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  • 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.

  • And the longer this goes on the longer

  • that that is going to make middle income, high income,

  • low income countries suffer.

  • And the impact on the younger generations, on employment,

  • on societies in general is going to be

  • profound and long lasting.

  • The quicker we come out of this through therapeutics, vaccines,

  • diagnostics, and enhanced public health,

  • the better the world economy will be.

  • So whatever we spend at the moment

  • will come to be seen in history as a tiny fragment of what

  • the world has lost through its economy.

  • And I just want to turn to the UK for a minute.

  • You're obviously a member of their Scientific Advisory

  • Group, Sage, which is informing the government

  • in its decisions.

  • And you've spoken about the need for transparency

  • before in that decision-making.

  • Do you think that the UK government is being transparent

  • enough with the public around its decisions?

  • And specifically on testing, given

  • that the lockdown has already begun to ease

  • do you think the UK's testing capabilities

  • - not just in terms of numbers, but in the turnaround

  • times for results and the groups that

  • are being targeted for tests - does that capability match

  • the risks associated with the easing of the lockdown?

  • It's a great question.

  • I would pay absolute tribute here

  • to the role of Patrick Vallance as the chair of Sage.

  • He has pushed to the Sage minutes

  • becoming available publicly.

  • And I think that's the first time that's

  • ever happened during the crisis, as opposed to some later date.

  • And I think all of the papers and the contributions of people

  • - more than 250 people that contribute to SAGE.

  • The fact that those minutes are now available, I think,

  • is a key step.

  • I do think we could go further.

  • I think there could be more questions and answers about how

  • certain scientific advice was gained.

  • As you know, and I've said this publicly,

  • I think the lockdown measures were

  • eased a little bit too early.

  • I would have rather they were lifted about now actually,

  • rather than three or so weeks ago.

  • Because now, three weeks on from when

  • the starting of the lockdowns was initiated,

  • the numbers in the UK have come down.

  • They were 10,000 new infections a day just a few weeks ago.

  • That is down now to about 3,000 new infections a day,

  • and it's continuing to come down.

  • When the numbers come down, as they

  • have done in much of continental Europe,

  • then your ability to deal with local epidemics,

  • to deal with little outbreaks that happen,

  • as are happening now in meat packing factories

  • and in other areas around the UK,

  • your ability to deal with those is much better.

  • I would have liked the test, trace, and isolate system

  • that Baroness Harding has put in place

  • to have been more mature and more

  • developed and able to respond to the new infections that

  • were coming.

  • That is almost in place now and fully functional.

  • I would like to see it a little bit more functional.

  • Because the fastest way out of this pandemic for the UK

  • is to drive down the numbers where

  • you can deal with them with your public health response,

  • have a really robust test, trace, and isolate system which

  • is both nationally run, but also locally responsive,

  • and have the ability to care for people in care homes,

  • in hare-to-reach communities, homeless shelters, factories,

  • and indeed in the NHS.

  • And that's what we need to have in place

  • as we lift the restrictions.

  • The worst thing that could happen

  • is we went too quickly with that,

  • and we have to reimpose the restrictions.

  • That would be very damaging to trust.

  • It would be very different damaging to the economy,

  • and would set us backwards if we had to reimpose restrictions.

  • That's what we need to avoid.

  • And we need to use this time of June, July, and August

  • to step back and think really carefully,

  • how can we make sure we're in the best

  • position possible with test, trace, isolate,

  • clinical care, caring of care homes,

  • vulnerable populations, for the inevitable coming of the autumn

  • and winter when we will see the normal respiratory infections

  • and maybe a second wave or rebound of the current?

  • That's what we need to use this three months for is really

  • stepping back, learning lessons, and thinking

  • what do we need to have in place for the autumn.

  • And I want to go back to the big picture now.

  • I mean, it's at about the six month mark

  • since the outbreak started.

  • And we've had some progress, as you say on, treatments.

  • And it sounds like a second wave is inevitable.

  • Is the autumn the time then where

  • we'll have that answer to the immunity question,

  • whether people who have previously been infected

  • have the antibodies and can't get infected again?

  • It is.

  • The autumn is the crucial time in the northern hemisphere.

  • But just to put the pandemic into perspective still,

  • Europe is in a position now where

  • the first wave is coming off its peak

  • and the numbers are dropping, including here in the UK.

  • But globally, the numbers are accelerating.

  • This pandemic is only just starting.

  • If I could just give you a figure for that,

  • it took two and a half months for the world

  • to have its first 100,000 cases.

  • Every day at the moment, there are 200,000 cases

  • being reported globally.

  • This pandemic globally is accelerating, getting worse,

  • and going into new jurisdictions that previously had not

  • suffered from it.

  • So this pandemic is very, very far from over.

  • And given that we believe only about 6 per cent

  • or 7 per cent of the populations in Europe

  • are protected, we believe, from having antibodies,

  • it means that 90 per cent plus others

  • remain susceptible to a potential second wave.

  • So whether a second wave comes or not is at least in part

  • dependent on the decisions we make today, the preparations

  • we make, and whether we can avoid it coming back in future.

  • But we should assume it's coming back

  • to make sure we use this three-month window

  • of relative peace and quietness in Europe to make

  • sure we're absolutely better prepared than we

  • were going into February or March of this year.

  • What would you say has been the most important lesson

  • for the scientific community since the outbreak started?

  • Most important lessons from the scientific community.

  • I think the importance of collaborations

  • are absolutely critical.

  • The importance of learning from experiences in China,

  • from experiences in Singapore, experiences in Korea,

  • and making sure you don't just learn from those

  • but you then implement those learnings.

  • The fact that we're dealing with a brand

  • new human infection which we've never seen before.

  • Is there immunity?

  • Does the virus change?

  • What sort of clinical syndrome does it cause?

  • How can we best manage patients?

  • And how can we develop treatments?

  • The coming of showing that dexamethasone,

  • through the recovery trial, has reduced mortality

  • in those people ventilated by 30 per cent

  • or so, that's a remarkable finding that science

  • had no idea about even three months ago.

  • The fact that chloroquine does not work in treatment

  • is an absolutely critical finding.

  • And the development of vaccines at an unprecedented pace.

  • We will have vaccines that are being

  • tested in 2020, less than a year after a new infection emerged.

  • That is a remarkable thing to say.

  • We must make sure that those vaccines are both safe

  • before we give them to hundreds of millions

  • of people around the world and also that they are effective.

  • We need to know they are safe as well as effective.

  • And we must not just think of putting all our money

  • into vaccines because we may not have a vaccine.

  • I sincerely hope we will, and I'm optimistic we will,

  • but we also have to develop the health

  • systems, the public health.

  • We have to push forward with the development of therapeutics

  • and drugs that can prevent and treat this infection,

  • and we have to roll out better diagnostics

  • so that we can understand where this infection is spreading.

  • But if we do all of those things,

  • and we commit the resources that are really needed,

  • and we work as a globe rather than as a single nation state,

  • then we will make progress.

  • And I would be absolutely optimistic

  • that we can come out of this Covid pandemic

  • at some point in the future.

  • And then we must develop the sort of world

  • and put in place the collaborations

  • at a global level that are going to be needed if we're

  • going to address emerging infections, climate

  • change, drug resistance, or the other great global challenges

  • of the 21st century.

  • And I'd like to end just by asking you

  • about that final point, that risk of failure.

  • Even with all the efforts going into looking

  • for a vaccine to trying to develop one across the world,

  • how big is the risk that those efforts will fail

  • and the virus is something that humanity just has to live with?

  • I mean, is there a plan B?

  • There is a plan B. And we will have to live with it.

  • I mean, physical distancing, which has been very effective

  • in reducing transmission, but you cannot keep it going

  • forever.

  • You cannot keep schools closed.

  • The inequality that closing schools

  • brings, the lack of educational opportunities for young people

  • is profound.

  • The impact on the economy - the shielding of elderly

  • populations therefore not able to see their loved ones -

  • is something that the world cannot keep going with in long.

  • Lockdowns do not change the fundamentals

  • of the biology of this virus.

  • They don't change transmission.

  • They do not change our ability to come out of the Covid.

  • They buy us time but they don't change the fundamentals.

  • The only way out of the pandemic and changing the fundamentals

  • is to have diagnostics, stronger public health, treatments

  • that can prevent and save lives, and a vaccine.

  • And we need all of those.

  • We shouldn't be betting on one of them.

  • We need all of them.

  • And if you ask me, will we succeed in any of those?

  • The answer is an unequivocal yes.

  • But I don't know which one of them

  • will have the biggest impact, and that's

  • why we have to invest in all of them

  • at scale, at risk, and as a world

  • rather than as individual nation states.

  • Jeremy Farrar, thank you very much.

  • Pleasure.

It's widely accepted that a vaccine is the only way

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杰里米·法拉尔(Jeremy Farrar)参加Covid-19疫苗全球竞赛(Jeremy Farrar on the global race for a Covid-19 vaccine | FT Interview)

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    joey joey 發佈於 2021 年 05 月 23 日
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