hi everyone and welcome to this live broadcast webinar event from Chetan house and we're really pleased that you can join us today and that you're giving up your Friday evening for what I think it's going to be an interesting and important discussion and this is a new format for us we're trying this for obvious reasons and but we're hoping that we'll be able to bring you the same range of diverse events over the next few months and why this this format and Robin nibblet our direction will stay a little bit more about that in just a moment we're joined this evening by three panelists our first speaker is Creon Butler Creon is the global economy and finance program at Chester powers and prior to joining Chatham House he worked in the Cabinet Office where he was director for International Economic Affairs in the National Security Secretariat he also served as sucia to the g7 and the g20 advising on global policy issues including global health threats before the Cabinet Office creon worked for HM Treasury for the foreigner person for the Bank of England and he was also deputy High Commissioner in New Delhi from 2006 to 2009 we have Emma Ross Emma is a senior consulting fellow in the center for universal health care at Chatham House she's also managing editor of the control of communicable diseases manual a reference book on infectious disease for public health experts and epidemiologists she's a strategic communication specialist working for a number of NGOs and who work in the public health and medical research areas while working for The Associated Press and we reported on outbreaks including SARS and avian flu and she also served as as the news team leader for the World Health Organization in Geneva where she advised the director-general and our final panelist is dr. Robin niblet Robin is director and chief executive of Chatham House and has been for the past 13 years previously Robin was the executive vice president and chief operating officer at the Center for Strategic and International Studies so a pretty well placed panel to you to talk to us today before we open the discussion before Emma rust opens the discussion on overnighting on this and the situation we're facing Robin is just going to say a few words about Chatham House Chatham lost its position and its plans for the next few months over to Robin thanks very much Laura and thanks for sharing this session on Friday afternoon and thank you to all of our members who've joined this session I can see we've got some 240 people or so online let's see if we can get this conversation done in 45 minutes I don't want to say much more other than that Chatham House is in full flow and full action at the moment but remotely and behind the scenes as you know we've had to in essence close our mill being to all of our members and guests during this period we only have a skeleton staff in a couple of days a week to keep things ticking over there but we are upgrading things we were doing already to try to make sure that we could be much more interactive in the way that we engaged with with all of our different members and different guests and this meeting I suppose is one of the first that's really a scale for our members now that we're all having to work on a much more social distancing basis but I don't want to say well mister I may use up a lot of time but I do want to say as my colleagues and I just thrilled and grateful AV would be joining us be you will be sustaining hopefully your membership through this difficult time but it is also a time to really think the way we think the way we all do our business and our work not just the government's that when companies we'll be talking about today but obviously all institutions and I'm hoping that will come out of this actually more agile probably a bit more carbon sensitive and carbon sustainable in the types of way that we work and despite the terrible tragedies and the loss of life that's coming with this crisis that we can all come through together in a much stronger position in the future so thank you for bearing with us hopefully it'll work well today I'm glad I'm going last it's Robin and they return Emma he's got the privilege of going first yes Thank You Laura good evening everybody and thank you for joining us I'm gonna start with where we are with the outbreak so as of last night the number of confirmed cases worldwide has now exceeded 200,000 and it took more than three months to reach the first hundred thousand and only 12 days to reach the next hundred thousand and with that we're nearing nine thousand deaths were at eight thousand seven seven eight and basically the pandemic is on the rise and although countries that are at different places in their epidemic curves the forecast is that we have a way to go with with it in this first wave and that we should expect a second wave the strategy for most is to dampen down the impact of this to relieve the pressure on the health services until technology maybe a vaccine brings us new tools and while countries have to base their response strategies on what stage of the outbreak they're in and that will look different in different countries at any one time international cooperation is critical if each country is to get the best result I think we've seen a lot of international cooperation on the scientific front we had practice with this during the SARS outbreak and it's been refined since then for instance the World Health Organization is coordinating for virtual networks of experts participating from around the world for this pandemic to track the outbreak and inform the response from the perspectives of the epidemiology that's what's happening with the spread of the disease the virology how best to manage patients and predictive modeling the modeling is something's been added since ours and this international cooperation is informing the global recommendations and the national responses around the world data and experiences are being shared it's also w-h-o is also sending tea of international experts two countries who request it to support the control efforts and this kind of international cooperation has provided us with the understanding that we had today of this disease the w-h-o director has repeatedly urged global solidarity is needed to control this outbreak not just scientific but also political and financial and what we'll hear a little bit about that both of those later in in this session but on the scientific level we're talking about the sharing of data knowledge supplies expertise and more a good example of that is there's a global genetic sequencing bank hundreds of genetic sequences have been submitted and that shown so far that the virus has not mutated to a significant strain difference changes in sequence you know have been minimal and it's this kind of cooperation that helps everyone do a better job of responding it also means providing technical and financial support to those low and in middle-income countries that need it to successfully respond and something that's going on there is huge efforts have been made to provide support to countries in Africa and elsewhere to build the capacity of their laboratories to diagnose the disease which of course is critical for detecting and tracking the outbreak spread and for working out how best to respond early in the outbreak reportedly there were only two labs in Africa that had the ability to test for the infection and after a really concerted effort to roll out test kits and training now the coverage has been bolstered significantly it's also about experts worldwide working together on addressing the research gaps so that we can better understand and control the disease effective international cooperation basically achieves quicker and better control of outbreaks and it and it helps target resources and energy where it's needed most global coordination is also an important aspect and it does look from some angles that there is a lack of global coordination in the response and in certain aspects that's true given that every country is not following a global plan there is no one plan for everybody to follow but there needs to be a differentiated approach as each country is facing a slightly different dynamics and not all at the same stage in their outbreak as each other but actually there is a level of global coordination so and w-h-o is at the center of this as is its mandate firstly in the way I just described with its corralling of leading international experts in these virtual groups and disseminating the insights that come out of them as well as guidance and recommendations also on global coordination there is a common goal basically everybody is looking for a combination of response measures that aim to delay the onset of this surge in cases if it's feasible level the demand for hospital beds protect the vulnerable and contain the outbreak in countries where there are only a few cases that can be traced in the chain of transmission broken many of those are the classic outbreak control measures we all hearing about hand-washing social distancing cancellation of mass gatherings etc so what we are seeing I think is a bit of a disconnect at the political level there is some criticism that WTO is not able to ensure that what needs to be done is done whatever w-h-o is trying to do or get countries to do including things for the global good the reality is that national sovereignty and national interest is sometimes overriding that crises like these are always an opportunity to shift towards a more resilient and sustainable healthcare architecture and to protect global health security it means making sure all countries have a resilient and sustainable system as infectious disease threats do not respect borders and many times there is commitment in the heat of the moment as we know and there's investment but when the memory of the threat fades away so does some of the will and the resources that are invested don't build the resilience or sustainability we were hoping for improvements have been made after outbreaks for sure for instance after the soil break the international health regulations were updated to require all countries to put in certain capacities that would bolster their preparedness and ability to respond then after the Ebola outbreak further efforts on that were made by introducing joint external evaluations and support for some low and middle income countries and building that capacity after it became apparent that even though they were required by the international health regulations to develop those capacities they weren't and even though they were self reporting that they have the capacity as it turned out they didn't so in another aspect these crises have clearly shown that you can't separate the health security issue from the Health System strengthening issue they are intertwined the SARS outbreak was instrumental in leading China to reform its health system and move towards universal health coverage most mostly publicly financed and that means everyone has access theoretically to the health services they need without financial hardship and recently the goal of universal health coverage has risen up the global political agenda to become one of the sustainable development goals and even in countries that don't have universal health coverage yet what we're seeing in this pandemic response is UHC style responses people are basically looking to their governments to take care of this the responses are in effect state governed and financed public health responses which is what you see in universal health coverage so in some aspects these crises have led to improvements but much more can be done and that's mostly capacities to detect and respond are still inadequate in many countries and health systems still need to be strengthened so that that's really kind of my introduction for where we stand from her in the health space on this Thanks well thanks very much and good evening everyone so I add a few comments from the economic perspective I think what is really clear now is we've never before seen an economic shock like the present one it's very unclear how long it's going to last and also how its end in terms of the current status it's very clear that strict social distancing is the only way in which you can prevent your public health system from being overloaded and so that is the the set of measures that many advanced countries in Europe the North America being putting in place these do have enormous economic costs present at least there is no alternative at the same time there is some evidence from what we've seen in China that if these measures are applied for a sufficient period of time and sufficiently rigorously point in which the virus is halted all the progress of the virus is halted but the problem is you know what comes next what is the next phase because China hasn't yet removed those street measures and it's not clear how you can restart your economy without in the initial response economics authorities did the things that you would expect they cut interest rates ensured that there was sufficient public expenditure for health systems and provided liquidity for for companies to enable them to get through the crisis as those measures were put in place and it became how much the crisis was going to be we've also seen move towards providing government guarantees for lending to companies and increasingly wage subsidies to ensure that those who are most directly affected by the crisis unable to maintain jobs and to maintain their businesses and this is a way of ensuring that the long-term economic damage is kept to a minimum I haven't seen yet but I think the expectation is the Chancellor in the UK will be announcing measures of risk later on today the other thing that we have seen is I think at best what you described in the economic space as a patchy degree of economic coordination and this I think contrast with what Emma was saying about the health response I think in the last week one has seen central banks produce a much more coordinated response and could see that in the last day or so with coordinated interest rate cuts and quantitative easing but we haven't yet seen if you like the response from governments we did see during the global financial crisis and this is because the effects stronger for confidence but also they can be more effective together in taking fiscal measures to disrupt the financial market conditions if each one is acting separately in a way that I think it is very important that we do see further steps in terms of coordinated government action I think essentially needs the u. s.
administration to realize that this is important and leadership in taking the necessary steps to produce that kind of coordination I think at some point people obviously will begin to start thinking about what long-term effects on our economy are going to be for this crisis and that will to some degree also depend on how much of like an adjustment takes place during this extraordinary period of strict social distancing I think you can expect to see that if you like the health sector within our economies is likely to be larger still in the future there may be a shift towards public provision of health for private sector provision in some countries one can also expect to see a internet a more Internet enabled economy with SME is having more internet facilities which then enables them once this is over to continue working in a manner that so they're going to be a number of effects in the long term which we will which we will explore as they develop so I think perhaps if I stop there and hand over to rob thank you very much indeed and as I said a minute ago happy to be going last not least because we're in such a complicated environment obviously this is probably the hardest time for us to assess what the implications are going to be of curve in 19 I would argue we're kind of at the fulcrum right now of the crisis given we have some sliced signs of recovery in China two days without any notification of new cases in Wuhan Europe now the epicenter America may be on the way up and who knows how it's going to play in the Middle East Africa and Latin America opening signs cropping up here and there um I think the way I would put it is that there's going to be an enormous difference between the world losing 15 to 20% of GDP over a three-month period and losing 15 to 20 percent of GDP over a 12-month period we know China's already counting a fifteen percent decline in GDP since December and if that gets stretched out globally and gets stretched out over several months it's gonna have a completely different implication to one where we're able to capture and try to limit to the implications of this crisis so I wanted to just rattle through four issues that are kind of framing the way I think about this crisis I suppose from at Chatham House standpoint the first is what are the immediate risks whose resilient a little bit about immediate responses something about longer-term risks and I'll finish up with a couple of the breakthroughs on immediate risks I would simply say we're not just talking about the numbers here yes Italy has her dreadful number of deaths high number of cases but if you look at the politics of it now our country that we thought was heading towards populism was split is seeing a huge social solidarity and support for Prime Minister Duceppe Conti a real social solidarity that seems to be existing across the country it's a country that has also despite his high debt levels some still produce significant levels of household savings and deeper protective levels economically so when you look at a country like Italy you have to separate out the different levels of its vulnerability um you look at the UK which seems to be earlier in the is in the pathway of this crisis which has a fantastic NHS which is ratcheting up its policy according to some of the best health advice in the world that's great but this crisis is happening at a moment of ultimate brexit vulnerability where people were already calling into question the strength of its economic model and survivability and guess what we've seen the pound maybe not noticed by as many people but down the lowest level against the dollar in 35 years it's pumping around somewhere 117 to the dollar right now why not just for exit when the UK goes into this crisis with a 5% current account deficit how is it going to be able to afford its economic livelihood at the same time as it closes itself down and if I were to take the u. s. there's a crisis that you know is going to be very hard to measure one of the most advanced countries in the world but obviously huge vulnerabilities in its health care system and a national strategic stockpile for an emergency of this sort that appears not to be ready as one might want 10% of the ventilator is likely to be necessary only 1% of the masks and respirators according to some assessments I've read and let's not forget China apparently accounts for 95% of the u.
s.
