Pandemic Center

In this episode Ben Plumley catches up with Dr. Seth Berkley, founder of the International AIDS Vaccine Initiative, former CEO of GAVI and amongst other responsibilities, now a senior advisor at Brown University's School of Public Health's Pandemic Center. Seth has recently published a new book “Fair Doses: An Insider's Story of the Pandemic and the Global Fight for Vaccine Equity” and he and Ben discuss the book’s topics of vaccine equity, misinformation, and the rapid innovations in vaccine development, particularly the success and future potential of mRNA vaccines. Dr. Berkley highlights the challenges posed by misinformation and the political landscape, as well as the importance of global collaboration in addressing pandemics. They also explore his defining role in Covax's efforts to distribute COVID vaccines, the need for local manufacturing, and the impacts of nationalistic policies on global health. Dr. Berkley stresses the critical role of ongoing innovation and funding in preparing for future health crises and ensuring equitable access to health technologies. And he pulls no punches on the current US administration’s failures in supporting global health research and partnerships.

Among its many painful lessons, the COVID-19 pandemic taught us that America’s defenses against a devastating health crisis were far weaker than most had reason to expect. More than 1.2 million Americans lost their lives to COVID, the most of any country. It’s puzzling and frightening to watch the Trump Administration dismantle initiatives aimed at keeping us safe from another pandemic.

And let’s not kid ourselves; another pandemic is evolutionarily inevitable. We can’t say when it will strike or if it will be worse than COVID. (Deadly as it was, COVID proved to be far less fatal than others we’ve seen recently, like Ebola, Marburg, MERS and SARS.) But research has projected that there is about a 50 percent chance another COVID-like magnitude of a pandemic (>25 million global deaths) will hit us in the next 20 to 25 years.

The world’s market for vaccines, as it exists today, depends on the United States. The U.S. has poured immense resources into the design and development of vaccines, and has paid far higher prices for doses than most other nations can afford. The federal government has issued broad vaccine recommendations, generating strong, consistent demand. “That’s a predictable market,” Richard Hughes IV, a public-health-law expert and the former vice president of public policy at Moderna, told me. It’s also a huge one. Seth Berkley, the former CEO of Gavi, which supports the immunization of about half the world’s children, told me that the U.S. accounts for 35 to 40 percent of global vaccine revenue at a minimum, more than all of Europe combined.

Vaccines have been making a lot of headlines over the last five years. First, because of the remarkable speed with which the Covid vaccine was developed, and more recently, because of the Trump administration’s hostility to vaccines. I can’t think of a better time to have a conversation with today’s guest, Seth Berkley, who for more than a decade ran the largest vaccination program in the world.

Arguably, one of humanity’s most dramatic successes has been the application of science to understand and then decisively intervene to improve these harrowing conditions. The global infant mortality rate is now less than 25 per 1000, with the US at 5.2 per 1000. Although clean water, sanitation, improved nutrition, and advances in neonatal and perinatal care have all played crucial roles in this progress, the greatest single contributor has been the development and widespread use of vaccines. The World Health Organization (WHO) Expanded Programme on Immunization is estimated to account for a 40% reduction in global infant mortality rate over the last 50 years, not including the dramatic effects of smallpox eradication.

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Health Secretary Robert F Kennedy Jr. says the U.S. will stop funding GAVI due to safety concerns. GAVI is a public-private partnership that vaccinates children in some of the poorest countries. The group has pushed back on the criticism.

Here & Now’s Asma Khalid learns more about the implications with Seth Berkley, the former CEO of GAVI, who is now a senior advisor to the Brown University School of Public Health Pandemic Center.