Subtitles section Play video Print subtitles It's widely accepted that a vaccine is the only way to end the Covid-19 pandemic. And there are various estimates of the number of vaccine projects currently under way. The London School of Hygiene and Tropical Medicine has put this figure at 183, and other estimates put that at over 200. Of all the vaccine projects that are currently in development, can you give a sense of how many of these have actually gone to human trial and you think are viable? What are the chances of success? Yeah, it's really important that there are a lot of vaccine candidates in play. Whether there's 183 or over 200, it's a big number. And that's a very good thing because we don't know which of them is going to work. We don't have any other vaccine for a human virus like this coronavirus. We don't have vaccines for Sars 1 as or Mers or indeed yet Sars 2. So it is important that there's a diverse portfolio to take forward. Of those 200 I would guess at the moment there are about 20 lead candidates. Of those 20 lead candidates I'm aware of probably about 10 that are in human trials already - phase 1, phase 2 trials around the world, from China to Europe to the US and elsewhere. Chances of success. It's a hugely important question. And it, of course, depends what you mean by success. But I think if you said each individual one at the moment maybe has a 10 per cent to 15 per cent chance of success, maybe 20 per cent with the more advanced ones, that's a reasonable estimate. Even with the number of vaccine projects in development, is it the case that most of the money that governments are investing are actually just going to a handful of these because they want to back a winner and ensure that their own population has access to a vaccine first? Yeah. Globally, there's investment in all of these 200, whether from national governments, from the ACT accelerator, which has just got started in the last month or so, or indeed from Cepi and other agencies. And it is absolutely crucial there's a broad portfolio because we don't yet know which vaccine is going to work. Yes, the lead candidates have had more funding. But that's a good thing because it allows them to progress at speed. And speed is very important here. But what is important is that we don't just back one vaccine or two vaccines because they may fail. What is important is that as a world we back a whole portfolio of these vaccines, including disruptive ways of making vaccines - RNA or DNA technology or other technologies which we haven't used before in vaccine developments. The danger will be that countries back one or two with all of their resources, and those one or two don't work. And then those countries that do that will be left without access to, hopefully, a potential future vaccine. And what about the production and distribution challenges? So once we hopefully actually get a vaccine. I mean, you have pharmaceutical companies now warning about shortages of glass vials. Can you give a sense of what our production and distribution capability for a vaccine is now compared to what it will need to be to do something that's never been done, to vaccinate the entire global population? Over time we will need to vaccinate very large percent... parts of the population of the world's 7bn people. But to begin with we would have to target those at highest risk. Healthcare workers, the elderly, people from other backgrounds who have suffered disproportionately in this infection. You're absolutely right, though. Having a vaccine is not enough. Having a vaccine that can be offered to 1,000 people is not enough. If we're going to really have the exit strategy through vaccines to this pandemic, we're going to have to be able to vaccinate very large numbers of people around the world. And that means doing the science. It means doing the research and development. But critically, in parallel, rather than in sequence, it means making sure we can turn that vaccine into the billions of doses that we need to provide for the world. And that means thinking about things in a very different way than traditional development. It means thinking in parallel, not in sequence. It means thinking now, if I had 200m doses of a vaccine could I put it into a vial? Have I got enough syringes? Do I have a cold chain that could deliver this all over the world? And instead of doing that one after another we're having to do that at risk, at scale, and as a global manufacturing base in ways that, frankly, we've never had to do before. And that is the thinking. It's the thinking behind what Cepi is doing, what Gavi is doing, what the WHO is leading, and what individual countries are all contributing to. And in terms of that equitable access to any vaccine, I mean, can you talk a little bit about the issue of vaccine nationalism? Is an internal agreement the only way to ensure equitable access to any vaccine? And to those priority groups that you mentioned - health workers, for example - even in the poorest countries, to ensure that they have access to it. How realistic do you think that is? It's got to be realistic. I mean, it may sound idealism and it may sound naive, but effectively that's what we have to do. And there are two reasons for doing it. One, because it's the right thing to do. Healthcare workers have suffered disproportionately through this, as indeed have the elderly, as indeed in many countries in Europe and North America have people from BAME backgrounds have suffered more than others. And we have to focus our vaccine strategies on those at highest risk. Vaccine nationalism. In other words, I'll make a vaccine for my country or my region, and I'll deal with my country first, and I'll leave the rest of the world for later. That is not enlightened self-interest. Not only is it the wrong ethical or moral thing to do, it's also not sensible. It's not smart science. The best way of addressing this pandemic is to see it as a global issue. It is not an issue for America or Britain or China or South Africa. It's an issue for all of us. And until we deal with this as a global issue we're not any of us are going to be safe. So we have to make the case that just looking after yourselves and leaving the rest of the world for later isn't going to be on the solvers to get out of this pandemic. Well, and on that point, as you say, this is a global issue. And global leadership arguably has been something that's been lacking, at least from among political leaders in this crisis. What is your response to how the US has handled this pandemic? And if China and the US, if powerful countries like China and the US aren't engaging or working constructively on the global stage together within this response, how damaging is that for efforts to not only find a treatment and vaccines, but also to ensure equitable access to those? At a scientific level, I mean, we have many partnerships and collaborations with scientists both in the United States and in China. And those are continuing. I appreciate the tensions that there are politically and the rhetoric that is there politically. But at a scientific level, whether it be in academics in China, academics in the United States, or in industry in either country, I have to say that we are very much engaged with both of those. And that's how we have to go forward. I'm afraid on this one the rhetoric from the politics is not something that I can get into. It's not something I can influence. What I can influence, and colleagues in Cepi, Gavi, WHO, and elsewhere, the European Union, et cetera, what we can influence is the partnerships at the scientific and the research and development and the manufacturing levels to make sure that we have vaccines available independent of your ability to pay and independent of which country you are in. Yes, I would love countries to come together to address a global crisis and come together in political partnership as well. And I hope out of this we have a new dawn which people will appreciate that whether it's pandemics like Covid, or indeed it's climate change or drug resistance or the issues of mental health that we all struggle with, that this will demonstrate to the world there is no future in narrow nationalism. There is no future in a polarised world. These are challenges which will face us all. And unless we work out ways to work together - yes, scientifically, but also as societies and politically - we won't be able to address them. Because nationalism is not the future and is not the answer to those great challenges. So at a scientific level actually we're making great progress. We talk to American scientists, Chinese scientists, not every day but almost every week. And we're finding great traction there and huge support from both of them in order to move forward. And let's talk about the funding behind all of this. I mean, you supported initial calls for an $8bn response fund to respond to this crisis which was met. Can you give a sense of where that money has been spent so far and how much more will be required? Yeah. That was the initial request. And as you rightly say, and I pay tribute here to the European Commission and to other governments that have played a critical role in bringing that together from the G20 to many countries around the world that have contributed. Yes, we were successful in raising that initial sum, in fact, a little bit past that. And that has allowed the work to go on since that pledging conference on the 4th of May. So the science, the research and development, the progress that's been made in health sciences and therapeutics. We mustn't forget the therapeutics angle either. That progress is continuing, and indeed there is tremendous progress both on vaccines, therapeutics, and diagnostics, and in support for health systems. But that was only ever a starting point. If you take that a new drug or a new vaccine... let's say it costs you a billion dollars to get to the first starting point of having a vaccine. And we need more than one vaccine, and we need therapeutics, and we need support diagnostics. And critically, we need to support the public health response, protection of healthcare workers, personal protective equipment, and the rest of it. We're going to need significantly more than that. What we're working with, with WHO, with Gavi, with Cepi, with the Therapeutics Accelerator, the Gates Foundation, Wellcome, many governments around the world, is to work out, now having had that initial injection to allow that first work to get started, what more is now going to be needed in order to enhance public health support around the world, to enhance the critical work of WHO and Gavi and other Cepis and others? What's really going to be needed to solve this crisis? They sound like eye-watering amounts of money. $8bn seemed a lot of money when we called for it in February. The new request will inevitably be bigger than that because the challenges are now greater. But if you look at what the world is losing as a global economy it is hundreds of billions of dollars a week.