Joint IMF – WHO – WTO – WBG Press Briefing

focus on a new

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call to expand equitable access to coveted 19 vaccines by the heads of the international monetary fund the imf the world bank group the world health organization and the world trade organization so today we have a special guest, miss christolina, managing director of the international monetary fund, mr david malpass, president of the world bank group, dr. ngozi ogunjo, the director general of the world trade organization and last but not least, dr. terrorist, adonai gabriel, director general of the world health organization. welcome, simultaneous interpretation is provided in the six official languages ​​Arabic Chinese French English Spanish and Russian, as well as Portuguese and Hindi.

Now the other participants that we will have in the room are, apart from Dr. Tedros, Dr. My Mike Ryan, who will be joining us shortly, the executive director of the health emergencies program, Dr. Maria von. kurkov the technical lead of covet 19 dr sumiya swaminathan chief scientist dr bruce elwood senior advisor to the director general dr kate o'brien director of vaccines and immunization biologics and dr jorge gaspar director of regulatory prequalification with this let me hand it over to dr tedros for the opening words you have the floor thank you thank you christian good morning good afternoon and good evening yesterday the world health assembly concluded a very productive week of debates and decisions that took place completely virtually while I was surprised and waiting Looking forward to meeting colleagues in person I was encouraged that together we adapted more than 30 resolutions and decisions on a wide range of health challenges, there was a clear consensus that the world needs a stronger double ho now more than ever and the three recent reviews of the international response The pandemic reflected the need for a paradigm shift in both the quantity and quality of funding, for which Member States also agreed to hold the diabolical specialization of the World Health Assembly in November to consider the possibility of developing a treaty or convention on pandemic preparedness and response. be a very important opportunity for a truly representative inclusive new global deal to keep our health systems, societies and economies safer, but there is still much work to do to end this pandemic, while we are encouraged that cases and bases continue declining in In many areas of the world there is no room for complacency.

The consistent use of public health measures in combination with equitable access to medical supplies. Oxygen tests. Treatments and vaccines remain essential. at its amc summit to further diversify its portfolio and purchase additional vaccines for low and lower middle income countries fully funding kovacs and rta is key to ending the increasingly two-way pandemic and I thank the government of Japan for hosting the summit from amc and today I am pleased to announce that the sinovac coronavac vaccine has been listed for emergency use after it was found to be safe, effective and quality assured after two doses of the inactivated vaccine.

Additionally, coronavac's simple storage requirements make it well suited for low-resource environments. This is now Eul's eighth vaccine, so it's now crucial to get these life-saving tools to the people who need them quickly overnight. I joined the leaders of the international monetary fund, the world trade organization and the world bank group to publish a message demanding a new commitment to a rapid investment of 50 billion in many newspapers around the world. of dollars to fund the equitable distribution of vaccines and other crucial health tools. We are especially pleased that in the proposal most of the new funding is intended to be made available quickly through grants, including to fill the law, accelerate the funding gap, this would help us dramatically increase the production of diagnostic treatments, oxygen, medical equipment and vaccines for equitable distribution, in addition, this new roadmap reflects the need to improve the preparedness and capacity of the country's systems to use these tools quickly, safely and effectively should be a real point of inflection and as G7 finance leaders meet in the UK this week, followed by the heads of state summit next week, there are multiple opportunities for leaders to step up and secure funding to implement health. tools equitably now is the time for leaders to share vaccination rules with the kovacs to ensure healthcare workers and other at-risk people are protected and extinguish variants last week I urged all companies and vaccine partners countries to work together to vaccinate at least 10 percent of the population. of each country by September and at least 30 percent by the end of the year, but as we said in our

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opinion piece, together with other agreements and increased investment, we may be able to reach 40 percent by the end of year through public health. measures and vaccines we have the means to end this pandemic quickly and save countless lives and livelihoods, but we need the will to make it happen they say where there is a will there is a way we know how the question is do we have the will To say more about how this can be achieved, I am glad that I am joined today by Cristalina Georgieva, managing director of the International Monetary Fund, Crystallina, thank you very much for joining us today and you have the floor.

Thank you very much, Dr. Tedros, for hosting us. this

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conference and also to you, the staff of who and all health workers for your selfless service to humanity, very happy to join you and david ngozi to discuss a matter of great urgency: the need to intensify a multifaceted and coordinated action to fight. The pandemic in parts of the world is lagging mainly due to the unequal distribution of vaccines between richer and poorer countries. You may wonder why the IMF is worried about vaccines. We are deeply concerned that an increasingly bidirectional pandemic is causing a two-way street. economic recovery with negative consequences for all countries and our data shows that in the short term vaccinating the world is the most effective way to boost global production;

In other words, vaccine policy is an economic policy based on the work of the WHO, the world bank and many others. Our staff has put forward a proposal, a $50 billion plan to end the pandemic, it has three broad elements and, as you suggested, would guide everyone on this call through the first to vaccinate at least 40 percent. percent of the population in all countries by n20 n2021. and at least 60 percent by the first half of 2022, this requires additional initial subsidies for kovacs donating surplus doses and free cross-border flows of raw materials and Finnish vaccines, secondly, guaranteeing against downside risks, such as new variants, this means investing in additional vaccine production capacity. in billion doses, diversify production and expand surveillance and contingency plans to manage virus mutations or supply crises, third, manage the interim period when vaccine supply is limited, with testing and widespread tracing, therapies and public health measures, in other words, the things we will learn. work and at the same time intensify preparations for the rollout of vaccines in countries that fall behind the 50 billion dollars we foresee.

Large financing of at least 35 billion dollars. The G20 governments have recognized the importance of providing around $22 billion in additional funding by 2021. to the accelerator bill so we need an additional $13 billion in grants the rest of the funding plan around $15 billion billions of dollars could come from national governments supported by concessional financing from multilateral development banks such as the world bank in today's call the $50 billion price tag is dwarfed by the estimated $9 trillion will be earned from increased economic activity by 2025, making it the best public investment in history. Success depends on speed. Initial financing. Initial vaccine donation.

Initial risk. foundations of private international financial institutions and our four fully subscribed institutions we at the IMF will not shirk our own responsibility we will continue to work with the international community to achieve faster vaccination and recovery so that we can ensure maximum efficiency and maximum impact of In our collective efforts, we are considering how to complement grants and highly concessional financing from others to covet vaccines when needed and are preparing a new allocation of special drawing rights unprecedented in their size to increase the reserves and liquidity of all our member countries. the pandemic is a problem that has a solution but requires coordinated global action now thank you tedros thank you thank you cristalina I couldn't agree more that this new injection of funds will be essential to increase the supply of life-saving medical tools and the pandemic Next , I am very pleased to welcome Dr.

Ngozi Okonjo Iwella, Director General of the World Trade Organization. Ngozi, you have the floor. Well, thank you very much, Dr. Tedros, thank you very much for having us today and I just want to make a comment. I also want to thank Christolina and the IMF staff for her document, but I want to say that we often talk about collaboration of international institutions and coherence. The very fact that the four of us are here today and our institutions are represented is very important because we know that it is about saving lives and this is the moment we have to work together and we are talking about saving lives of people in developing countries by saying that They will never be left behind, that is why we have united and thank you all.

I want to thank my colleagues and their staff for bringing us here now there is a joke about two economists out for a walk one sees a hundred dollar bill on the ground and exclaims look there is a hundred dollar bill on the sidewalk the second economist doesn't even looks down she says it can't be a hundred dollar bill if it was, someone would have already picked it up on the IMF staff document, like Crystalina talked about. We have been shown that there are trillion dollar bills on the curb to pick up. we only need to invest 50 billion dollars upfront and we also need more cooperation on trade after some initial disruptions.

I just want to tell you the role that trade has played, many people are not aware of it after the initial disruptions to supply chains. Trade played a critical role in the movement of medical supplies and goods, for example, in 2020 total global merchandise fell by seven percent in terms of value, but the value of trade in medical supplies increased by 16 percent. hundred. The trade covered relevant products such as mass ventilator sterilizers and ultrasonic equipment. scanners increased by 31 percent, trade in test kits and diagnostic reagents increased by more than 40 percent for personal protective equipment, ppe directly grew by 50 percent, including with agriculture, trade Global agriculture remained stable throughout 2020, reinforcing food security, which was another area of ​​concern for leaders and, of course, we cover 19 vaccines we manufacture the value chains of several countries, we know that these value chains are very sophisticated and complex.

We have all heard of the example of the Pfizer beyond tech vaccine which uses 280 components from 86 sites in 19 countries, but it was trade that helped move these supplies, but we have also had limitations on trade, export restrictions are a challenge that we continue to face and monitor, although it is positive that the number of export restriction measures has decreased from 109 at the beginning of the pandemic to 51, there are signs that trade restrictions still exist, covering 19 vaccine supply chains and weighing on the Production trade policy can help scale up vaccines in three areas, first, by freeing up supply chains for raw materials and finished vaccines, second, by working with manufacturers to make the most of existing production facilities and Creating new manufacturing capacity, especially in regions that lack it, working with manufacturers to keep supply chains open is essential so we can get more vaccines.

Thirdly, we know that there is a debate about travel, adebate on exemption. in the WTO and although I cannot take sides, we must reach a conclusion in this debate, we must also promote the transfer of technology and knowledge to achieve lasting increases in production capacity. WTO members can and must deliver on all three fronts this year and To echo Crystallina, we increasingly see a world divided over access to vaccines and over economic prospects. The two, of course, are related. That is why he said that vaccine policy is an economic policy. The divergence is visible in trade data also in Europe and North America.

The import volumes are said. To surpass pre-pandemic levels this year by 2022, European imports are said to be almost four percent higher and exports 3.5 percent higher than in 2019 over the same three-year period, the North American imports will increase by 9.7 percent and exports by almost four percent. Asian imports will grow by nine percent and exports by an even greater 12.5 percent, but, on the contrary, Latin American imports will increase by a modest 1.7 percent and exports by 1.2 percent and in Africa the Imports are only on track to reach pre-pandemic levels by 2022. Exports are expected to have increased by 2.3 percent by then, which is why I also say that vaccine policy is a trade policy and vice versa, we will not get the increase in production of vaccines that we need without measures on trade and without ending the vaccine shortage we will not be able to achieve lasting trade. and the economic recovery we need we want global cooperation to save lives and collect those trillion dollar bills thank you, thank you, thank you very much ngozi, you have been fighting this pandemic from the beginning in a variety of roles and I appreciate your point that you also While that WTO financing is doing everything possible to ensure the smooth flow of goods and raw materials across borders to increase access while accelerating negotiations on intellectual property, we are finally joined by David Malpass, President of the Bank World.group David thank you very much for joining and the word is yours thank you very much I joined my colleagues to ex

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the urgency of quickly making approved vaccines available to everyone each of us has an important role in this global vaccination effort my priority immediate is countries that have enough supply to quickly release doses again to countries that have vaccination rollout programs the world bank has $12 billion in vaccine financing available now and more if needed to help countries buy and distribute 19 coveted vaccines and encourage vaccinations by the end of June we will have approved vaccination operations in more than 50 countries these countries can immediately use kovacs vaccines from manufacturers and the donor countries themselves as soon as they are available it is vital that we accelerate the chain of supply we need to shorten the time from manufacturing the vaccine to shots into arms there are currently too many doses waiting to be allocated, they may be stuck in paperwork in inventory somewhere or they are not the type of vaccine the country can use to maximize the number of vaccination doses should match national programs as soon as they are manufactured it is important to share information about allocations so that countries can plan ahead the world bank provides transparent access to very detailed information about our projects through an online portal available at the world bank.org cuts vaccines we urge other development partners to publish detailed information on their vaccine financing and deployment programs and their delivery schedules.

Our website also includes links to the 140 vaccine readiness assessments mentioned in our op-ed today, which will help us fill capacity gaps. and quickly add more financing operations financing can be available to countries immediately for the poorest countries it is in the form of a grant or on very favorable terms we are also working to expand the offer and will make investment announcements by the IFC the sector private of the World Bank group Every day the development arm counts to provide vaccine supplies to developing countries with rollout programs. I look forward to working closely with my colleagues on these vital tasks and with that, thank you very much, thank you very much, thank you very much David and again to all the speakers that together we have established a new comprehensive health threat and economic roadmap to increase equity in health and accelerate a truly global and rapid recovery.

I thank you again and Christian I thank you all very much, thank you Dr. Teddrus. With this we open the round. For media Q&As, we already have a long list, but if you still intend to stand in line, raise your hand using the raise hand icon and then mute your voice when it's your turn. The first question on my list is for Marlin Zhang. from xinhua marlin please unmute hello, can you hear me very well? Come on, okay, thank you, I'm marlene shaw from uh china shingle news agency. Thank you for this opportunity. First I have two questions.

I would like to ask Madame Gorgieva. The IMF has been repeatedly arguing that vaccine policy is economic policy. Do you think all major countries now understand this? The second question is for all the panelists: If possible, everyone has mentioned the limited supply of vaccines, so I was wondering what the main obstacles to expansion are. global vaccine production and supply thank you very much, thank you very much and let me turn it over to crystalina george eva, managing director of the imf, thank you very much for this question. It is now increasingly clear to leaders around the world and to ordinary people that we are not going to overcome the economic crisis that this pandemic unleashed unless we put a lasting end to the pandemic in our commitment to the finance ministers from around the world.

One of the problems is the problem of divergence. Countries with more physical space and rapid vaccination are emerging from the crisis quickly, they are growing, but those, especially with low vaccination rates, are falling behind and that is dangerous for everyone because it would slow down the global recovery. and second, that we are creating a breeding ground for mutations unless we act decisively to accelerate the end of the pandemic worldwide. At the IMF, we are committed to continuing to provide credible and up-to-date assessments of how vaccines are linked to the economic recovery. We will see a huge benefit, a whopping $9 trillion between now and 2025, if we move forward with vaccines much faster in everywhere and it is important to recognize that sixty percent of the benefits of this sixty percent of these nine trillion would go to waste. to emerging markets in developing countries, but forty percent would go to advanced economies, they will generate $1 trillion of tax revenue as a result of global action and we will continue to maintain that message to mobilize everyone to step forward in benefit of all.

Thank you for this. Maybe the second part of the question we could ask you. Dr. Ngosi from the World Trade Organization. Well thank you very much. I mean it's a very important question about the limited supply of vaccines and the main vial. Next, let me name. two or three that the manufacturers of the pharmaceutical companies themselves talk about first of all, I think we have a limitation in manufacturing capacity, the world normally has the capacity to manufacture around 5 billion doses of vaccines, but now we need 10 to 15 billion doses depending on whether we need boosters, so this is two or three times the capacity, so we simply do not invest enough in manufacturing capacity and that is why we have been working with the manufacturers together with Dr Tedros, who said he had created a vaccine working group to work with the industry is trying to rectify this, this goes along with issues of technology and knowledge transfer for manufacturing, of course, including considerations of how to get to a good agreement on intellectual property issues with intellectual property.

I think the second factor is raw material supplies. Many manufacturers mention that they are competing with other types of cancer drug vaccines for these raw materials and supplies, so there is a shortage. I think the third part is the skills that you know to make vaccines. You really need specialized skills because quality is so important in the area of ​​vaccines and these are not always in great supply and then fourthly, I talked earlier about export restrictions and bans. Some countries still have restrictions on the supply of raw materials entering supply chains and bureaucracy in some countries also hinders movement.

You heard David Malpass. I mean it eliminates bureaucracy and makes it easier for things to move faster. Those are four factors that I think we need to work with to increase supplies as well. Thank you so much. Let me continue with the next question and that is Bloomberg's current Gretler. but at the same time let me remind everyone watching the long list of journalists interested in asking questions to only ask one question at a time. Hi Corrine, go ahead. Hello, thanks for answering my question. It's one for WHO officials. um, I wanted to ask about the variant first detected in Vietnam um, which according to the country's Ministry of Health is like a hybrid of the alpha and delta strains, so um, I just wanted to see, you know, who pays special attention to it um, what does it do? you know so far, you know, it could be a candidate for a variant to be a variant of interest, just your update.

Thank you very much and Dr. Maria Van Kirk, thank you for the question and I especially appreciate you using it. the new who labels that we announced yesterday, so thank you very much for that, yes, as you know, there are variants that are being detected around the world and this happens because there is good surveillance of the sars kobe 2 virus and there is good genomic sequencing . That is happening all over the world and has in fact been increasing since the pandemic began. This variant of the virus that has been detected in Vietnam and reported by the Ministry of Health of Vietnam is b1617.2, the delta variant for which we recently provided a label.

To remove some of the stigma associated with countries that have reported these variants, what we understand is that it is this b1617.2 variant with an additional deletion in the location of the spike protein, we know that b1617.2 is the delta variant. It has higher transmissibility, meaning it can spread more easily between people. It has to do with mutations that are identified and allow the virus to attach to the cell and infect the cell more easily. What I think is important to remember is that all these variants. They are combinations of mutations, so this has been reported to be a hybrid, but in fact what it is is this mutation, the delta variant, with an additional deletion, so what we are really seeing is this convergence of evolution and the changes in these mutations. on the virus, which is to be expected because with over 170 million cases reported to date, which is really an underestimate of the actual number of infections worldwide, this virus will continue to change.

We are grateful for the surveillance that will be carried out. We appreciate that these variants are reported. We want to encourage this to continue happening. Studies are underway to take a closer look at the delta variant and look at these specific mutations. The more we learn about this, the more we will report, but we do. We know that with increased transmissibility this means that social and public health measures work, but they need to be enforced and used, so with the four variants of concern that were being tracked around the world, our social and public health measures continue to work, the diagnostics, the therapies and the vaccines continue to be effective against the variation that we are concerned about, so we really need to do everything we can to reduce transmission and I will just emphasize that in Vietnam they have a lot of experience with infectious diseases and they work to control the spread of Cyrus Kobe 2. and other infectious pathogens, so we continue to recommend that good surveillance be carried out worldwide and that this information be reported through these existing systems.

Thank you very much, Dr. van Kerkov, let's go to margarita sera from tsf radio portugal and I understand that we do not have a Portuguese translation, so please. use another language, thanks margarita, can you try unmute? Please, it's okay, it seems like we didn't get to it. Next in line is AFP's Neil Larson. Nina pleaseactivate silence. Yes, hello, thanks for answering my question. I wanted to do it. Returning to the topic of the lack of vaccines, you are calling today for an investment of 50 billion dollars for a more equitable distribution of vaccines, but even with all that money, um kovacs still faces a huge supply.

The gap is largely due at this time to the situation in India, where the supply of representative vaccines from the Durham Institute has been cut off. What possibilities do you see of reaching where you wanted to be with deliveries without the serum for participation and Are you waiting for the Chinese vaccines that have now received emergency use? Thumbs up to your mental health again. Thank you very much Nina and Dr. Bruce Elwood. Thanks suppose. Thank you so much. Christian and thank you. I think that is the key. The findings of the analyzes carried out by the IMF are that there are enough vaccines in the world to reach the coverage levels that, let's say, the document aspires to.

Now, to get there, we have Kovac's supplies that allow us to obtain a part. By the way, we have additional products in this quarter, as we announced a couple of weeks ago, the J vaccine, there is an additional Pfizer product, there is also an additional Z product, but in addition to that, as the IMF highlights. We need countries that have contracted large volumes to be able to donate those doses and at the world health summit we had big announcements about the commitment of the European team to reach more than 100 million doses this year. United States the commitment to donate more than 80 million doses and these are great, the challenge now will be to advance the moment because the crucial period, as you say, will be in the coming weeks and months if we support the eight Now it is going to be very difficult catch up and realize the kind of benefits that Dr.

George once laid out in her comments, so the big call is to introduce those nations as soon as possible to fully fund them. uh kovacs and the act accelerator so we can further diversify the portfolio as you said there are now new products that have w-h-o-e-u-l and could potentially be used and of course we are calling as dr mentioned. ngozi uh to look for other opportunities. increase the speed with which we can fill finished products and use them, so the bottom line is that vaccines are in the world, to get there, the problem is distributing them, scaling them up as quickly as possible and, fundamentally, share them. and that's what the call is for to bring all that front-loading so that we can make the promise of the plan, this bold plan that has been presented, a reality.

Thank you very much, dr. ellwood and I understand, we will see if jita kopinat, the IMF economist. The director of the council and the research department would add something. I just completely endorse what Bruce just said, which is that if you look at the problem, the reason why everyone here, including when CEO George said this is a solvable problem, is because even under very conservative assumptions. there is a significant amount of vaccines in process to achieve that goal of 40, the problem is in terms of who has access to those vaccines, that is why we need vaccine donations in advance, also to prevent spoilage so as not to waste doses that are stored in some refrigerator, those donations must be made now, we need, as dr. ngozi, removing restrictions on exports of raw materials and our finished vaccines, these are actually very small steps that are needed at this time.

It's good, this is the solution to a problem and we can achieve these objectives as long as we work in a coordinated manner. Thank you very much and just to give everyone again the name of Dr. Ita Gopinat, the IMF economic advisor and leader of the research department the next line of question is for claudia terence from the ap claudia please unmute hello hello can you hear me very well go ahead great thank you very much for answering my question maybe this is for the international monetary fund um latin america has been very very affected by the pandemic, could you be a little more specific and tell us what priority Latin America has and how exactly all these millions Will they help the region?

Thank you very much and yes, your donor, please, and I suppose you will ask us later, Mr. Melcas, yes, then the proposal talks about moving the vaccines as quickly as possible to where they would have the greatest impact and one of the observations we make is that While it is important that there is a distribution based on population, we also have to think about where the urgency to act is most significant and, unfortunately for Latin America, a good number of countries are affected by the brutal force of greed 19 and So what we would advocate for is making sure that we have the capacity to deliver vaccines where we would save the most. lives kovacs has a clause that allows it and our newspaper recommends that we be thoughtful and thoughtful about that clause.

I am in constant contact with many of the leaders of Latin America and one of the topics that each of them would put on top. The list is where are the vaccines, even countries that have money to buy them cannot access them and therefore this mobilization in which gita and bruce talked about actions from all perspectives, which is to produce more distribute quickly where more is needed, including the vaccines that are likely to be in access in the countries that reserve them, do it in advance and since I have the floor, I want to acknowledge that we have a gita governor who led the work on the call, we also have Russia Agarwal , the other after the author of the plan, huh.

I can't tell you how important it is to act comprehensively and not focus on a single peace, and that for Latin America is even more important than for the rest of the world. uh I want to ask Gita, do you want to add something or do we? we should move on to david we should move on to david thank you david uh thank you thank you uh so it is essential to match the supply with the countries that have programs in Latin America we have programs in Ecuador El Salvador and Honduras they are looking for 220 million doses, so you could say how it can be possible.

Well, that is necessary for the population and for double doses. When you solve it, we have financing available and the critical thing then is the countries that have excess. supply or sufficient supply to release those and Crystalina made this point and these are these are critical points that, as you look at the U.S., there is, its, the vaccination effort is being done at a very young age, so One of the things that needs to be done fairly and safely for everyone is that we need to vaccinate vulnerable people around the world right now and that means freeing up doses for programs that already exist, so that's what I am urging and we are ready to work on new programs.

We can push new programs through the board very quickly with a fast-track approach and there is a receptiveness to doing that and we need countries to have more confidence. Point out well, often, that one of the key things we are trying to do is build confidence in countries so that they can get their economies back on track, so we hope for that, but the bottom line here is to release excess supplies from those countries that have access and that, one positive thing I want to say, my impression of the vaccine manufacturers is that their supply is increasing very rapidly, they are talking about production levels that will reach billions of doses. at the end of this year or in 2022 uh and so uh so this is critical these next few weeks are vital that, in particular, the US releases access to go to the programs that exist, we are ready to take them tomorrow on the three countries that I mentioned and within two weeks in more countries within Latin America thank you very much quote the next question is for valeria roman from the infomer valeria please activate the silence malaria to listen to us oh hello can you listen to me paladia uh oh hello can you listen to me if you will oh I am I would like to know uh uh how this proposal from different international organizations uh can help Argentina and other Latin American countries with access to the vaccine exactly thank you very much Valeria let me look around maybe Dr Elwood sure, thank you very much Christian, no I understood the whole question, but if I understood, it was specifically how the plan and actions could help countries like Argentina in terms of access to more vaccines and, if that is correct, the intention of the plan is to ensure that all countries can access more vaccines more quickly, especially those that are currently, let's say, lagging behind the goals we have set to be at least 10 by the end of September in terms of coverage globally and then to 40 percent by the end of this year As Dr.

George Eva just stated in her comments, this means that there have to be multiple solutions, so it means donations of vaccines from countries that have contracted many doses, it means greater production, it means freeing up the movement of vaccines, so as the raw materials needed to produce them, so the key here is to really move across all of those dimensions to move increasing volumes globally as quickly as possible and try to address the gaps in distribution that we face today. It's a holistic approach that should benefit all countries certainly economically and all countries in terms of vaccines and then obviously countries in terms of disease reduction, ideally and especially in mortality and morbidity in the short term.

Thank you very much and Dr. Mike Ryan, please, I'm sorry. Oh, and perhaps in relation to both questions, not specifically about vaccines, but simply to reflect on the fact that the situation in South America at the moment remains of great concern to WHO and to our Alliance colleagues Panamericana de Salud. US organization or regional office in Washington. Eight of the top ten countries reporting the highest death rates per population in the last week have been from the Americas region and particularly South America. South American countries represent four of the main ones. ten countries globally just in case there were incidents over the last week and those countries include paraguay uruguay argentina colombia brazil followed by bolivia peru and chile so there are real challenges um uh in the south in south america still and uh The mortality, like You know, it has increased in some countries between Paraguay and Bolivia by more than 20 percent over the last week and when you look at the case fatality rates in South America in general, they are higher than in many parts of the rest of the world. three to five percent and again that may reflect the severity of the disease, but it also reflects access to adequate medical care and the pressure that the system in many South American countries has been under for a long time despite the wonderful efforts of health workers and health systems must do that, which is why test positivity remains remarkably high in some countries in Paraguay, it is almost 37 percent in Argentina, 33 in Colombia, 30 percent percent in Ecuador, 29 and very few countries in South America have rates below 10, so again the disease. transmission is intense, community transmission is widespread, the health system remains under pressure and that has been reflected in the mortality rates, so I think it is very, very important and the question was asked about the impact, the point of impact of this pandemic changes and we are moving from Looking at the tragedy in India and Nepal, that point of impact changes and has really been driven by the underlying incidence and the basic capacity of the health system to cope with it and, in the absence of high levels of vaccination , are the two factors that are going to drive the impact of this disease in the coming months how intense the transmission is how well your system is able to deal with that transmission the vaccine can break that cycle because right now the intense Transmission in all countries of the world has led to intense pressure on the health system and increased case fatality rates.

Vaccination can break that cycle. Continuing to implement social and public health measures can break that cycle, but that cycle will continue and unfortunately we will at this time. I think if any of you have kids, you watch them play. football and everyone is chasing a football down the field because we are all chasing what is moving and the moving target right now is the point of impact of this pandemic and we have to take a step back and realize that we have to break that cycle that We simply have to break that sign and vaccinate and increase the vaccination rollout.

The continued support for social and public health measures seen today in countries like Malaysia have had to again implement very strict measures from public health consortia because they simply do not have the vaccine to make the vaccine. difference at the moment, so the countries that have done well so far, the countries that have sustained their effort for many months, kept mortality and incidence rates low, are struggling to do so, a year and a half later of the pandemic, struggling to asktheir populations to even leave. Also, very, very tough as you watch other countries get vaccinated, left, right and center, so there are a lot of issues to consider here, but I think it's important that we look.

South America was really in a difficult situation just a couple of months ago and all. The situation is once again beginning to turn in the wrong direction and we must take this into account. Thank you just for briefly touching on the point that Mike was doing one of the things that sometimes gets lost in analyzing the IMF proposal and and uh uh. Dr. George Evan, he may wish to speak with this crystalline. If you look at the proposal, we talked about the vaccine part, but if you look at the third element of this proposal that Christline emphasized, was ensuring that as we move forward. in fact, if you look at that $50 billion investment, most of it is to try to implement those public health measures and scale them up quickly to save lives and make sure that we're reducing transmission through those measures, like Mike emphasized, so it's not one thing or the other, it's the whole package faster with the necessary initial financing and the cooperation collaboration at the international level to be able to implement everything.

Thank you very much, dr. ellwood and since we're running out of time we're going to move on to a final round of comments from our special guests and I'm checking who should go first because we have someone who has to go very soon, I think it's Miss George Eva, I thought it was Dr. Ngozi had an urgent appointment, so I would let her go first. Thank you very much for this and then, Dr. Ngosi, please, thank you. All I want to say is that we should keep in touch. Keep in mind that we are talking about saving lives and we have the tools to do it, we have the finances in the world to do it, we have the policy mix to do it, so we have made sure that this The opinion piece we did was to the seven G7 countries before they hold their summit to pay attention to a world where people have to queue for life-saving vaccines when we have the technology.

That doesn't work either for those countries or for rich countries. I think they've had all the numbers and all the reasons why it doesn't work, so I just want to say to the media that you know, please help us spread this message. it will save lives thank you thank you very much tongozi so now I look at david matas president of the world bank group please thank you very much it's good it's good to be here today the world is facing these huge challenges and clearly vaccines are a real Good investment and we want to encourage people to get vaccinated when they are available and what the policy objective is to make them available to the most vulnerable people.

I believe there is an efficient path to making vaccines available. to countries that have vaccination programs that can administer vaccines quickly and that have specified what types of vaccines they are prepared to use and so we can avoid waste, so my final thought is that we should measure our success in the next In three months, how many people around the world are vaccinated, especially how many vulnerable people are vaccinated, and we should try to reach very high numbers that the vaccines are available, we have to accelerate the pace to connect them with the demand, thank you, thank you.

So much for this and um with Crystalina managing director of the IMF. Well thank you very much. The approach we have taken is to ask the right question and that is what would it take for the recovery to accelerate everywhere and lives to be lost unnecessarily. saved and the answer to this question is in the plan before you first we have to establish a goal that will lead us to protect lives and accelerate recovery 40 this year 60 by the middle of next year instead of asking how much money we can raise we ask ourselves how much we can and should spend to reach that goal and what would be necessary in producing vaccines, reallocating excess vaccines so we can protect against new variants, and disseminating protective measures that lie between receiving the vaccines and now so that we can collectively do the best work we see now.

In countries that are successful, the answer to the right question is that we are pushing hard for all of us to come together and provide this to the world and I am confident that we can do it. I'm also very encouraged by the interest. We have seen that plan all over the world, it is a multifaceted plan that requires all hands on deck and I promise you that each and every one of the hands of the IMF is on this platform. Thank you very much for this and thank you very much to everyone. Thank you very much for your participation now before I turn back to Dr.

Tedros for his final comments. We will send the audio files and Dr. Tedros' comments immediately after the press conference and of course the full transcript will be available starting tomorrow on our WJO website. If you have any other follow-up questions, please email media inquiries at w dot int and you will also receive the press release with the press contacts for the other organizations below with this dr. Teddrus, thank you, thank you very much, Christian. I would like to start by thanking christalina angozi and david, thank you very much, in fact, I think that this joint effort, I know it will help us defeat this pandemic, I think it has already been said, but I will repeat it, perhaps explaining to you how.

Well, you know, what we're proposing can actually work because it works in countries where vaccination coverage is better, that is, in high-income countries where access to the vaccine is better and those that have vaccinated a significant proportion of Its population is in the coveted situation. is declining or the number of cases and this is declining significantly in some countries it is actually a nosedive so we have both that's why we said we have the public health measures at hand that have been working in many countries and now we have the additional tool, the vaccine. If we get to work, we can end this pandemic quickly and free this world from this terrible virus and the only thing that remains is, as we have said, the willingness to really use the tools and share the technology that we have, share the finances we have.

We have and this is of interest to all nations, whether they are low, middle or high income countries, as Cristalina and other colleagues put it, clearly the world could recover faster and all countries can benefit from that rapid recovery with this small investment, so the message is very very clear, so we ask you, I join my colleagues, I ask especially high-income countries to share what they have and also to help boost production and have better access to vaccines and we like what we see in high-income countries, the situation in low and middle countries. Income countries can also improve significantly so that the world can open up everywhere, so many thanks again colleagues and I look forward to working closely with you to make this proposal a reality and many thanks especially to the IMF to Crystalina for putting this proposal together and I think this can really open up the world by ending the pandemic, so thank you very much for that.

I also thank the media who joined today and look forward to seeing you at our next press. Thank you.