

And so if you get this reversal in the property, uh, it's it's not equitable at all.

Uh, the extra work, having the kids at home, uh, you know, finding enough food.

Uh, you know, extreme poverty is waking up and worrying where you have enough to eat every day and you know, the gold by 2030.

The sustainable development goal is to bring an end to extreme poverty.

On the track record.

There, particularly in Asia, has been quite good.

It's been going down a lot.

The place where, uh, it's been toughest is in Africa.

We have very high population growth.

You have the difficulty of climate change making the farming less predictable.

So you have years where you don't get enough.

And, you know, we'd hoped that with generous aid with better seeds, uh, that Africa to would start, uh, kind of miracles that we've seen in Asia.

But this, at best, is a three or four year setback to that quest to have almost no one live in extreme poverty.

You know, there's so little good news in this report, and understandably so.

But do you see any innovations that might come out of having to deal with with this disease?

Or do you see any you know anything?

That what are the hopeful lifelines that you could throw out there?

Well, there's no doubt that having ignored the warnings about, uh, the pandemic this time, the rich countries, including the U.

S, will take the threat seriously, and they'll do the kind of simulations toe prepare they'll have in a large scale diagnostic capability immediately available, which the US in particular was the worst on that will, you know, mature some of these vaccine platforms that are not only worthwhile for pandemics but will be used to make vaccines for malaria, TB and HIV.

And so, just like in war time, uh, you know, we moved quickly and trying new things, you know, even in terms of our lifestyle.

Can you use telemedicine?

Can you use online education?

Can you avoid some of the business travel We do.

You know, we are Eyes have been opened up and, you know, so the, uh you know, that software is getting a lot better.

Uh, and you know, So it's a really acceleration there, Uh, it doesn't offset all the negative things that come out of the pandemic, but, yes, three ingenuity in the pharmaceutical companies.

That's why we have six vaccine candidates, several of which are extremely likely to prove safe and efficacious by early next year.

So if this pandemic could come 10 years ago, you know our Internet bandwidth one the let us do our office jobs.

The vaccine platforms would be as far along.

So, you know, it's it's phenomenal.

We could say that within a few years, with a little bit of luck on the vaccines and some generosity, real effort to get the word out that it's safe.

Uh, this pandemic will come to a close, you know, So a lot more negative would be saying, Oh, my God.

This, uh, is going to continue indefinitely that unfortunately, because of science, the pharma companies jumping in That's not the case.

And so do you think as a last just thought has the US learned its lesson, if you will, about taking pandemic seriously and being prepared and, you know, getting ready.

That's I mean, the problem is you get ready, and then nothing happens.

Nothing happens.

Nothing happens, and then you get unprepared.

So but do you think that this will have made that impression a lasting woman?

Well, we'll go into a post mortem.

Uh, the CDC made some mistakes at the start, and then you have things moved upto a political level without expertise where the willingness to admit mistakes with zero, you know?

So the fact that we still have test results that take more than 24 hours, that is just a desire to say, Oh, I solved the testing thing.

You shouldn't reimburse for those, uh, delayed test results.

So we still, you know, our, uh, performing way below what we should, you know.

So I do think there'll be a lesson toe.

Let the professionals, uh, do their work.

There'll be lots of research and development about how you can ramp up, uh, testing drugs and vaccines very quickly.

So, yes, I think unlike, you know, the title of my 2015 talk, which was we're not ready for the next pandemic.

I think three years from now we will be ready for the next pandemic.

Well, I hope there isn't the next one, but I appreciate the optimism around that.

We'll still thank you so much for talking with us at National Geographic about your latest goalkeepers report.

Thank you.