Seth Berkley & Eric Topol - Discuss Fair Doses Book

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Ground Truths 47 min 2 speakers transcribed

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Eric Topol 0:00

am just delighted on our new podcast of Ground Truths to welcome Seth Berkley. Seth has been a major force in vaccines around the world, and he has a new book called Fair Doses, which we're going to be discussing today. And if you have questions, you can put them in the message as we go forward, and we're going to get right into it. Seth is a noted physician epidemiologist who has been so active in these international public-private partnerships with the AIDS vaccine and then 12 years of Gavi. And in this new book, He describes the story, which I guess we'll start back at Davos, January 2020. You're in the Hard Rock, is it a bar, the cafe?

Seth Berkley 0:56

It's a bar. As all these stories start in the bar, you know, it has to.

Eric Topol 1:00

This is an incredible story, one that would really be, you know, in the archives of just beyond belief in medicine. So it's January 2020. Most people haven't even acknowledged that there's a pandemic. Right. And you're making some big plans. Tell us about what was going on then.

Seth Berkley 1:20

Well, it was a funny time because it was a few weeks after we heard about what was going on in Wuhan. And, you know, initially it was thought to be a transmission from a wet market, you know, to people. There wasn't any well-documented evidence of person-to-person transmission, although... Of course, we were beginning to hear rumors of that going on. And of course, that's what gets you nervous if you're a public health person. And so the question we had at that moment was, is this the big one or is this just a dress rehearsal for the big one? And Richard Hatchett, who runs CEPI, the Coalition for Epidemic Preparedness Innovation, myself and my wife, Cynthia, who's also a physician, were sitting there and having that discussion.

Seth Berkley 2:02

Meanwhile, Donald Trump was down the street saying, oh, yeah, some case came to the U.S., but don't worry about it. There's no problem. It's not going anywhere. We got it completely under control. The system's great. Nothing. And, you know, we were not sure about that at that moment. And so really the question was, you know, how do you begin to scale up? And we had at that point no mandate, no money, and no people. Of course, Gavi was a large operation providing vaccines to more than 50% of the world's children. But the board was quite clear that we couldn't take money away from that to do this new work. Richard had had money for epidemic vaccine production. So he right away was able to make some grants, including the first gland to Moderna for their clinical lot.

Seth Berkley 2:51

And so this was really, you know, we basically sat around and proverbially writing it out on a on what it would look like. And after Davos, I went back and met with all of the partners of the alliance and he went back and began to scale up. And that really was the launch of COVAX, which is ultimately the largest and fastest rollout of vaccine in history, although it had all kinds of problems. And one of the reasons I wrote the book was to try to document that, both the good and bad, because if you don't follow history, you're doomed to repeat it. So that's a little bit of a start.

Eric Topol 3:28

You know, it's just incredible the insight that you all had and the partners like Richard Hatchett and Seppi and others that you brought together so early, you know, months before people started to realize that this was a real deal, major pandemic. And it's extraordinary because what this led to, I think a lot of people don't know this, Sepp. This led to, as you said, the fastest, but we're talking about 39 days after the very first vaccine, and it's in Ghana with COVAX.

Seth Berkley 4:03

It actually isn't in Ghana. Sorry. 39 days, it was in India, and the reason was because— India's regulatory authority had already approved it, but WHO hadn't pre-qualified it. That's a requirement for us for countries that have weaker systems. It was another 43 days after that before it hit Ghana and Cote d'Ivoire. We felt bad about that because we had vaccine doses ready to go. That's one of the lessons is how do we get faster approvals moving forward. But after that launch in Africa,