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[Music]

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hello bonjour in ahoy

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i'm roger hilton defense and security

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research fellow at globetech

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coming to you live from the 2021

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globetech bratislava forum

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it's day one and it's my pleasure in the

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future for the next three days to be

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bringing you video highlights

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recaps and all of the major updates from

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our international conference

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we have a rockstar lineup of speakers

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and moderators and we really hope you

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look forward to watching us in the

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future

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we started bright and early with our

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annual european defense roundtable

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and launched globesec's future security

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and defense council

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following the official welcome presented

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by our masters of ceremony

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we heard a keynote from slovakian

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president suzanne chaputova

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on building back better we were then

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privileged to hear a video message

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from his holiness pope francis who spoke

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to our world audience

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on the merits of hard work and

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compassion

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staying in central and eastern europe

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both the president of poland and croatia

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delivered keynotes and stressed the need

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for global solidarity

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in times of crisis shifting to a topic

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of the future

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an energetic debate on the state of the

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future of transatlantic relations in the

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digital sphere took place

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while on our second stage the global

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perspectives on how to fight kovid and

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emerge from the pandemic stronger

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also happened finally to wrap up the day

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the prime ministers of austria and

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slovakia

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as well as the deputy prime minister of

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czechia discussed the european recovery

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plan and how to jump start the

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continental economy

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for more information on our other

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world-class panels

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make sure to check our website and our

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various social media channels on

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facebook and instagram

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see you on day 2.

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[Music]

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[Applause]

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[Music]

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ladies and gentlemen welcome the

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moderator of the first session of day

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two

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sarah wheaton

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good morning everybody thank you for

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joining us bright and early for this

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panel on redesigning healthcare systems

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in the wake of

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coven 19. and before we get started with

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our panel

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i would like to introduce his excellency

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vladimir

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lengvarsky he's the health minister of

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slovakia

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please

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nice to meet you please take the podium

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ladies and gentlemen distinguished

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guests

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it's the great honor for me to be here

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on this great globe sec forum

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and i'm pleased to address you today

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with the remarks on the lessons learned

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and the way forward especially in terms

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of reshaping the health care

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system it is

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doubtless that the resilience of the

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health system has been strongly

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challenged

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by the outset of the pandemic however a

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concise approach to health policy

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enables

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us to bounce back and regain lost

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grounds

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the health emergency has also caused

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that the house architecture

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has been put in the spotlight with the

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adamant call of

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its re adjustment first of all

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the pandemic has shown that we have to

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review the approach to preparedness and

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strength strengthen

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the precautionary measures

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by taking into account to two key

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factors the adaptive

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ability of health system and the

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importance of considering the

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socio-economic challenges

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from this perspective the social

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determinants of the health

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will shape a major impact on the ability

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to reduce health

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inquires secondly this pandemic has

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widely exposed to the mental health

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related

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matters so that further investments

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in the strategy strategies centered at

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mental health

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is prominent and preventive measures

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will be crucial

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in eliminating the social pathologies

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derived from isolation a lack of social

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interaction

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thirdly it is indispensable to look

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further towards to data

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harmonization so that reporting is

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performed

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in a unified way and the equal

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indicators

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are being reported at international

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level

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the importance the importance of having

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an accurate data is critical

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in the moment of making responsible

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decisions

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in order to reach the correspondent and

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prevent

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the potential third way third wave from

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bringing another standstill

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we have to implement technologies which

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have brought considerable results

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such as waste border tasting for

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revealing the concentrated incidence of

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the coronavirus infection

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as well as sharing the best practice and

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fostering expert

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exchanges alongside facing new variants

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increased sequencing capacities

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capacities

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are inevitable also with regard to

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travel related summer season

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speaking about the collective immunity

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the key role

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has to be attributed to targeted

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vaccination campaign

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for the purpose of raising awareness

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minimizing the vaccine hesitancy

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and even tackling the misinformation

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on a broader scale and from the

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strategic point of view

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the hospital network optimization is

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another important step

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which will largely contribute to

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healthcare performance improvement

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moreover it is designed in a way that it

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will bring about

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not only the high quality but also

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accessible healthcare for the patients

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on the site of dignified working

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conditions for the healthcare

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professionals

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on the other apart of

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apart from that it will also reinforce

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the long term

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and after care as well as provide better

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conditions for the patients suffering

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from the chronic diseases

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lastly in light of today interconnected

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world

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the effort of tackle efficiently the

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presence health emergency have to

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orchestrate it globally in the close

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cooperation with the world health

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organization

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which stands as a strategic health

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pillar with mandated governance

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in the european union as the cornerstone

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of partnership and trust because

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the only road to the future is the road

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taken together thank you for your

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attention you so much mr health minister

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for joining us

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we know that you have a very busy

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schedule so we will forgive you if you

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can't stay for the

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for the panel

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[Music]

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[Applause]

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[Music]

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all right and without further ado on

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with the on with the panel

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so um joining us online we have two

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participants

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franchesca colombo she is the head of

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the health division at the oecd

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we have johanna hanefeld who is joining

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us from berlin

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and she is the head of international

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health protection at the robert koch

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institute in

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germany here with me

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i have martin smatana he's the associate

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fellow for economic growth and

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sustainability program here at globe sac

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and gabriella grom is public policy lead

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for the mid-europe region

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at msd so thanks to all of you thanks to

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all of you for being here in person

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thanks to those of you who are watching

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online uh and i like to keep things

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interactive so you have several

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different ways to engage

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and ask questions for those of you who

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are in the room you can raise your hand

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and once i give you the floor you can go

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up to the microphone here

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you can also use the globesac app which

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has a way to type your questions using

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slido

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um and if any of you are connected by a

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zoom to the virtual studio that's also a

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way

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to ask a question so actually let's

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let's kick things off

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um with a poll to help you

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you know get warmed up with with slido

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um

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so just to kind of set the stage um we

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have a poll

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about where i want to hear your view

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about what will be the most

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important urgent challenge for

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healthcare systems over the next

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three years so in this kind of postcovid

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recovery period

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so covet induced backlog of chronic

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disease management

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antimicrobial resistance mental health

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long-term care and preparing for the

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next pandemic so let me know what's most

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urgent

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in your view and we'll check back in

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with the results later

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um and francesca if i could actually go

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ahead and start with you

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on that long-term care point i know that

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the the oecd

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recently did um did a study uh

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of huge survey of european uh or no

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i'm sorry not european citizens people

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around the oecd countries

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and long-term care emerged as as uh kind

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of a pretty big concern no

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sure absolutely and i think uh the

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pre-existing

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weaknesses in the uh aged care sector

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and the long-term

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care sector have been brought to the

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fore really by

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the pandemic because let's remember that

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those who

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suffer the most in terms of death but

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also in terms

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of the most serious conditions are the

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people who are

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elderly the people with preexisting

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conditions with the people

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with with health issues and

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unfortunately the sector the

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the aged care sector was already prior

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to the pandemic

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characterized by some structural

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weaknesses

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in terms of quality assurance mechanism

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in terms of availability of enough and

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also trained health professionals and

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workforce in terms

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also of infection control systems

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so i think the pandemic and that's the

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case for the elderly care sector the

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long-term care center

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you mentioned but it's probably more of

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a broader point the pandemic has

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revealed some

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some pre-existing weaknesses of our

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health system

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and brought to the fore the need really

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00:11:10,399 --> 00:11:12,000
to address and improve

295
00:11:12,000 --> 00:11:14,000
um you know the why health system work

296
00:11:14,000 --> 00:11:16,000
for the future

297
00:11:16,000 --> 00:11:19,519
thanks and and gabriella um

298
00:11:19,519 --> 00:11:22,399
as far as as managing these chronic

299
00:11:22,399 --> 00:11:23,519
conditions

300
00:11:23,519 --> 00:11:24,959
you know what should we be thinking

301
00:11:24,959 --> 00:11:26,959
about as people kind of emerge maybe

302
00:11:26,959 --> 00:11:28,079
feel safe

303
00:11:28,079 --> 00:11:30,480
uh going to a doctor without a mask on

304
00:11:30,480 --> 00:11:31,680
that sort of thing

305
00:11:31,680 --> 00:11:34,800
yeah so i think first of all it's uh

306
00:11:34,800 --> 00:11:37,200
it's um i i see that there is a lot of

307
00:11:37,200 --> 00:11:39,120
impact on the crisis

308
00:11:39,120 --> 00:11:41,680
from the pandemic in a negative way and

309
00:11:41,680 --> 00:11:43,440
we need to restart therapy

310
00:11:43,440 --> 00:11:46,399
so we have seen that for example the

311
00:11:46,399 --> 00:11:48,720
number of diagnosis in cancer

312
00:11:48,720 --> 00:11:51,440
went down by 40 percent which puts a

313
00:11:51,440 --> 00:11:52,959
huge backlog in place

314
00:11:52,959 --> 00:11:55,279
of when we think about patients which

315
00:11:55,279 --> 00:11:57,279
are not taken care of

316
00:11:57,279 --> 00:12:00,320
patients which especially in oncological

317
00:12:00,320 --> 00:12:02,720
conditions come too late potentially for

318
00:12:02,720 --> 00:12:04,720
their treatment or for a

319
00:12:04,720 --> 00:12:07,839
kind of a good kind of course of the

320
00:12:07,839 --> 00:12:09,440
disease

321
00:12:09,440 --> 00:12:12,880
disease and cure men so i think

322
00:12:12,880 --> 00:12:15,440
we now are in a situation that we need

323
00:12:15,440 --> 00:12:17,040
to restart things as

324
00:12:17,040 --> 00:12:20,000
far as fast as possible and that goes

325
00:12:20,000 --> 00:12:20,320
for

326
00:12:20,320 --> 00:12:24,240
chronic uh patients as well as also for

327
00:12:24,240 --> 00:12:27,440
for patients with acute diseases on the

328
00:12:27,440 --> 00:12:28,480
other hand i see

329
00:12:28,480 --> 00:12:30,880
also that it's a huge opportunity to

330
00:12:30,880 --> 00:12:32,079
think about

331
00:12:32,079 --> 00:12:35,440
our prevention goals and how much we

332
00:12:35,440 --> 00:12:37,839
think about prevention how much we think

333
00:12:37,839 --> 00:12:39,200
about

334
00:12:39,200 --> 00:12:42,399
immunization overall uh in

335
00:12:42,399 --> 00:12:44,399
under normal conditions so now we of

336
00:12:44,399 --> 00:12:46,240
course we have to clean up all what the

337
00:12:46,240 --> 00:12:48,320
the pandemic costs but at the same time

338
00:12:48,320 --> 00:12:49,920
we need to look into

339
00:12:49,920 --> 00:12:52,480
what were the areas which came out now

340
00:12:52,480 --> 00:12:54,639
that have not been so strong in our

341
00:12:54,639 --> 00:12:56,240
health care systems

342
00:12:56,240 --> 00:12:59,040
and this is this is not only treatment

343
00:12:59,040 --> 00:13:00,720
but it's also prevention

344
00:13:00,720 --> 00:13:03,040
so it's both angles which we need to be

345
00:13:03,040 --> 00:13:04,800
very clear on

346
00:13:04,800 --> 00:13:06,160
and martin you've been taking a close

347
00:13:06,160 --> 00:13:07,600
look at some of the lessons that we that

348
00:13:07,600 --> 00:13:08,800
we can already learn

349
00:13:08,800 --> 00:13:10,880
and and you've seen some things some

350
00:13:10,880 --> 00:13:12,160
you've learned some things already about

351
00:13:12,160 --> 00:13:13,040
kind of

352
00:13:13,040 --> 00:13:15,600
the importance of of prevention and

353
00:13:15,600 --> 00:13:17,279
having kind of a good baseline of

354
00:13:17,279 --> 00:13:20,000
of health care right um yes so at

355
00:13:20,000 --> 00:13:20,959
lobster we've

356
00:13:20,959 --> 00:13:22,399
been working on paper which summarizes

357
00:13:22,399 --> 00:13:24,160
lessons learned and

358
00:13:24,160 --> 00:13:25,839
one of them and just to continue

359
00:13:25,839 --> 00:13:27,760
gabriel's ideas was that

360
00:13:27,760 --> 00:13:29,120
when we look into the most successful

361
00:13:29,120 --> 00:13:30,720
countries we figure out that in most

362
00:13:30,720 --> 00:13:31,680
cases they have

363
00:13:31,680 --> 00:13:33,279
several trades in common and one of them

364
00:13:33,279 --> 00:13:35,360
was that they really ramped up the

365
00:13:35,360 --> 00:13:37,680
their diagnostic capacities right so

366
00:13:37,680 --> 00:13:39,519
just to expand it uh in terms of the

367
00:13:39,519 --> 00:13:40,800
number of tests done they made it

368
00:13:40,800 --> 00:13:42,240
affordably accessible

369
00:13:42,240 --> 00:13:43,839
and well all you need to do is just

370
00:13:43,839 --> 00:13:45,440
replace copied with

371
00:13:45,440 --> 00:13:47,360
breast cancer or prostate cancer because

372
00:13:47,360 --> 00:13:48,720
it is virtually the same

373
00:13:48,720 --> 00:13:51,279
the successful management depends uh if

374
00:13:51,279 --> 00:13:53,600
you can catch the disease at early stage

375
00:13:53,600 --> 00:13:54,639
which is linked to the

376
00:13:54,639 --> 00:13:57,040
the diagnostics and the secondly uh and

377
00:13:57,040 --> 00:13:58,639
this is one of the very few positives of

378
00:13:58,639 --> 00:14:00,480
kovit is that illustrated that

379
00:14:00,480 --> 00:14:02,800
heavy investment will repay in time the

380
00:14:02,800 --> 00:14:04,320
only difference between kovit and

381
00:14:04,320 --> 00:14:06,399
stabilization diseases is actually that

382
00:14:06,399 --> 00:14:07,839
kovitt fast forwarded

383
00:14:07,839 --> 00:14:09,440
um the relationship between a risk

384
00:14:09,440 --> 00:14:11,360
factor diagnostics and

385
00:14:11,360 --> 00:14:13,839
and actually a result uh which is uh

386
00:14:13,839 --> 00:14:15,600
either hospitalization and the death

387
00:14:15,600 --> 00:14:18,959
so kowitz showed us that it can work and

388
00:14:18,959 --> 00:14:21,440
it actually brings return on money which

389
00:14:21,440 --> 00:14:23,279
is in most cases the reasons why

390
00:14:23,279 --> 00:14:26,079
payers or ministries refuse to to invest

391
00:14:26,079 --> 00:14:28,000
because all they see is that i will

392
00:14:28,000 --> 00:14:29,920
do and pay 50 tests and i will find just

393
00:14:29,920 --> 00:14:31,920
one positive but kovy demonstrated

394
00:14:31,920 --> 00:14:33,519
clearly that it is worth it

395
00:14:33,519 --> 00:14:36,000
all we need to do is just to make it uh

396
00:14:36,000 --> 00:14:36,880
accessible

397
00:14:36,880 --> 00:14:39,519
uh affordable and uh well let's say

398
00:14:39,519 --> 00:14:40,959
strategically placed within the health

399
00:14:40,959 --> 00:14:42,160
system

400
00:14:42,160 --> 00:14:45,760
and and do you have a clear sense of of

401
00:14:45,760 --> 00:14:49,120
where europe is as as far as advancing

402
00:14:49,120 --> 00:14:50,880
their diagnostic capacity and

403
00:14:50,880 --> 00:14:53,360
are things equally kind of in an equal

404
00:14:53,360 --> 00:14:54,320
situation or

405
00:14:54,320 --> 00:14:57,360
are are they are are we seeing east-west

406
00:14:57,360 --> 00:14:58,880
divides north-south what's going on

407
00:14:58,880 --> 00:14:59,279
there

408
00:14:59,279 --> 00:15:00,880
well unfortunately this is not something

409
00:15:00,880 --> 00:15:02,320
that will be unified even though there

410
00:15:02,320 --> 00:15:03,279
are some attempts

411
00:15:03,279 --> 00:15:04,720
and this is another large lessons

412
00:15:04,720 --> 00:15:06,639
learned i really strongly believe and

413
00:15:06,639 --> 00:15:08,000
there is a strong opinion that eu

414
00:15:08,000 --> 00:15:09,199
commission should

415
00:15:09,199 --> 00:15:11,120
have let's say greater world in health

416
00:15:11,120 --> 00:15:12,399
policies and health management health

417
00:15:12,399 --> 00:15:14,000
system and which is rather funny coming

418
00:15:14,000 --> 00:15:15,680
from me because i was a member of

419
00:15:15,680 --> 00:15:17,040
social protection committee on behalf of

420
00:15:17,040 --> 00:15:18,800
slovakia for five years and i was one of

421
00:15:18,800 --> 00:15:20,000
the guys who really struggled to make

422
00:15:20,000 --> 00:15:21,519
sure that eu commission does not have a

423
00:15:21,519 --> 00:15:22,480
strong word

424
00:15:22,480 --> 00:15:25,600
but pandemic showed us that we need a

425
00:15:25,600 --> 00:15:27,440
unified unified approach rather than

426
00:15:27,440 --> 00:15:28,880
some disconnected strategies

427
00:15:28,880 --> 00:15:31,120
including diagnostics because i think

428
00:15:31,120 --> 00:15:32,560
that ministries

429
00:15:32,560 --> 00:15:34,079
and prime ministers need to hear from

430
00:15:34,079 --> 00:15:36,240
the top that this is a priorities works

431
00:15:36,240 --> 00:15:37,600
and you need to find funding

432
00:15:37,600 --> 00:15:39,040
because exactly as you said there is a

433
00:15:39,040 --> 00:15:41,040
great this connection between uh

434
00:15:41,040 --> 00:15:43,440
what type of tests are available uh what

435
00:15:43,440 --> 00:15:44,160
age groups

436
00:15:44,160 --> 00:15:46,959
can get the test uh starting with uh

437
00:15:46,959 --> 00:15:48,720
genetics and genomics ending with

438
00:15:48,720 --> 00:15:51,040
all cities and mris you can imagine so

439
00:15:51,040 --> 00:15:53,120
unfortunately there is a great uh

440
00:15:53,120 --> 00:15:55,360
variance and this need to be tackled

441
00:15:55,360 --> 00:15:56,720
well i want to put a bookmark

442
00:15:56,720 --> 00:15:59,199
in that idea of a health union um and

443
00:15:59,199 --> 00:16:00,160
but gabriella

444
00:16:00,160 --> 00:16:01,519
definitely had some thoughts on the

445
00:16:01,519 --> 00:16:03,839
apartment and i really wanted to

446
00:16:03,839 --> 00:16:05,839
to contribute with this because what we

447
00:16:05,839 --> 00:16:08,560
did we have collected some data

448
00:16:08,560 --> 00:16:10,880
and the data is about how long it takes

449
00:16:10,880 --> 00:16:12,000
for a patient

450
00:16:12,000 --> 00:16:13,839
from the first time when you see the

451
00:16:13,839 --> 00:16:15,600
first symptoms for example if you have

452
00:16:15,600 --> 00:16:17,839
lung cancer if you start to cut to cuff

453
00:16:17,839 --> 00:16:18,880
and so on

454
00:16:18,880 --> 00:16:21,040
to the time when you really get the

455
00:16:21,040 --> 00:16:22,480
treatment you need

456
00:16:22,480 --> 00:16:25,040
and we have screened it across europe

457
00:16:25,040 --> 00:16:27,360
and we see that especially in central

458
00:16:27,360 --> 00:16:28,480
eastern europe

459
00:16:28,480 --> 00:16:31,839
we see long long times until

460
00:16:31,839 --> 00:16:33,920
from the moment the patient presents for

461
00:16:33,920 --> 00:16:36,160
the first time for example at a gp

462
00:16:36,160 --> 00:16:38,560
until he or she gets the treatment she

463
00:16:38,560 --> 00:16:39,680
needs

464
00:16:39,680 --> 00:16:42,959
it can take up to 300 days

465
00:16:42,959 --> 00:16:46,560
and if you think about especially cancer

466
00:16:46,560 --> 00:16:49,839
time is really everything if you have

467
00:16:49,839 --> 00:16:52,000
delays in your diagnosis

468
00:16:52,000 --> 00:16:54,480
uh if you have delays in your next

469
00:16:54,480 --> 00:16:56,560
referral that you need to go to another

470
00:16:56,560 --> 00:16:58,240
center because you're not sitting at the

471
00:16:58,240 --> 00:16:59,519
same pace

472
00:16:59,519 --> 00:17:02,800
at the sa at the right place if your gp

473
00:17:02,800 --> 00:17:04,160
doesn't really

474
00:17:04,160 --> 00:17:06,640
understand what needs to be done next

475
00:17:06,640 --> 00:17:08,720
and is delaying the process

476
00:17:08,720 --> 00:17:11,599
this can be actually the death sentence

477
00:17:11,599 --> 00:17:13,039
for the patients

478
00:17:13,039 --> 00:17:15,679
and that's exactly why we need to speed

479
00:17:15,679 --> 00:17:18,559
up and accelerate and create clarity in

480
00:17:18,559 --> 00:17:20,240
all this patient journey

481
00:17:20,240 --> 00:17:22,959
including testing including the proper

482
00:17:22,959 --> 00:17:25,520
diagnosis at the right time

483
00:17:25,520 --> 00:17:27,679
and this is where we also create really

484
00:17:27,679 --> 00:17:29,760
the value for the patient by the end of

485
00:17:29,760 --> 00:17:30,880
the day

486
00:17:30,880 --> 00:17:33,679
and do we have a sense of i mean do we

487
00:17:33,679 --> 00:17:35,120
just need to throw more money in is

488
00:17:35,120 --> 00:17:36,799
there other some sort of health system

489
00:17:36,799 --> 00:17:37,919
reform or

490
00:17:37,919 --> 00:17:40,720
i think there is reform needed uh it's

491
00:17:40,720 --> 00:17:42,160
also money needed so

492
00:17:42,160 --> 00:17:44,960
it it starts with creating clear clarity

493
00:17:44,960 --> 00:17:46,240
on standards

494
00:17:46,240 --> 00:17:49,679
clarity or for the patient clarity in

495
00:17:49,679 --> 00:17:51,760
the pathway the patient has to go

496
00:17:51,760 --> 00:17:54,720
but also a lot of education on the side

497
00:17:54,720 --> 00:17:55,679
of

498
00:17:55,679 --> 00:17:58,400
of the medical community but also on the

499
00:17:58,400 --> 00:17:59,039
paid uh

500
00:17:59,039 --> 00:18:01,679
the site of patients to really help to

501
00:18:01,679 --> 00:18:02,640
get through

502
00:18:02,640 --> 00:18:05,919
this process and currently in many

503
00:18:05,919 --> 00:18:07,520
countries it's a jungle

504
00:18:07,520 --> 00:18:09,600
and the patient goes back and forward

505
00:18:09,600 --> 00:18:11,600
and if if there is a certain kind of

506
00:18:11,600 --> 00:18:12,000
test

507
00:18:12,000 --> 00:18:14,240
needed it takes three or three weeks to

508
00:18:14,240 --> 00:18:15,440
get the result

509
00:18:15,440 --> 00:18:17,360
then it comes out that there is another

510
00:18:17,360 --> 00:18:19,200
test needed because

511
00:18:19,200 --> 00:18:22,799
potentially the uh the the specific

512
00:18:22,799 --> 00:18:25,679
specimen is not not enough and so on so

513
00:18:25,679 --> 00:18:26,480
it's a

514
00:18:26,480 --> 00:18:28,559
and all of that needs to be streamlined

515
00:18:28,559 --> 00:18:30,160
according to let's say

516
00:18:30,160 --> 00:18:33,200
best medical practice

517
00:18:33,200 --> 00:18:35,520
francesca what broad trends are you

518
00:18:35,520 --> 00:18:36,799
seeing as far as

519
00:18:36,799 --> 00:18:39,520
as health system investment and is there

520
00:18:39,520 --> 00:18:41,360
any particular system that maybe is

521
00:18:41,360 --> 00:18:42,000
getting the best

522
00:18:42,000 --> 00:18:43,679
bang for the buck maybe they don't

523
00:18:43,679 --> 00:18:45,760
actually spend the most per person but

524
00:18:45,760 --> 00:18:49,440
they they have very good health outcomes

525
00:18:49,440 --> 00:18:50,960
very difficult to say because actually

526
00:18:50,960 --> 00:18:53,600
across you know all health system

527
00:18:53,600 --> 00:18:55,600
in oecd countries around the world there

528
00:18:55,600 --> 00:18:56,960
are

529
00:18:56,960 --> 00:18:58,559
areas in which perhaps there are

530
00:18:58,559 --> 00:19:00,400
excellence but also in the same health

531
00:19:00,400 --> 00:19:02,000
system you will find

532
00:19:02,000 --> 00:19:04,640
a lot of inefficiencies and waste that

533
00:19:04,640 --> 00:19:05,520
happens

534
00:19:05,520 --> 00:19:07,440
and so it's very difficult to say which

535
00:19:07,440 --> 00:19:09,120
countries gets getting best

536
00:19:09,120 --> 00:19:11,039
certainly i think there are some

537
00:19:11,039 --> 00:19:12,880
messages that come out from the crisis

538
00:19:12,880 --> 00:19:13,760
the first one

539
00:19:13,760 --> 00:19:15,440
it has been mentioned yes we do need to

540
00:19:15,440 --> 00:19:17,840
invest more in in health systems and

541
00:19:17,840 --> 00:19:19,919
it's quite clear there are some critical

542
00:19:19,919 --> 00:19:21,760
areas of under investment

543
00:19:21,760 --> 00:19:24,240
um prevention that was mentioned uh if

544
00:19:24,240 --> 00:19:25,039
we look across

545
00:19:25,039 --> 00:19:27,200
countries it's only three percent of

546
00:19:27,200 --> 00:19:29,039
total health budgets which are actually

547
00:19:29,039 --> 00:19:30,400
devoted to prevention

548
00:19:30,400 --> 00:19:32,400
so quite clearly we're not creating that

549
00:19:32,400 --> 00:19:34,559
resilience in populations

550
00:19:34,559 --> 00:19:37,600
by addressing uh underlying risk factors

551
00:19:37,600 --> 00:19:38,480
by

552
00:19:38,480 --> 00:19:40,320
addressing some of the social broader

553
00:19:40,320 --> 00:19:41,600
social determinants

554
00:19:41,600 --> 00:19:43,039
of health as was mentioned by the

555
00:19:43,039 --> 00:19:45,200
minister as well that will allow us to

556
00:19:45,200 --> 00:19:46,559
be much better prepared

557
00:19:46,559 --> 00:19:49,360
to deal both with an infectious disease

558
00:19:49,360 --> 00:19:50,960
and with

559
00:19:50,960 --> 00:19:53,919
long and disabling um chronic conditions

560
00:19:53,919 --> 00:19:54,880
so that's one thing

561
00:19:54,880 --> 00:19:56,400
you know we do need to invest more we

562
00:19:56,400 --> 00:19:57,679
need to invest more in prevention we

563
00:19:57,679 --> 00:19:58,799
need to invest more in

564
00:19:58,799 --> 00:20:01,520
better data systems it's unbelievable

565
00:20:01,520 --> 00:20:01,919
how

566
00:20:01,919 --> 00:20:05,120
health are still stuck in uh you know in

567
00:20:05,120 --> 00:20:06,960
the previous century in terms of

568
00:20:06,960 --> 00:20:09,280
the digital transformations in terms of

569
00:20:09,280 --> 00:20:10,880
using data to understand

570
00:20:10,880 --> 00:20:14,320
the pathway of care of an individual

571
00:20:14,320 --> 00:20:16,720
in terms of linking data sets across

572
00:20:16,720 --> 00:20:18,400
different parts of the whole system

573
00:20:18,400 --> 00:20:20,400
for improving not just quality but also

574
00:20:20,400 --> 00:20:22,480
the governance of the system

575
00:20:22,480 --> 00:20:25,600
the research uh the the empowerment and

576
00:20:25,600 --> 00:20:27,200
the people centeredness and so forth so

577
00:20:27,200 --> 00:20:28,799
huge opportunities from data but we're

578
00:20:28,799 --> 00:20:29,600
not using it

579
00:20:29,600 --> 00:20:31,440
and all of that does require uh

580
00:20:31,440 --> 00:20:32,880
additional investments

581
00:20:32,880 --> 00:20:34,720
at the same time we probably need to do

582
00:20:34,720 --> 00:20:36,480
things differently we need to make sure

583
00:20:36,480 --> 00:20:37,679
that where there are

584
00:20:37,679 --> 00:20:40,159
instances in which we have spending that

585
00:20:40,159 --> 00:20:41,360
does not deliver

586
00:20:41,360 --> 00:20:43,919
any value we address that you know

587
00:20:43,919 --> 00:20:44,960
medical errors

588
00:20:44,960 --> 00:20:47,919
uh which in many cases can be prevented

589
00:20:47,919 --> 00:20:49,679
can be addressed and those are not

590
00:20:49,679 --> 00:20:51,440
creating any value for health system of

591
00:20:51,440 --> 00:20:53,120
course so we can redirect

592
00:20:53,120 --> 00:20:54,960
resources rather than addressing a

593
00:20:54,960 --> 00:20:56,960
medical error to really making sure they

594
00:20:56,960 --> 00:20:57,600
improve

595
00:20:57,600 --> 00:21:00,240
outcomes and and value and we need to

596
00:21:00,240 --> 00:21:02,400
think also a health system which much

597
00:21:02,400 --> 00:21:03,600
more fluid

598
00:21:03,600 --> 00:21:06,320
with a strong clearly primary healthcare

599
00:21:06,320 --> 00:21:07,120
you know it's like

600
00:21:07,120 --> 00:21:09,280
from prevention people are taking care

601
00:21:09,280 --> 00:21:10,159
early on in

602
00:21:10,159 --> 00:21:13,200
in their uh journey um and

603
00:21:13,200 --> 00:21:15,840
and making sure that the risks move also

604
00:21:15,840 --> 00:21:17,280
functioning of the health system

605
00:21:17,280 --> 00:21:18,880
across different different parts and

606
00:21:18,880 --> 00:21:20,960
different silos so there is both

607
00:21:20,960 --> 00:21:23,919
these needs of investing more but also

608
00:21:23,919 --> 00:21:24,720
addressing

609
00:21:24,720 --> 00:21:27,120
uh some of the clear weaknesses which

610
00:21:27,120 --> 00:21:27,919
pre-existed

611
00:21:27,919 --> 00:21:30,080
as i mentioned the kubernetes crisis but

612
00:21:30,080 --> 00:21:31,919
the crisis has made it even more

613
00:21:31,919 --> 00:21:34,960
um more prominent

614
00:21:34,960 --> 00:21:36,799
uh obviously there is quite a lot that

615
00:21:36,799 --> 00:21:38,159
needs to be done to make sure that we

616
00:21:38,159 --> 00:21:39,600
are ready also for

617
00:21:39,600 --> 00:21:41,600
an infectious disease and the pandemic

618
00:21:41,600 --> 00:21:43,679
of uh the scale and proportion of what

619
00:21:43,679 --> 00:21:44,799
we have seen and

620
00:21:44,799 --> 00:21:47,120
that requires all sorts of things to be

621
00:21:47,120 --> 00:21:48,240
done at the global

622
00:21:48,240 --> 00:21:51,039
level as well as the national level

623
00:21:51,039 --> 00:21:51,840
thank you and

624
00:21:51,840 --> 00:21:53,600
and johanna i think we have your

625
00:21:53,600 --> 00:21:56,840
connection working working well at this

626
00:21:56,840 --> 00:21:59,840
point

627
00:22:01,280 --> 00:22:03,760
um let's let's pick up on on one of the

628
00:22:03,760 --> 00:22:06,000
points that um that francesca just made

629
00:22:06,000 --> 00:22:07,039
about um

630
00:22:07,039 --> 00:22:09,360
uh digitalization and i know that that

631
00:22:09,360 --> 00:22:11,039
even before the pandemic that was kind

632
00:22:11,039 --> 00:22:12,080
of a big

633
00:22:12,080 --> 00:22:13,919
mission of the of the german health

634
00:22:13,919 --> 00:22:15,120
system um

635
00:22:15,120 --> 00:22:17,520
so how is that going and has it been

636
00:22:17,520 --> 00:22:18,320
sped along

637
00:22:18,320 --> 00:22:20,480
by the pandemic or is it still kind of

638
00:22:20,480 --> 00:22:23,440
in the same going at the same pace

639
00:22:23,440 --> 00:22:25,280
no i do think we have seen a lot of

640
00:22:25,280 --> 00:22:27,440
innovation during the pandemic and in

641
00:22:27,440 --> 00:22:29,039
some sense this has been a window of

642
00:22:29,039 --> 00:22:30,799
opportunity i think to

643
00:22:30,799 --> 00:22:33,280
to innovate at a pace that would not

644
00:22:33,280 --> 00:22:35,280
otherwise have been possible

645
00:22:35,280 --> 00:22:37,360
so i think we have seen digital

646
00:22:37,360 --> 00:22:38,799
solutions we've seen the

647
00:22:38,799 --> 00:22:40,799
we've seen the use of of contract

648
00:22:40,799 --> 00:22:42,640
tracing apps for example

649
00:22:42,640 --> 00:22:46,000
but we've also seen uh some work around

650
00:22:46,000 --> 00:22:47,039
telemedicine

651
00:22:47,039 --> 00:22:50,159
in uh in lower income settings so

652
00:22:50,159 --> 00:22:51,520
so the center for international health

653
00:22:51,520 --> 00:22:54,080
protection that i lead uh would

654
00:22:54,080 --> 00:22:56,320
be able to support that and that's been

655
00:22:56,320 --> 00:22:58,080
that's really helped

656
00:22:58,080 --> 00:23:00,000
uh bringing some of the clinical skills

657
00:23:00,000 --> 00:23:02,080
to countries where where there was less

658
00:23:02,080 --> 00:23:03,679
experience and expertise are really

659
00:23:03,679 --> 00:23:05,919
sharing as the waves of the pandemic

660
00:23:05,919 --> 00:23:09,039
uh transform but for me i think uh

661
00:23:09,039 --> 00:23:10,880
that speaks to a broader lesson from

662
00:23:10,880 --> 00:23:12,799
this pandemic in many ways i think

663
00:23:12,799 --> 00:23:15,200
health systems people what we have seen

664
00:23:15,200 --> 00:23:16,880
is is that some of the systems we would

665
00:23:16,880 --> 00:23:18,799
have classified previously as high

666
00:23:18,799 --> 00:23:20,080
performing

667
00:23:20,080 --> 00:23:23,280
indeed not do so whereas others were

668
00:23:23,280 --> 00:23:24,960
able to do that and i think what that

669
00:23:24,960 --> 00:23:26,960
really has shown is that for systems to

670
00:23:26,960 --> 00:23:29,760
be resilient and to respond to a crisis

671
00:23:29,760 --> 00:23:30,000
or

672
00:23:30,000 --> 00:23:33,039
shock they need to be able not just to

673
00:23:33,039 --> 00:23:35,679
not just to respond but really to adopt

674
00:23:35,679 --> 00:23:36,400
adapt

675
00:23:36,400 --> 00:23:39,120
and to transform in that response and i

676
00:23:39,120 --> 00:23:40,080
think it's that

677
00:23:40,080 --> 00:23:42,240
transformative capacity that we need to

678
00:23:42,240 --> 00:23:43,919
invest in going forward

679
00:23:43,919 --> 00:23:46,000
so that includes the prevention that

680
00:23:46,000 --> 00:23:48,240
we've heard about that includes the

681
00:23:48,240 --> 00:23:50,320
strong emphasis on determinants that

682
00:23:50,320 --> 00:23:51,440
we've also

683
00:23:51,440 --> 00:23:53,840
uh that was also already mentioned but i

684
00:23:53,840 --> 00:23:55,600
think it's also been about

685
00:23:55,600 --> 00:23:58,159
creating space to innovate for

686
00:23:58,159 --> 00:23:59,679
healthcare workers

687
00:23:59,679 --> 00:24:02,400
and and i think there are examples from

688
00:24:02,400 --> 00:24:02,720
from

689
00:24:02,720 --> 00:24:05,039
individual health facilities all the way

690
00:24:05,039 --> 00:24:06,400
up through the health system that have

691
00:24:06,400 --> 00:24:07,440
really shown

692
00:24:07,440 --> 00:24:10,400
that this innovation capacity is quite

693
00:24:10,400 --> 00:24:11,919
essential and that there

694
00:24:11,919 --> 00:24:13,919
we need leadership and we need

695
00:24:13,919 --> 00:24:16,640
governance structures that enable that

696
00:24:16,640 --> 00:24:19,039
so yeah we hear we hear this idea of

697
00:24:19,039 --> 00:24:19,679
health

698
00:24:19,679 --> 00:24:22,640
transformation a lot and i've been

699
00:24:22,640 --> 00:24:24,080
covering health policy actually at the

700
00:24:24,080 --> 00:24:25,600
eu level for a long time and i still

701
00:24:25,600 --> 00:24:26,720
don't always

702
00:24:26,720 --> 00:24:28,400
totally have an idea of what that means

703
00:24:28,400 --> 00:24:29,840
uh

704
00:24:29,840 --> 00:24:32,080
joanna just gave us some examples of of

705
00:24:32,080 --> 00:24:33,200
her conception of it

706
00:24:33,200 --> 00:24:34,880
gabriella where did what what does

707
00:24:34,880 --> 00:24:36,559
health system transformation mean

708
00:24:36,559 --> 00:24:37,600
mean to you to get a little

709
00:24:37,600 --> 00:24:39,360
philosophical first thing in the morning

710
00:24:39,360 --> 00:24:41,360
so health system transformation so

711
00:24:41,360 --> 00:24:43,440
that's really about

712
00:24:43,440 --> 00:24:45,360
creating resilience in health system

713
00:24:45,360 --> 00:24:47,360
creating the flexibility which we just

714
00:24:47,360 --> 00:24:48,559
heard about

715
00:24:48,559 --> 00:24:51,760
but i think also innovation is a very

716
00:24:51,760 --> 00:24:53,360
important point here

717
00:24:53,360 --> 00:24:56,240
and it is innovation when it comes to

718
00:24:56,240 --> 00:24:57,919
applying new technologies

719
00:24:57,919 --> 00:25:00,400
it is innovation and to do maybe things

720
00:25:00,400 --> 00:25:01,600
differently also

721
00:25:01,600 --> 00:25:04,159
data and analytics will play a major

722
00:25:04,159 --> 00:25:05,440
role in the future

723
00:25:05,440 --> 00:25:08,400
and i think there's a huge potential uh

724
00:25:08,400 --> 00:25:10,799
to create efficiency in the systems and

725
00:25:10,799 --> 00:25:11,120
to

726
00:25:11,120 --> 00:25:14,240
create also better outcome for patients

727
00:25:14,240 --> 00:25:16,159
but i think also what we need to

728
00:25:16,159 --> 00:25:17,279
consider is

729
00:25:17,279 --> 00:25:19,360
innovation need to be accessible to

730
00:25:19,360 --> 00:25:20,400
patients

731
00:25:20,400 --> 00:25:22,799
and that's one of the other issues which

732
00:25:22,799 --> 00:25:24,159
we see in some of the

733
00:25:24,159 --> 00:25:27,120
of the of the current systems that there

734
00:25:27,120 --> 00:25:28,159
is too long

735
00:25:28,159 --> 00:25:30,400
wait time until patients can actually

736
00:25:30,400 --> 00:25:32,159
access and benefit from

737
00:25:32,159 --> 00:25:35,360
new uh innovations from new technologies

738
00:25:35,360 --> 00:25:37,919
uh after they have been brought to to

739
00:25:37,919 --> 00:25:39,120
approval to

740
00:25:39,120 --> 00:25:42,240
actually uh even in the european uh

741
00:25:42,240 --> 00:25:45,919
level we see that uh so far access is

742
00:25:45,919 --> 00:25:46,559
not

743
00:25:46,559 --> 00:25:50,000
let's say equal across eu and

744
00:25:50,000 --> 00:25:53,039
so it would be of course a desire to

745
00:25:53,039 --> 00:25:53,679
create

746
00:25:53,679 --> 00:25:56,000
equal opportunities in in kind of

747
00:25:56,000 --> 00:25:57,520
benefiting from

748
00:25:57,520 --> 00:26:00,080
a new innovation from new technology to

749
00:26:00,080 --> 00:26:02,080
all patients across europe

750
00:26:02,080 --> 00:26:05,120
and we see we see unfortunately

751
00:26:05,120 --> 00:26:08,320
also here more on the eastern european

752
00:26:08,320 --> 00:26:11,039
uh end that there are that there are

753
00:26:11,039 --> 00:26:12,159
serious delays

754
00:26:12,159 --> 00:26:14,960
until uh when patients or as of when

755
00:26:14,960 --> 00:26:16,240
patients can

756
00:26:16,240 --> 00:26:19,200
uh actually access and benefit from

757
00:26:19,200 --> 00:26:19,919
these uh

758
00:26:19,919 --> 00:26:21,840
innovations and there is a huge

759
00:26:21,840 --> 00:26:24,880
discrepancy versus western europe

760
00:26:24,880 --> 00:26:26,880
at the same time and i'm talking again

761
00:26:26,880 --> 00:26:27,919
with uh on

762
00:26:27,919 --> 00:26:30,720
on the example of oncology we see the

763
00:26:30,720 --> 00:26:32,240
highest mortality

764
00:26:32,240 --> 00:26:35,200
especially in countries where new

765
00:26:35,200 --> 00:26:36,559
technologies

766
00:26:36,559 --> 00:26:40,159
take longer to get to to be uh readily

767
00:26:40,159 --> 00:26:41,600
available to patients

768
00:26:41,600 --> 00:26:43,679
so there is a very clear connection

769
00:26:43,679 --> 00:26:46,960
between outcome and innovation so to say

770
00:26:46,960 --> 00:26:50,000
well and so i always if there's a if

771
00:26:50,000 --> 00:26:50,880
there's somebody who works in the

772
00:26:50,880 --> 00:26:52,320
pharmaceutical industry i have to ask

773
00:26:52,320 --> 00:26:53,760
them is this lack of access

774
00:26:53,760 --> 00:26:56,720
because prices are too high no i don't

775
00:26:56,720 --> 00:26:57,279
think so

776
00:26:57,279 --> 00:27:01,120
no i think there is today

777
00:27:01,200 --> 00:27:04,159
a kind of an ability to to actually

778
00:27:04,159 --> 00:27:04,880
discuss

779
00:27:04,880 --> 00:27:08,320
on specific kind of agreements and we

780
00:27:08,320 --> 00:27:10,320
are doing this as a company

781
00:27:10,320 --> 00:27:12,240
depending really on the need of the

782
00:27:12,240 --> 00:27:14,240
country so it's really target

783
00:27:14,240 --> 00:27:16,720
target made and we have many examples

784
00:27:16,720 --> 00:27:17,279
where

785
00:27:17,279 --> 00:27:20,080
we had been able to manage with many

786
00:27:20,080 --> 00:27:22,880
governments and all across europe

787
00:27:22,880 --> 00:27:26,720
in different also economic conditions

788
00:27:26,720 --> 00:27:30,080
to make products available and so very

789
00:27:30,080 --> 00:27:30,960
often we see

790
00:27:30,960 --> 00:27:34,159
a lot of a lot of bureaucracy is in the

791
00:27:34,159 --> 00:27:34,559
way

792
00:27:34,559 --> 00:27:37,279
a lot of very heavy bulky processes

793
00:27:37,279 --> 00:27:40,559
which doesn't make it easier and fast

794
00:27:40,559 --> 00:27:42,720
whereas in other environments we see

795
00:27:42,720 --> 00:27:44,559
that there is also here much more

796
00:27:44,559 --> 00:27:47,279
fluidity much more flexibility

797
00:27:47,279 --> 00:27:49,760
to actually think about what do we want

798
00:27:49,760 --> 00:27:50,960
to accomplish

799
00:27:50,960 --> 00:27:54,000
and then to to to find and develop a

800
00:27:54,000 --> 00:27:55,679
joint solution

801
00:27:55,679 --> 00:27:57,840
to actually serve the need of patients

802
00:27:57,840 --> 00:27:59,200
and

803
00:27:59,200 --> 00:28:01,679
there are countries which enable that

804
00:28:01,679 --> 00:28:03,760
which clearly also finally

805
00:28:03,760 --> 00:28:06,720
find the benefit so in oncology and i'm

806
00:28:06,720 --> 00:28:08,799
giving this example we have

807
00:28:08,799 --> 00:28:11,279
molecules which have different uh

808
00:28:11,279 --> 00:28:13,360
indications so it's the same molecule

809
00:28:13,360 --> 00:28:14,399
but you can

810
00:28:14,399 --> 00:28:17,039
today use it for or it had been approved

811
00:28:17,039 --> 00:28:19,279
for melanoma and the next day it's in

812
00:28:19,279 --> 00:28:21,520
in breast cancer and the third day it's

813
00:28:21,520 --> 00:28:23,360
somewhere else but it comes in different

814
00:28:23,360 --> 00:28:24,559
times

815
00:28:24,559 --> 00:28:27,600
and every time you come with a new kind

816
00:28:27,600 --> 00:28:30,320
of indication you need to go to the full

817
00:28:30,320 --> 00:28:32,240
process of reimbursement which takes of

818
00:28:32,240 --> 00:28:33,760
course many many months

819
00:28:33,760 --> 00:28:36,880
or even years and with this although you

820
00:28:36,880 --> 00:28:38,880
had already discussed some

821
00:28:38,880 --> 00:28:41,600
economic grounds on this molecule you

822
00:28:41,600 --> 00:28:43,200
still need to go through the same

823
00:28:43,200 --> 00:28:44,000
process and

824
00:28:44,000 --> 00:28:46,799
during that time imagine many many

825
00:28:46,799 --> 00:28:49,120
patients might have

826
00:28:49,120 --> 00:28:52,159
might have created a benefit from this

827
00:28:52,159 --> 00:28:55,360
product if they could have gotten it so

828
00:28:55,360 --> 00:28:58,399
we had an example in belgium where we

829
00:28:58,399 --> 00:28:59,679
were able to

830
00:28:59,679 --> 00:29:02,399
think about a long-term solution to come

831
00:29:02,399 --> 00:29:03,039
to bring

832
00:29:03,039 --> 00:29:05,440
all of these different indications under

833
00:29:05,440 --> 00:29:06,559
one roof

834
00:29:06,559 --> 00:29:08,720
and with this we created a massive

835
00:29:08,720 --> 00:29:10,080
impact in terms of

836
00:29:10,080 --> 00:29:12,320
patients how they could use it so

837
00:29:12,320 --> 00:29:13,200
instead of

838
00:29:13,200 --> 00:29:17,120
6 000 the patient lives impacted

839
00:29:17,120 --> 00:29:20,159
we were able to have 11 000 patients

840
00:29:20,159 --> 00:29:22,080
having a positive impact on

841
00:29:22,080 --> 00:29:24,799
on their life so this is the difference

842
00:29:24,799 --> 00:29:26,720
you can make through

843
00:29:26,720 --> 00:29:29,039
flexible processes through innovation

844
00:29:29,039 --> 00:29:30,640
through also of course

845
00:29:30,640 --> 00:29:33,520
discussion coming to the table trying to

846
00:29:33,520 --> 00:29:34,559
find solution

847
00:29:34,559 --> 00:29:36,799
uh in an in a in a partnership and i

848
00:29:36,799 --> 00:29:38,720
think that's very important

849
00:29:38,720 --> 00:29:40,559
and martin what are some of the lessons

850
00:29:40,559 --> 00:29:42,159
about transformation

851
00:29:42,159 --> 00:29:44,399
that that we've dr we can draw from from

852
00:29:44,399 --> 00:29:45,600
covid

853
00:29:45,600 --> 00:29:48,640
right so um let's say the person has

854
00:29:48,640 --> 00:29:51,360
a type 2 diabetes body mass index

855
00:29:51,360 --> 00:29:53,760
greater than 35

856
00:29:53,760 --> 00:29:56,000
hypertension he drinks smokes doesn't

857
00:29:56,000 --> 00:29:57,679
move so his likelihood of actually

858
00:29:57,679 --> 00:29:59,520
once getting a coffee to having a very

859
00:29:59,520 --> 00:30:01,520
serious case actually dying is

860
00:30:01,520 --> 00:30:03,600
a multiple of ten right and actually

861
00:30:03,600 --> 00:30:05,360
this the same applies to

862
00:30:05,360 --> 00:30:07,200
every other civilization disease to some

863
00:30:07,200 --> 00:30:08,799
extent to a great extent

864
00:30:08,799 --> 00:30:12,000
and the lesson learned is that um we

865
00:30:12,000 --> 00:30:15,279
actually we saw this in uh in uh

866
00:30:15,279 --> 00:30:17,919
in our on our own eyes on a daily basis

867
00:30:17,919 --> 00:30:18,399
and

868
00:30:18,399 --> 00:30:21,120
uh in order to make the leap we need to

869
00:30:21,120 --> 00:30:22,640
make we need to make sure that people

870
00:30:22,640 --> 00:30:23,520
who actually

871
00:30:23,520 --> 00:30:25,919
are staying healthy are trying to uh

872
00:30:25,919 --> 00:30:27,200
improve their health are

873
00:30:27,200 --> 00:30:29,760
to some extent benefited because it is i

874
00:30:29,760 --> 00:30:30,240
know that

875
00:30:30,240 --> 00:30:31,919
in most of our health care system it is

876
00:30:31,919 --> 00:30:33,440
we are based on a solidarity but where

877
00:30:33,440 --> 00:30:34,880
is the solidarity in the fact

878
00:30:34,880 --> 00:30:36,480
that somebody is actually looking after

879
00:30:36,480 --> 00:30:38,159
his health and the rest are not because

880
00:30:38,159 --> 00:30:38,960
we saw

881
00:30:38,960 --> 00:30:41,760
how uh what the health outcomes of the

882
00:30:41,760 --> 00:30:42,399
ones who

883
00:30:42,399 --> 00:30:45,360
are not looking after are how much they

884
00:30:45,360 --> 00:30:46,480
cost and everything so

885
00:30:46,480 --> 00:30:47,760
in order to make all these

886
00:30:47,760 --> 00:30:49,679
transformations i think mean to start

887
00:30:49,679 --> 00:30:50,799
with the people

888
00:30:50,799 --> 00:30:52,880
and i know this is not very popular i

889
00:30:52,880 --> 00:30:54,799
know this is something that

890
00:30:54,799 --> 00:30:56,640
uh politicians always love to tell that

891
00:30:56,640 --> 00:30:57,840
they want to either

892
00:30:57,840 --> 00:31:01,440
uh increase uh premiums for the ones who

893
00:31:01,440 --> 00:31:03,679
don't behave well or motivate them to to

894
00:31:03,679 --> 00:31:06,159
to get better uh but it never never

895
00:31:06,159 --> 00:31:07,200
actually

896
00:31:07,200 --> 00:31:09,519
implements or never is put in practice

897
00:31:09,519 --> 00:31:11,200
but i think this needs to be done it is

898
00:31:11,200 --> 00:31:11,679
very

899
00:31:11,679 --> 00:31:13,519
unpopular but if we don't change the way

900
00:31:13,519 --> 00:31:15,039
people behave we can

901
00:31:15,039 --> 00:31:17,120
we can get into the market whatever

902
00:31:17,120 --> 00:31:18,720
innovation whatever new product it will

903
00:31:18,720 --> 00:31:19,919
never be enough

904
00:31:19,919 --> 00:31:22,159
and if you look into how uh all these

905
00:31:22,159 --> 00:31:23,760
risk factors and these behaviors have

906
00:31:23,760 --> 00:31:25,600
changed since let's say 2000

907
00:31:25,600 --> 00:31:27,600
in most countries it is still stable but

908
00:31:27,600 --> 00:31:29,120
the levels are way too high

909
00:31:29,120 --> 00:31:30,640
and for example in slovakia it is

910
00:31:30,640 --> 00:31:32,559
estimated actually by oecd that uh

911
00:31:32,559 --> 00:31:35,120
48 percent of all that can be attributed

912
00:31:35,120 --> 00:31:36,480
to risk factors

913
00:31:36,480 --> 00:31:39,360
which could have been prevented if uh us

914
00:31:39,360 --> 00:31:41,440
as a population would be motivated to

915
00:31:41,440 --> 00:31:42,159
get better

916
00:31:42,159 --> 00:31:44,880
to behave uh in a different way and in

917
00:31:44,880 --> 00:31:46,399
order to do this we need

918
00:31:46,399 --> 00:31:47,919
we need to change the way how premiums

919
00:31:47,919 --> 00:31:49,840
are calculated how prevention mechanisms

920
00:31:49,840 --> 00:31:50,480
are

921
00:31:50,480 --> 00:31:52,799
organized and make sure that we as

922
00:31:52,799 --> 00:31:54,159
individuals as

923
00:31:54,159 --> 00:31:55,919
inhabitants of the countries feel

924
00:31:55,919 --> 00:31:57,440
responsible for our

925
00:31:57,440 --> 00:32:00,720
well-being francesca and he invoked some

926
00:32:00,720 --> 00:32:02,720
oecd research are there other things

927
00:32:02,720 --> 00:32:04,159
that we know about how we can wield

928
00:32:04,159 --> 00:32:05,200
policy

929
00:32:05,200 --> 00:32:09,279
to to encourage healthier behavior

930
00:32:09,600 --> 00:32:11,679
yes i mean healthier behavior is

931
00:32:11,679 --> 00:32:13,360
obviously the results of

932
00:32:13,360 --> 00:32:14,799
many different things some of them are

933
00:32:14,799 --> 00:32:16,559
within the health sector some of them

934
00:32:16,559 --> 00:32:17,120
are

935
00:32:17,120 --> 00:32:19,120
outside of the health center so the

936
00:32:19,120 --> 00:32:21,679
whole notion that we hear about

937
00:32:21,679 --> 00:32:24,720
you know a whole of a society uh you

938
00:32:24,720 --> 00:32:25,200
know

939
00:32:25,200 --> 00:32:27,919
approach to health addressing the social

940
00:32:27,919 --> 00:32:29,279
determinants

941
00:32:29,279 --> 00:32:32,000
um clearly you know doing things also in

942
00:32:32,000 --> 00:32:33,440
school in the education

943
00:32:33,440 --> 00:32:36,480
systems are quite fundamental for uh for

944
00:32:36,480 --> 00:32:37,360
prevention

945
00:32:37,360 --> 00:32:39,840
and they're the type of approaches that

946
00:32:39,840 --> 00:32:41,279
you can use can be

947
00:32:41,279 --> 00:32:44,320
both addressed to the individual itself

948
00:32:44,320 --> 00:32:45,440
or they can be more

949
00:32:45,440 --> 00:32:47,440
addressed to the broader population so

950
00:32:47,440 --> 00:32:48,880
if you have things like

951
00:32:48,880 --> 00:32:50,720
uh making sure that you have goods

952
00:32:50,720 --> 00:32:52,320
communication campaigns

953
00:32:52,320 --> 00:32:55,039
about healthy uh behavior that are

954
00:32:55,039 --> 00:32:56,320
addressed to the entire

955
00:32:56,320 --> 00:32:58,159
population but you can also if you think

956
00:32:58,159 --> 00:33:00,480
about a person who is obese have some

957
00:33:00,480 --> 00:33:01,440
counseling

958
00:33:01,440 --> 00:33:02,880
in primary health care which is more

959
00:33:02,880 --> 00:33:04,559
directly targeted to

960
00:33:04,559 --> 00:33:06,799
the individual affected as well and you

961
00:33:06,799 --> 00:33:09,600
can have a mix of

962
00:33:09,600 --> 00:33:12,880
more intrusive if you wants or more

963
00:33:12,880 --> 00:33:16,000
you know stronger interventions uh

964
00:33:16,000 --> 00:33:19,760
using regulatory mechanism uh using uh

965
00:33:19,760 --> 00:33:22,799
also you know pricing and fiscal

966
00:33:22,799 --> 00:33:23,600
policies

967
00:33:23,600 --> 00:33:25,039
or you can have things which are more

968
00:33:25,039 --> 00:33:26,880
trying to uh

969
00:33:26,880 --> 00:33:29,679
nudge individuals into behavior through

970
00:33:29,679 --> 00:33:30,399
education

971
00:33:30,399 --> 00:33:32,799
through uh trying to to change their

972
00:33:32,799 --> 00:33:34,640
perception and so forth and all of that

973
00:33:34,640 --> 00:33:36,880
are important i mean the the the

974
00:33:36,880 --> 00:33:38,240
analysis that we have done

975
00:33:38,240 --> 00:33:40,720
on the economics of prevention at the

976
00:33:40,720 --> 00:33:42,240
oecd has shown how

977
00:33:42,240 --> 00:33:44,720
to really address those risk factors and

978
00:33:44,720 --> 00:33:45,840
unhealthy behavior

979
00:33:45,840 --> 00:33:48,240
you need the package the most

980
00:33:48,240 --> 00:33:49,440
cost-effective way

981
00:33:49,440 --> 00:33:51,360
of addressing it is through a package

982
00:33:51,360 --> 00:33:52,880
which includes a mix of all those

983
00:33:52,880 --> 00:33:54,000
interventions some

984
00:33:54,000 --> 00:33:55,760
of them more targeted individuals some

985
00:33:55,760 --> 00:33:57,440
of them more targeted population as a

986
00:33:57,440 --> 00:33:58,080
whole

987
00:33:58,080 --> 00:34:01,039
uh some of them uh that use nudging and

988
00:34:01,039 --> 00:34:02,480
some of them which are a little bit more

989
00:34:02,480 --> 00:34:03,440
compelling

990
00:34:03,440 --> 00:34:05,200
uh through the use of fiscal or

991
00:34:05,200 --> 00:34:07,600
regulatory policies

992
00:34:07,600 --> 00:34:09,359
thank you and and joanna we've been

993
00:34:09,359 --> 00:34:11,359
talking about kind of how to

994
00:34:11,359 --> 00:34:14,399
how to drive individuals but what about

995
00:34:14,399 --> 00:34:16,480
um healthcare workers how you know what

996
00:34:16,480 --> 00:34:18,239
are we learning about how

997
00:34:18,239 --> 00:34:21,280
how we can help train them to to

998
00:34:21,280 --> 00:34:22,719
really maximize their impact on the

999
00:34:22,719 --> 00:34:24,719
system

1000
00:34:24,719 --> 00:34:26,879
yeah thank you for the question i think

1001
00:34:26,879 --> 00:34:28,480
one of the big lessons again that has

1002
00:34:28,480 --> 00:34:29,520
been underlined

1003
00:34:29,520 --> 00:34:31,918
uh during the pandemic has really been

1004
00:34:31,918 --> 00:34:32,560
the

1005
00:34:32,560 --> 00:34:35,599
essential role of healthcare workers and

1006
00:34:35,599 --> 00:34:36,560
making a difference

1007
00:34:36,560 --> 00:34:39,119
and and allowing them the space to

1008
00:34:39,119 --> 00:34:41,199
innovate but also provide support to

1009
00:34:41,199 --> 00:34:41,918
them so

1010
00:34:41,918 --> 00:34:44,320
again i think what we have seen in a lot

1011
00:34:44,320 --> 00:34:46,480
of partner countries where we have been

1012
00:34:46,480 --> 00:34:49,040
supporting the response to covet is

1013
00:34:49,040 --> 00:34:50,079
really that the

1014
00:34:50,079 --> 00:34:51,599
the type of support available to

1015
00:34:51,599 --> 00:34:52,960
healthcare workers has made a huge

1016
00:34:52,960 --> 00:34:53,760
difference

1017
00:34:53,760 --> 00:34:55,040
and i think healthcare workers can

1018
00:34:55,040 --> 00:34:57,200
really can become big champions so

1019
00:34:57,200 --> 00:34:59,200
francesca already mentioned the primary

1020
00:34:59,200 --> 00:35:00,640
healthcare interventions that can be

1021
00:35:00,640 --> 00:35:02,000
targeted at individuals

1022
00:35:02,000 --> 00:35:03,359
if you think about the prevention of

1023
00:35:03,359 --> 00:35:05,520
non-communicable diseases

1024
00:35:05,520 --> 00:35:08,079
there again healthcare workers are big

1025
00:35:08,079 --> 00:35:09,760
champions can be big champions that make

1026
00:35:09,760 --> 00:35:11,440
a huge difference in those types of

1027
00:35:11,440 --> 00:35:12,560
interventions

1028
00:35:12,560 --> 00:35:15,520
and i think that um and and i think this

1029
00:35:15,520 --> 00:35:16,000
is the

1030
00:35:16,000 --> 00:35:17,280
the sort of thing where we need to

1031
00:35:17,280 --> 00:35:18,800
support healthcare workers to become

1032
00:35:18,800 --> 00:35:20,079
these types of champions

1033
00:35:20,079 --> 00:35:22,000
again they cannot do this on their own i

1034
00:35:22,000 --> 00:35:24,800
think it's very important to recognize

1035
00:35:24,800 --> 00:35:26,480
the approach you need the different

1036
00:35:26,480 --> 00:35:28,000
levers within the healthcare system so

1037
00:35:28,000 --> 00:35:28,800
you also

1038
00:35:28,800 --> 00:35:31,839
need to be able to have the regulation

1039
00:35:31,839 --> 00:35:33,119
you need to be able to regulate

1040
00:35:33,119 --> 00:35:34,400
especially when you talk about

1041
00:35:34,400 --> 00:35:36,480
addressing non-communicable diseases

1042
00:35:36,480 --> 00:35:38,640
that is an essential part that you can

1043
00:35:38,640 --> 00:35:40,400
that you can address the systemic

1044
00:35:40,400 --> 00:35:41,440
factors that

1045
00:35:41,440 --> 00:35:43,119
that drive these things but i think

1046
00:35:43,119 --> 00:35:44,480
healthcare workers really

1047
00:35:44,480 --> 00:35:46,160
are at the forefront of both addressing

1048
00:35:46,160 --> 00:35:48,000
the communicable disease pandemics as

1049
00:35:48,000 --> 00:35:49,200
well as the epidemics of

1050
00:35:49,200 --> 00:35:50,800
non-communicable diseases

1051
00:35:50,800 --> 00:35:53,599
and as such i think are essential if we

1052
00:35:53,599 --> 00:35:55,119
are thinking again about this theme of

1053
00:35:55,119 --> 00:35:56,640
resilient health systems of

1054
00:35:56,640 --> 00:35:58,240
of transforming health systems for the

1055
00:35:58,240 --> 00:36:00,000
future to me they're

1056
00:36:00,000 --> 00:36:02,079
a very essential building block and one

1057
00:36:02,079 --> 00:36:04,240
that we mustn't forget

1058
00:36:04,240 --> 00:36:05,680
thank you and before i go on are there

1059
00:36:05,680 --> 00:36:07,839
any questions in the room

1060
00:36:07,839 --> 00:36:10,720
for now not yet feel free to just raise

1061
00:36:10,720 --> 00:36:12,560
your hand at any at any point and i'll

1062
00:36:12,560 --> 00:36:14,720
i'll take note of it oh all right well

1063
00:36:14,720 --> 00:36:16,880
thank you please please um join us at

1064
00:36:16,880 --> 00:36:20,160
the at the microphone here

1065
00:36:21,119 --> 00:36:22,560
just yeah word to the wise if you wait

1066
00:36:22,560 --> 00:36:23,920
for the last five minutes to ask your

1067
00:36:23,920 --> 00:36:24,640
question

1068
00:36:24,640 --> 00:36:27,119
we might not get to it so thank you i'm

1069
00:36:27,119 --> 00:36:30,160
coming from a biomedical research area

1070
00:36:30,160 --> 00:36:33,200
and i clearly see a connection between

1071
00:36:33,200 --> 00:36:36,560
sustainable support of research and

1072
00:36:36,560 --> 00:36:39,680
excellent research performance with

1073
00:36:39,680 --> 00:36:42,320
the status or quality of the healthcare

1074
00:36:42,320 --> 00:36:43,520
system so

1075
00:36:43,520 --> 00:36:45,599
do you think that another lesson to be

1076
00:36:45,599 --> 00:36:47,440
learned from this pandemic is

1077
00:36:47,440 --> 00:36:49,440
the role of research and supporting the

1078
00:36:49,440 --> 00:36:51,280
role of research

1079
00:36:51,280 --> 00:36:54,720
to improve healthcare systems

1080
00:36:54,720 --> 00:36:56,400
thank you thank you for that um uh

1081
00:36:56,400 --> 00:36:58,160
francesca do you want to start um

1082
00:36:58,160 --> 00:37:00,720
uh with with that with the relationship

1083
00:37:00,720 --> 00:37:01,280
between

1084
00:37:01,280 --> 00:37:03,680
research and healthcare systems and and

1085
00:37:03,680 --> 00:37:04,320
i think it's

1086
00:37:04,320 --> 00:37:07,680
uh as was mentioned in in these

1087
00:37:07,680 --> 00:37:08,640
questions uh

1088
00:37:08,640 --> 00:37:10,640
again this pandemic what we have seen

1089
00:37:10,640 --> 00:37:11,839
it's a

1090
00:37:11,839 --> 00:37:14,400
huge role in uh in researching the

1091
00:37:14,400 --> 00:37:15,040
clique

1092
00:37:15,040 --> 00:37:17,599
in the quick r d and developments at a

1093
00:37:17,599 --> 00:37:19,440
speed that was completely

1094
00:37:19,440 --> 00:37:21,680
unexpected and unthinkable of new

1095
00:37:21,680 --> 00:37:23,119
vaccine in in

1096
00:37:23,119 --> 00:37:26,240
really less than one one year and that

1097
00:37:26,240 --> 00:37:27,839
would have not been possible without

1098
00:37:27,839 --> 00:37:30,560
having had the research and development

1099
00:37:30,560 --> 00:37:32,480
being done beforehand so you know the

1100
00:37:32,480 --> 00:37:34,320
the new platform

1101
00:37:34,320 --> 00:37:37,599
mrna uh is the results of uh years of

1102
00:37:37,599 --> 00:37:38,880
work that was done

1103
00:37:38,880 --> 00:37:41,680
before uh before that so it's there was

1104
00:37:41,680 --> 00:37:42,320
a

1105
00:37:42,320 --> 00:37:44,160
huge uh you know investments that was

1106
00:37:44,160 --> 00:37:46,480
done beforehand in understanding also

1107
00:37:46,480 --> 00:37:48,560
um you know what uh what was the

1108
00:37:48,560 --> 00:37:50,800
experience with previous coronavirus

1109
00:37:50,800 --> 00:37:52,480
um you know investigations that were

1110
00:37:52,480 --> 00:37:54,160
made in the past

1111
00:37:54,160 --> 00:37:55,920
that were helpful then to make sure that

1112
00:37:55,920 --> 00:37:57,359
vaccine rd

1113
00:37:57,359 --> 00:37:59,520
did not start from zero but could build

1114
00:37:59,520 --> 00:38:01,680
on something you know build on

1115
00:38:01,680 --> 00:38:03,280
something which already was known

1116
00:38:03,280 --> 00:38:06,240
building on new uh technology platform

1117
00:38:06,240 --> 00:38:08,880
building on extensive uh knowledge also

1118
00:38:08,880 --> 00:38:10,800
from uh previous vaccine and all of that

1119
00:38:10,800 --> 00:38:11,599
really

1120
00:38:11,599 --> 00:38:14,160
made clear um you know accelerated the

1121
00:38:14,160 --> 00:38:15,440
process of development

1122
00:38:15,440 --> 00:38:17,680
vaccine itself so i think there is a

1123
00:38:17,680 --> 00:38:20,240
clear role for ensuring that we have uh

1124
00:38:20,240 --> 00:38:22,400
research and strong investment in

1125
00:38:22,400 --> 00:38:24,480
research there is probably a need also

1126
00:38:24,480 --> 00:38:25,119
to

1127
00:38:25,119 --> 00:38:26,800
understand and making sure that we

1128
00:38:26,800 --> 00:38:28,640
direct the research

1129
00:38:28,640 --> 00:38:31,680
to highest priority needs for regulators

1130
00:38:31,680 --> 00:38:34,079
and that has to do also with things that

1131
00:38:34,079 --> 00:38:35,359
sometimes might be

1132
00:38:35,359 --> 00:38:37,440
neglected with areas where there is

1133
00:38:37,440 --> 00:38:38,960
perhaps less

1134
00:38:38,960 --> 00:38:42,560
less invest investments the mr mentioned

1135
00:38:42,560 --> 00:38:44,320
mental health for example we still have

1136
00:38:44,320 --> 00:38:46,320
very little by way of innovations in

1137
00:38:46,320 --> 00:38:48,160
mental health for example so there are

1138
00:38:48,160 --> 00:38:50,240
definitely areas in which there is a

1139
00:38:50,240 --> 00:38:51,839
role also for governments

1140
00:38:51,839 --> 00:38:53,760
to make sure that we create a different

1141
00:38:53,760 --> 00:38:55,200
mechanism for

1142
00:38:55,200 --> 00:38:58,839
uh you know prioritizing areas of

1143
00:38:58,839 --> 00:39:01,599
research thank you gabriella

1144
00:39:01,599 --> 00:39:04,079
as what role should should government be

1145
00:39:04,079 --> 00:39:06,320
playing in research and how can we drive

1146
00:39:06,320 --> 00:39:08,320
uh more focus on areas that have been

1147
00:39:08,320 --> 00:39:10,240
neglected and maybe are not very

1148
00:39:10,240 --> 00:39:12,480
easily commercially viable yeah so i

1149
00:39:12,480 --> 00:39:13,520
think

1150
00:39:13,520 --> 00:39:15,920
also here what we have seen now in the

1151
00:39:15,920 --> 00:39:17,920
in the pandemic and the development of

1152
00:39:17,920 --> 00:39:19,040
the vaccines is

1153
00:39:19,040 --> 00:39:21,599
partnerships so partnerships are really

1154
00:39:21,599 --> 00:39:22,320
helping

1155
00:39:22,320 --> 00:39:25,040
partnerships are driving us speeding up

1156
00:39:25,040 --> 00:39:25,680
and

1157
00:39:25,680 --> 00:39:28,240
and when you mention now areas where we

1158
00:39:28,240 --> 00:39:30,640
need more research and where it seems

1159
00:39:30,640 --> 00:39:32,960
from a commercial point of view not that

1160
00:39:32,960 --> 00:39:33,760
let's say

1161
00:39:33,760 --> 00:39:38,079
attractive it's a antimicrobial

1162
00:39:38,079 --> 00:39:41,599
entity resistance is the area

1163
00:39:41,599 --> 00:39:43,839
where we see that there is a big big

1164
00:39:43,839 --> 00:39:45,359
need of new

1165
00:39:45,359 --> 00:39:48,480
new antibiotics which are actually

1166
00:39:48,480 --> 00:39:51,599
still effective in an environment where

1167
00:39:51,599 --> 00:39:52,560
we see

1168
00:39:52,560 --> 00:39:56,640
increasing resistance our company is

1169
00:39:56,640 --> 00:39:59,200
investing a lot there also it's uh it's

1170
00:39:59,200 --> 00:39:59,839
um an

1171
00:39:59,839 --> 00:40:02,480
area which uh is not very attractive but

1172
00:40:02,480 --> 00:40:03,280
still

1173
00:40:03,280 --> 00:40:05,280
there is a great commitment and moving

1174
00:40:05,280 --> 00:40:06,319
things forward and

1175
00:40:06,319 --> 00:40:08,240
actually providing the benefit to

1176
00:40:08,240 --> 00:40:10,560
patients but i think these kind of

1177
00:40:10,560 --> 00:40:12,079
initiatives

1178
00:40:12,079 --> 00:40:15,440
would require a kind of a collaboration

1179
00:40:15,440 --> 00:40:18,160
it could be partnerships it could be a

1180
00:40:18,160 --> 00:40:19,040
different

1181
00:40:19,040 --> 00:40:22,960
type of of a consortium or whatever

1182
00:40:22,960 --> 00:40:25,520
could be funded around these and then uh

1183
00:40:25,520 --> 00:40:26,560
i think

1184
00:40:26,560 --> 00:40:29,680
one of the results which was which we

1185
00:40:29,680 --> 00:40:31,280
see now with all the the covet

1186
00:40:31,280 --> 00:40:32,319
vaccination is

1187
00:40:32,319 --> 00:40:35,200
is a result which uh could be uh

1188
00:40:35,200 --> 00:40:35,839
actually

1189
00:40:35,839 --> 00:40:38,480
kind of copied and pasted for other

1190
00:40:38,480 --> 00:40:40,160
areas as well so

1191
00:40:40,160 --> 00:40:42,079
i think there is a big chance but we

1192
00:40:42,079 --> 00:40:44,400
need to speak to each other we need to

1193
00:40:44,400 --> 00:40:47,040
uh to to to discuss what are the

1194
00:40:47,040 --> 00:40:48,880
objectives what are the needs and then

1195
00:40:48,880 --> 00:40:51,440
and then we will find solutions together

1196
00:40:51,440 --> 00:40:53,839
thank you johanna um especially dealing

1197
00:40:53,839 --> 00:40:55,359
with parts of the world where

1198
00:40:55,359 --> 00:40:57,760
um some of the diseases that affect them

1199
00:40:57,760 --> 00:40:58,560
tend to be

1200
00:40:58,560 --> 00:41:00,240
neglected auras where as we're actually

1201
00:41:00,240 --> 00:41:02,480
seeing with uh with kovid now

1202
00:41:02,480 --> 00:41:04,880
um the the global north is getting is

1203
00:41:04,880 --> 00:41:06,960
getting access to the vaccines much more

1204
00:41:06,960 --> 00:41:08,319
quickly than the global south

1205
00:41:08,319 --> 00:41:10,480
what do you see um as potential

1206
00:41:10,480 --> 00:41:12,480
solutions as far as research and then

1207
00:41:12,480 --> 00:41:15,760
also having access to those innovations

1208
00:41:15,760 --> 00:41:17,680
okay so i think you touched on two very

1209
00:41:17,680 --> 00:41:19,440
important things there so first of all

1210
00:41:19,440 --> 00:41:22,079
we definitely need the basic research

1211
00:41:22,079 --> 00:41:23,280
and we need to work

1212
00:41:23,280 --> 00:41:25,599
on a system where we can have uh where

1213
00:41:25,599 --> 00:41:28,240
we can speed up the equal access to the

1214
00:41:28,240 --> 00:41:30,160
fruits of that research to the to the

1215
00:41:30,160 --> 00:41:31,839
outcomes of that research and kovacs i

1216
00:41:31,839 --> 00:41:32,880
think is a good

1217
00:41:32,880 --> 00:41:34,319
is a good example for that we need

1218
00:41:34,319 --> 00:41:36,160
further support for co-workers thinking

1219
00:41:36,160 --> 00:41:36,640
about

1220
00:41:36,640 --> 00:41:38,960
covet but there's a big area of research

1221
00:41:38,960 --> 00:41:40,480
that we haven't mentioned here so far

1222
00:41:40,480 --> 00:41:42,240
and that's operations research so

1223
00:41:42,240 --> 00:41:43,599
operational research

1224
00:41:43,599 --> 00:41:46,000
understanding how health systems work

1225
00:41:46,000 --> 00:41:47,680
and how to make health systems

1226
00:41:47,680 --> 00:41:50,560
more effective and efficient um so what

1227
00:41:50,560 --> 00:41:52,319
types of policies what types of

1228
00:41:52,319 --> 00:41:54,720
financing arrangement works for example

1229
00:41:54,720 --> 00:41:56,160
work for example in addressing

1230
00:41:56,160 --> 00:41:58,079
antimicrobial resistance so i don't have

1231
00:41:58,079 --> 00:41:58,560
to

1232
00:41:58,560 --> 00:42:00,640
develop a new antibiotic that's you know

1233
00:42:00,640 --> 00:42:02,079
that that's of course

1234
00:42:02,079 --> 00:42:05,200
the golden end point but but there are

1235
00:42:05,200 --> 00:42:06,800
other things we can do we can innovate

1236
00:42:06,800 --> 00:42:08,640
within our health system and i think

1237
00:42:08,640 --> 00:42:10,880
operations research that looks at how

1238
00:42:10,880 --> 00:42:13,040
policies can be designed

1239
00:42:13,040 --> 00:42:16,000
to support interventions to ensure that

1240
00:42:16,000 --> 00:42:17,839
primary prevention works at primary

1241
00:42:17,839 --> 00:42:19,040
healthcare level

1242
00:42:19,040 --> 00:42:21,119
to ensure that we can use for example

1243
00:42:21,119 --> 00:42:22,880
when we think about nudging of behaviors

1244
00:42:22,880 --> 00:42:23,920
and ncps

1245
00:42:23,920 --> 00:42:25,520
what are the technical interventions

1246
00:42:25,520 --> 00:42:27,200
that work there are there certain things

1247
00:42:27,200 --> 00:42:29,040
on an app on a mobile phone mobile

1248
00:42:29,040 --> 00:42:29,760
telephony

1249
00:42:29,760 --> 00:42:32,000
using that using mobile telephony for

1250
00:42:32,000 --> 00:42:33,599
health insurance purposes

1251
00:42:33,599 --> 00:42:35,599
all of these are aspects which we need

1252
00:42:35,599 --> 00:42:36,880
operations research

1253
00:42:36,880 --> 00:42:39,359
alongside the actual intervention so for

1254
00:42:39,359 --> 00:42:40,000
me

1255
00:42:40,000 --> 00:42:42,640
um research is absolutely vital it's

1256
00:42:42,640 --> 00:42:44,079
been shown

1257
00:42:44,079 --> 00:42:45,839
the importance of that has been shown by

1258
00:42:45,839 --> 00:42:48,400
the really breathtaking speed of

1259
00:42:48,400 --> 00:42:50,240
innovation that we have seen

1260
00:42:50,240 --> 00:42:52,560
uh during the pandemic that is helping

1261
00:42:52,560 --> 00:42:54,640
us now

1262
00:42:54,640 --> 00:42:56,880
to to address the pandemic much more

1263
00:42:56,880 --> 00:42:58,640
effectively the the vaccine that was

1264
00:42:58,640 --> 00:43:00,000
discussed obviously

1265
00:43:00,000 --> 00:43:03,040
both the result of breathtaking speed

1266
00:43:03,040 --> 00:43:05,440
but sustained long-term investment and

1267
00:43:05,440 --> 00:43:06,160
research

1268
00:43:06,160 --> 00:43:08,880
of of those of the scientists in those

1269
00:43:08,880 --> 00:43:10,319
scientists

1270
00:43:10,319 --> 00:43:12,400
but alongside that also for me the other

1271
00:43:12,400 --> 00:43:14,640
side is understanding what types of

1272
00:43:14,640 --> 00:43:16,480
interventions we can do to

1273
00:43:16,480 --> 00:43:18,640
to best protect our healthcare workers

1274
00:43:18,640 --> 00:43:19,520
to best protect

1275
00:43:19,520 --> 00:43:21,200
our populations what are the policies

1276
00:43:21,200 --> 00:43:23,040
that incentivize a lot of the stuff

1277
00:43:23,040 --> 00:43:24,480
around prevention in the healthcare

1278
00:43:24,480 --> 00:43:26,400
system must not cost a lot of money

1279
00:43:26,400 --> 00:43:27,359
necessarily

1280
00:43:27,359 --> 00:43:28,880
it doesn't require a new drug

1281
00:43:28,880 --> 00:43:30,400
necessarily

1282
00:43:30,400 --> 00:43:33,040
and i think for me evidence and research

1283
00:43:33,040 --> 00:43:34,960
also there has a very very big role to

1284
00:43:34,960 --> 00:43:36,160
play and i think

1285
00:43:36,160 --> 00:43:38,400
again we have seen this and i think we

1286
00:43:38,400 --> 00:43:41,280
see this in the differential experiences

1287
00:43:41,280 --> 00:43:43,359
that countries have had that even within

1288
00:43:43,359 --> 00:43:44,560
countries different groups of

1289
00:43:44,560 --> 00:43:46,079
populations have had

1290
00:43:46,079 --> 00:43:47,760
in our healthcare systems when we look

1291
00:43:47,760 --> 00:43:49,280
at the health outcomes that they have be

1292
00:43:49,280 --> 00:43:51,040
it non-communicable diseases

1293
00:43:51,040 --> 00:43:54,480
albeit for covet thank you the really

1294
00:43:54,480 --> 00:43:55,280
great points

1295
00:43:55,280 --> 00:43:57,760
um so we have we have about uh 12

1296
00:43:57,760 --> 00:43:58,560
minutes left

1297
00:43:58,560 --> 00:44:00,720
so um in just a second i'm going to ask

1298
00:44:00,720 --> 00:44:02,240
the floor for if you have more questions

1299
00:44:02,240 --> 00:44:03,040
but first

1300
00:44:03,040 --> 00:44:04,640
um let's let's take a peek at the

1301
00:44:04,640 --> 00:44:06,319
results of our poll

1302
00:44:06,319 --> 00:44:08,800
uh which again was about the most urgent

1303
00:44:08,800 --> 00:44:09,920
health challenge

1304
00:44:09,920 --> 00:44:13,839
for systems over the next three years um

1305
00:44:13,839 --> 00:44:16,079
so yeah people are very concerned about

1306
00:44:16,079 --> 00:44:17,760
the the idea that people

1307
00:44:17,760 --> 00:44:19,520
haven't been um haven't been getting the

1308
00:44:19,520 --> 00:44:21,119
care that they need uh

1309
00:44:21,119 --> 00:44:23,839
for chronic diseases things like cancer

1310
00:44:23,839 --> 00:44:24,720
mental health

1311
00:44:24,720 --> 00:44:27,119
also very high up on there um

1312
00:44:27,119 --> 00:44:28,720
interesting that preparing for the next

1313
00:44:28,720 --> 00:44:30,720
pandemic and antimicrobial resistance

1314
00:44:30,720 --> 00:44:32,400
which could well end up being related to

1315
00:44:32,400 --> 00:44:34,000
each other interesting in this room that

1316
00:44:34,000 --> 00:44:35,119
that

1317
00:44:35,119 --> 00:44:37,839
that's not that's not a big factor um

1318
00:44:37,839 --> 00:44:38,720
what what

1319
00:44:38,720 --> 00:44:40,079
how would how would how would you two

1320
00:44:40,079 --> 00:44:41,599
answer martin what would your answer be

1321
00:44:41,599 --> 00:44:42,720
to that poll

1322
00:44:42,720 --> 00:44:44,400
yeah probably the same the the battle of

1323
00:44:44,400 --> 00:44:46,079
growing diseases because we

1324
00:44:46,079 --> 00:44:48,800
um did some preliminary calculations uh

1325
00:44:48,800 --> 00:44:50,720
based on

1326
00:44:50,720 --> 00:44:53,359
that the decline in number of diagnostic

1327
00:44:53,359 --> 00:44:55,040
procedures undertaken in the last

1328
00:44:55,040 --> 00:44:57,280
quarter of last year and when we

1329
00:44:57,280 --> 00:44:58,640
extrapolated in the future

1330
00:44:58,640 --> 00:45:00,800
uh we've calculated that for every

1331
00:45:00,800 --> 00:45:01,920
single day

1332
00:45:01,920 --> 00:45:03,520
of let's say decreased production or

1333
00:45:03,520 --> 00:45:05,599
decreased number of tests undertaken

1334
00:45:05,599 --> 00:45:09,920
uh 90 to 120 undetected cases

1335
00:45:09,920 --> 00:45:11,920
would happen right so every day we would

1336
00:45:11,920 --> 00:45:14,480
lose 920 of

1337
00:45:14,480 --> 00:45:17,599
cancer cases that otherwise would have

1338
00:45:17,599 --> 00:45:18,000
been

1339
00:45:18,000 --> 00:45:20,319
detected and out of the person out of

1340
00:45:20,319 --> 00:45:21,920
these 90 20

1341
00:45:21,920 --> 00:45:24,079
roughly 30 to 40 percent would be in the

1342
00:45:24,079 --> 00:45:26,319
stage 1 to 2 cancer which means

1343
00:45:26,319 --> 00:45:29,280
more or less treatable stage so for me

1344
00:45:29,280 --> 00:45:29,760
for sure

1345
00:45:29,760 --> 00:45:31,599
the backlog of chronic diseases and the

1346
00:45:31,599 --> 00:45:33,760
diagnostics would be on the first place

1347
00:45:33,760 --> 00:45:35,599
gabriella yeah yeah for me as well i

1348
00:45:35,599 --> 00:45:37,359
mean the first point is really the

1349
00:45:37,359 --> 00:45:40,000
urgency it might be not the importance

1350
00:45:40,000 --> 00:45:43,280
on a long term on a strategic

1351
00:45:43,280 --> 00:45:45,119
perspective but it's really the most

1352
00:45:45,119 --> 00:45:46,880
urgent piece so now

1353
00:45:46,880 --> 00:45:50,079
in order to to avoid more harm um

1354
00:45:50,079 --> 00:45:52,240
versus what we have already created with

1355
00:45:52,240 --> 00:45:54,400
the pandemic and of course the

1356
00:45:54,400 --> 00:45:56,960
disruption in regular therapy we need to

1357
00:45:56,960 --> 00:45:58,160
act fast and

1358
00:45:58,160 --> 00:46:01,520
uh and and uh get to get patients back

1359
00:46:01,520 --> 00:46:02,720
in treatment

1360
00:46:02,720 --> 00:46:04,240
yeah indeed i did put that three-year

1361
00:46:04,240 --> 00:46:06,240
time time frame on it francesca you're

1362
00:46:06,240 --> 00:46:07,040
uh

1363
00:46:07,040 --> 00:46:09,760
which would you choose in that poll uh

1364
00:46:09,760 --> 00:46:10,400
well

1365
00:46:10,400 --> 00:46:12,400
i think the first and the second can be

1366
00:46:12,400 --> 00:46:14,319
even brought together because uh

1367
00:46:14,319 --> 00:46:16,400
there is clearly a backlog also in

1368
00:46:16,400 --> 00:46:17,520
addressing uh

1369
00:46:17,520 --> 00:46:20,640
mental health issues but it's quite

1370
00:46:20,640 --> 00:46:21,359
clear that

1371
00:46:21,359 --> 00:46:24,000
uh you know as we uh move into the

1372
00:46:24,000 --> 00:46:24,720
pandemic

1373
00:46:24,720 --> 00:46:28,240
and once we have had the immediate

1374
00:46:28,240 --> 00:46:31,280
acute phase there is a issues about what

1375
00:46:31,280 --> 00:46:33,200
would be the longer term consequences so

1376
00:46:33,200 --> 00:46:34,560
you know the chronic conditions which is

1377
00:46:34,560 --> 00:46:36,000
not really just

1378
00:46:36,000 --> 00:46:38,640
the cancer care but also people with

1379
00:46:38,640 --> 00:46:40,560
cardiovascular disease for example

1380
00:46:40,560 --> 00:46:43,680
which you know also have a backlog of

1381
00:46:43,680 --> 00:46:44,079
care

1382
00:46:44,079 --> 00:46:46,880
and even in terms of preventions in uh

1383
00:46:46,880 --> 00:46:48,880
in maintaining also continuity

1384
00:46:48,880 --> 00:46:50,880
uh of care mental health as i mentioned

1385
00:46:50,880 --> 00:46:51,920
even um

1386
00:46:51,920 --> 00:46:53,920
elective surgery there's been uh you

1387
00:46:53,920 --> 00:46:54,960
know data

1388
00:46:54,960 --> 00:46:57,520
really starting to show up about delays

1389
00:46:57,520 --> 00:46:58,240
in uh

1390
00:46:58,240 --> 00:47:00,560
in electric surgery that why what they

1391
00:47:00,560 --> 00:47:02,240
may not be life-frightening

1392
00:47:02,240 --> 00:47:03,839
they do make a huge difference to the

1393
00:47:03,839 --> 00:47:06,240
quality of life and the questions really

1394
00:47:06,240 --> 00:47:08,079
is how to make health systems which are

1395
00:47:08,079 --> 00:47:12,160
both able to very quickly surge capacity

1396
00:47:12,160 --> 00:47:14,720
and react in very agile way to an

1397
00:47:14,720 --> 00:47:15,839
emergency

1398
00:47:15,839 --> 00:47:18,480
that has come up that obviously we hope

1399
00:47:18,480 --> 00:47:19,359
can be

1400
00:47:19,359 --> 00:47:21,839
if not prevented at least you know

1401
00:47:21,839 --> 00:47:24,640
reduce the the initial input through

1402
00:47:24,640 --> 00:47:26,960
better preparedness for for emergency

1403
00:47:26,960 --> 00:47:28,400
that will be fundamental

1404
00:47:28,400 --> 00:47:30,880
but how can we make those two things

1405
00:47:30,880 --> 00:47:32,480
coexist you know ability to search

1406
00:47:32,480 --> 00:47:34,240
capacity and to manage

1407
00:47:34,240 --> 00:47:37,119
um an unexpected emergency on the one

1408
00:47:37,119 --> 00:47:37,760
hand

1409
00:47:37,760 --> 00:47:40,640
with maintaining the continuity of care

1410
00:47:40,640 --> 00:47:42,800
for for all patients

1411
00:47:42,800 --> 00:47:44,640
thank you and johanna your your response

1412
00:47:44,640 --> 00:47:47,040
to the poll

1413
00:47:48,160 --> 00:47:49,440
i don't know if you're able to if you

1414
00:47:49,440 --> 00:47:51,680
were able to see it i can i can

1415
00:47:51,680 --> 00:47:54,640
or if you're still with us all right

1416
00:47:54,640 --> 00:47:55,440
well

1417
00:47:55,440 --> 00:47:57,280
um i'll see if there are any questions

1418
00:47:57,280 --> 00:47:58,640
uh on the floor for

1419
00:47:58,640 --> 00:48:03,280
now no okay we'll move on so

1420
00:48:03,280 --> 00:48:05,359
um preparing for the next pandemic uh

1421
00:48:05,359 --> 00:48:07,599
not seen as necessarily super urgent

1422
00:48:07,599 --> 00:48:09,440
over the next three years by by this

1423
00:48:09,440 --> 00:48:11,359
group but i'm curious

1424
00:48:11,359 --> 00:48:14,640
um uh and martin i'll start with you

1425
00:48:14,640 --> 00:48:17,040
how would you rate our preparedness for

1426
00:48:17,040 --> 00:48:18,400
the next pandemic

1427
00:48:18,400 --> 00:48:19,680
at this point are we going to be

1428
00:48:19,680 --> 00:48:22,160
starting from scratch or have do we have

1429
00:48:22,160 --> 00:48:24,000
we set up some good systems

1430
00:48:24,000 --> 00:48:25,920
uh well it depends what do you mean by

1431
00:48:25,920 --> 00:48:27,599
us and what do you mean by an expanded

1432
00:48:27,599 --> 00:48:28,079
mix

1433
00:48:28,079 --> 00:48:31,359
fair enough okay fair enough well that's

1434
00:48:31,359 --> 00:48:32,400
the problem we don't know what the next

1435
00:48:32,400 --> 00:48:34,079
pandemic is going to be right or else we

1436
00:48:34,079 --> 00:48:35,680
could start making the vaccine now but

1437
00:48:35,680 --> 00:48:36,160
another

1438
00:48:36,160 --> 00:48:38,880
another infectious disease um you know

1439
00:48:38,880 --> 00:48:40,160
people have said maybe we were lucky

1440
00:48:40,160 --> 00:48:41,920
with covid because it didn't affect

1441
00:48:41,920 --> 00:48:44,559
didn't really affect children um you

1442
00:48:44,559 --> 00:48:46,079
know most people

1443
00:48:46,079 --> 00:48:47,599
most people get but if there's an even

1444
00:48:47,599 --> 00:48:50,240
worse pandemic or a pandemic flu as many

1445
00:48:50,240 --> 00:48:51,920
had had predicted

1446
00:48:51,920 --> 00:48:54,559
will we handle will governments uh in

1447
00:48:54,559 --> 00:48:55,040
europe

1448
00:48:55,040 --> 00:48:57,599
handle handle the next the next one

1449
00:48:57,599 --> 00:48:59,280
better uh well it all depends on

1450
00:48:59,280 --> 00:49:00,480
what's going to happen with the lessons

1451
00:49:00,480 --> 00:49:01,440
learned if they are going to actually

1452
00:49:01,440 --> 00:49:03,200
put in practice or just ignore them

1453
00:49:03,200 --> 00:49:04,880
or have just some nice conferences and

1454
00:49:04,880 --> 00:49:06,480
discuss them for hours and do extra

1455
00:49:06,480 --> 00:49:07,200
nothing

1456
00:49:07,200 --> 00:49:10,319
um because well let's say that

1457
00:49:10,319 --> 00:49:12,480
because that always happens you know i

1458
00:49:12,480 --> 00:49:13,920
see that plenty of you have attended

1459
00:49:13,920 --> 00:49:16,400
such conferences or workshops and

1460
00:49:16,400 --> 00:49:17,839
the conclusion was that yes let's do

1461
00:49:17,839 --> 00:49:19,200
something but it has actually never

1462
00:49:19,200 --> 00:49:20,079
never happened

1463
00:49:20,079 --> 00:49:22,640
um well but let's say that uh most of

1464
00:49:22,640 --> 00:49:23,440
countries had the

1465
00:49:23,440 --> 00:49:25,520
first wave then a summer break second

1466
00:49:25,520 --> 00:49:27,119
wave and now it's going to be slightly

1467
00:49:27,119 --> 00:49:28,319
better and then we like it to have a

1468
00:49:28,319 --> 00:49:29,200
third wave

1469
00:49:29,200 --> 00:49:31,200
and just when you ask yourself what

1470
00:49:31,200 --> 00:49:32,880
actually changed between the first and

1471
00:49:32,880 --> 00:49:34,319
the second wave in some countries yes

1472
00:49:34,319 --> 00:49:35,520
they prepared for the second wave

1473
00:49:35,520 --> 00:49:35,920
they've

1474
00:49:35,920 --> 00:49:37,599
they've created more resilient systems

1475
00:49:37,599 --> 00:49:40,079
supported diagnostics procedures etc but

1476
00:49:40,079 --> 00:49:41,280
in many countries they just

1477
00:49:41,280 --> 00:49:43,040
they haven't done anything yet slovakia

1478
00:49:43,040 --> 00:49:44,480
czech republic for example is

1479
00:49:44,480 --> 00:49:46,559
a nice example of that and from that

1480
00:49:46,559 --> 00:49:48,640
perspective i'm afraid that there always

1481
00:49:48,640 --> 00:49:49,760
will be some countries

1482
00:49:49,760 --> 00:49:51,839
unless they are forced by eu commission

1483
00:49:51,839 --> 00:49:53,760
or another authority to change

1484
00:49:53,760 --> 00:49:55,839
that they will just uh claim that yes we

1485
00:49:55,839 --> 00:49:57,040
are going to change it as we are going

1486
00:49:57,040 --> 00:49:58,240
to prepare but

1487
00:49:58,240 --> 00:50:00,400
eventually they won't do it and if you

1488
00:50:00,400 --> 00:50:01,680
have one country which is

1489
00:50:01,680 --> 00:50:03,440
which is higher incidence than others

1490
00:50:03,440 --> 00:50:04,559
that it will always spread to

1491
00:50:04,559 --> 00:50:05,839
neighboring countries

1492
00:50:05,839 --> 00:50:07,040
then to the surrounding surrounding

1493
00:50:07,040 --> 00:50:08,319
countries and then you will have wave

1494
00:50:08,319 --> 00:50:09,599
coming from the west to the east from

1495
00:50:09,599 --> 00:50:10,400
the north of the

1496
00:50:10,400 --> 00:50:13,200
uh to the south so from my perspective

1497
00:50:13,200 --> 00:50:13,839
if

1498
00:50:13,839 --> 00:50:16,400
one country in the eu uh doesn't do the

1499
00:50:16,400 --> 00:50:17,200
job

1500
00:50:17,200 --> 00:50:19,520
all will suffer and i'm afraid that

1501
00:50:19,520 --> 00:50:21,839
unless as i said eu doesn't step in

1502
00:50:21,839 --> 00:50:24,960
and uh we won't be prepared for another

1503
00:50:24,960 --> 00:50:26,240
pandemics

1504
00:50:26,240 --> 00:50:29,280
gabriele are anything has anything

1505
00:50:29,280 --> 00:50:30,960
changed within the

1506
00:50:30,960 --> 00:50:34,000
pharma industry to prepare for the next

1507
00:50:34,000 --> 00:50:35,359
pandemic

1508
00:50:35,359 --> 00:50:37,200
i think what is always important and

1509
00:50:37,200 --> 00:50:39,200
that goes for our industry as well

1510
00:50:39,200 --> 00:50:42,160
is to learn from these events and then

1511
00:50:42,160 --> 00:50:42,640
to

1512
00:50:42,640 --> 00:50:45,359
clearly have conclusions learnings and

1513
00:50:45,359 --> 00:50:46,079
then to

1514
00:50:46,079 --> 00:50:49,359
to bring to to to act on it and that is

1515
00:50:49,359 --> 00:50:50,160
also

1516
00:50:50,160 --> 00:50:53,040
valid for for government uh for for

1517
00:50:53,040 --> 00:50:53,599
everything

1518
00:50:53,599 --> 00:50:56,480
in life i mean for every individual uh

1519
00:50:56,480 --> 00:50:58,720
once we have experienced the crisis we

1520
00:50:58,720 --> 00:51:00,640
learn from it but then we can only

1521
00:51:00,640 --> 00:51:02,880
become stronger if we act on what we

1522
00:51:02,880 --> 00:51:04,160
have learned on

1523
00:51:04,160 --> 00:51:07,040
and i think if we are not able to put

1524
00:51:07,040 --> 00:51:09,119
reforms into place when we have seen

1525
00:51:09,119 --> 00:51:10,559
that there is a

1526
00:51:10,559 --> 00:51:13,520
an issue and a lack of resilience in our

1527
00:51:13,520 --> 00:51:15,599
health care systems and even if we

1528
00:51:15,599 --> 00:51:18,079
increased it now over the pandemic i

1529
00:51:18,079 --> 00:51:19,760
think it's not enough

1530
00:51:19,760 --> 00:51:23,040
uh to to actually uh stand strong

1531
00:51:23,040 --> 00:51:25,520
in the in the potential next pandemic to

1532
00:51:25,520 --> 00:51:26,160
come

1533
00:51:26,160 --> 00:51:29,599
if we don't change things if we don't um

1534
00:51:29,599 --> 00:51:32,160
apply the learnings uh we will we will

1535
00:51:32,160 --> 00:51:33,119
we will

1536
00:51:33,119 --> 00:51:36,000
be in a in the same position again i

1537
00:51:36,000 --> 00:51:37,119
mean i'm sorry to put you on the spot

1538
00:51:37,119 --> 00:51:38,480
but is there is there a particular

1539
00:51:38,480 --> 00:51:39,680
change that you can point to that's

1540
00:51:39,680 --> 00:51:41,280
happened over the past year

1541
00:51:41,280 --> 00:51:43,920
uh within within msd that you can say is

1542
00:51:43,920 --> 00:51:45,200
the result of lessons learned

1543
00:51:45,200 --> 00:51:47,839
yeah i think there is a there is many

1544
00:51:47,839 --> 00:51:50,240
lessons learned and there is a clear

1545
00:51:50,240 --> 00:51:52,720
kind of understanding on how important

1546
00:51:52,720 --> 00:51:53,760
research is how

1547
00:51:53,760 --> 00:51:56,640
how important is also risk taking in

1548
00:51:56,640 --> 00:51:58,640
research for us as a company because i

1549
00:51:58,640 --> 00:52:00,240
mean our model is a

1550
00:52:00,240 --> 00:52:03,040
is a high risk model in all of the

1551
00:52:03,040 --> 00:52:05,040
investment in research but it

1552
00:52:05,040 --> 00:52:09,119
it really um it really um kind of uh

1553
00:52:09,119 --> 00:52:11,599
showed how important it is to take this

1554
00:52:11,599 --> 00:52:13,920
risk and to take even maybe the higher

1555
00:52:13,920 --> 00:52:15,440
risk because the

1556
00:52:15,440 --> 00:52:18,800
uh the messenger rna vaccinations which

1557
00:52:18,800 --> 00:52:21,520
are now proving very well

1558
00:52:21,520 --> 00:52:24,640
seem to be even and it's a much newer

1559
00:52:24,640 --> 00:52:27,280
technology than some of the vector

1560
00:52:27,280 --> 00:52:30,000
vaccinations and immunizations so the

1561
00:52:30,000 --> 00:52:32,319
risk was higher with uh with

1562
00:52:32,319 --> 00:52:35,520
messenger rna vaccines but it proved

1563
00:52:35,520 --> 00:52:36,480
that this was

1564
00:52:36,480 --> 00:52:39,520
the good thing to do and we

1565
00:52:39,520 --> 00:52:41,520
we should have johanna back and i'm glad

1566
00:52:41,520 --> 00:52:42,960
that she will be able to weigh in on

1567
00:52:42,960 --> 00:52:45,599
this question i asked

1568
00:52:45,599 --> 00:52:48,319
to what extent we can be confident that

1569
00:52:48,319 --> 00:52:49,359
changes

1570
00:52:49,359 --> 00:52:51,920
uh or if we can observe already that

1571
00:52:51,920 --> 00:52:54,240
changes as a result of this pandemic are

1572
00:52:54,240 --> 00:52:55,119
preparing

1573
00:52:55,119 --> 00:52:56,880
preparing us for the next pandemic or

1574
00:52:56,880 --> 00:52:58,640
does it still seem to be business as

1575
00:52:58,640 --> 00:53:01,440
usual in your view

1576
00:53:01,440 --> 00:53:03,520
i think we're seeing real change i think

1577
00:53:03,520 --> 00:53:04,640
the importance of

1578
00:53:04,640 --> 00:53:06,319
somebody who works in global health i

1579
00:53:06,319 --> 00:53:08,240
think the importance of health and

1580
00:53:08,240 --> 00:53:10,559
health systems and our preparedness

1581
00:53:10,559 --> 00:53:13,119
has been recognized by everybody on the

1582
00:53:13,119 --> 00:53:15,280
street and by the decision makers at the

1583
00:53:15,280 --> 00:53:16,319
highest level

1584
00:53:16,319 --> 00:53:18,559
so i do think it is now about the point

1585
00:53:18,559 --> 00:53:21,280
of con of translating that into concrete

1586
00:53:21,280 --> 00:53:22,000
actions

1587
00:53:22,000 --> 00:53:23,760
and i think that's where i see our

1588
00:53:23,760 --> 00:53:25,680
community and us collectively here in

1589
00:53:25,680 --> 00:53:27,040
this room and beyond

1590
00:53:27,040 --> 00:53:29,280
as as having a certain responsibility so

1591
00:53:29,280 --> 00:53:31,280
we need to make those changes happen

1592
00:53:31,280 --> 00:53:33,520
i think there are real i think there are

1593
00:53:33,520 --> 00:53:35,119
real changes afoot i

1594
00:53:35,119 --> 00:53:36,720
a really important point about the

1595
00:53:36,720 --> 00:53:38,160
importance of partnership

1596
00:53:38,160 --> 00:53:39,839
what this pandemic i think has shown

1597
00:53:39,839 --> 00:53:41,599
above everything else

1598
00:53:41,599 --> 00:53:43,520
not just about the importance of science

1599
00:53:43,520 --> 00:53:45,119
and evidence but i think about the

1600
00:53:45,119 --> 00:53:47,359
importance of partnership right so we

1601
00:53:47,359 --> 00:53:49,119
can only do this together

1602
00:53:49,119 --> 00:53:51,040
and i think this is the spirit that we

1603
00:53:51,040 --> 00:53:52,640
we have to use as

1604
00:53:52,640 --> 00:53:55,200
as a catalyst or have to catalyze to

1605
00:53:55,200 --> 00:53:56,000
strengthen i think

1606
00:53:56,000 --> 00:53:57,359
further strengthen the existing

1607
00:53:57,359 --> 00:53:59,599
political institutions the multilateral

1608
00:53:59,599 --> 00:54:00,400
system

1609
00:54:00,400 --> 00:54:02,960
the the the scientific community the

1610
00:54:02,960 --> 00:54:03,920
scientific system

1611
00:54:03,920 --> 00:54:06,400
and then to see where are their aspects

1612
00:54:06,400 --> 00:54:07,200
beyond that

1613
00:54:07,200 --> 00:54:09,520
so the pandemic treaty which is which is

1614
00:54:09,520 --> 00:54:10,720
will be discussed

1615
00:54:10,720 --> 00:54:12,960
in a special session at the world health

1616
00:54:12,960 --> 00:54:15,040
assembly this autumn is one such

1617
00:54:15,040 --> 00:54:18,160
instrument is already a sign um the g7

1618
00:54:18,160 --> 00:54:20,240
discussed extensively the leaders the

1619
00:54:20,240 --> 00:54:21,760
highest leaders of our of the

1620
00:54:21,760 --> 00:54:24,640
of the g7 governments did discuss health

1621
00:54:24,640 --> 00:54:26,960
extensively unlike ever before

1622
00:54:26,960 --> 00:54:29,520
and i think it's now about uh about a

1623
00:54:29,520 --> 00:54:30,160
host of

1624
00:54:30,160 --> 00:54:32,400
us in a way making these commitments and

1625
00:54:32,400 --> 00:54:33,760
making sure that these commitments are

1626
00:54:33,760 --> 00:54:35,920
turned into a new normal into reality

1627
00:54:35,920 --> 00:54:36,720
where we are

1628
00:54:36,720 --> 00:54:38,319
much more aware and preparing much

1629
00:54:38,319 --> 00:54:40,319
better for the next pandemic because not

1630
00:54:40,319 --> 00:54:42,160
only do we have the chronic diseases

1631
00:54:42,160 --> 00:54:43,599
that we know will continue

1632
00:54:43,599 --> 00:54:45,440
i think unfortunately we are also so

1633
00:54:45,440 --> 00:54:48,000
aware that antimicrobial resistance is a

1634
00:54:48,000 --> 00:54:49,599
real threat and we know there will be

1635
00:54:49,599 --> 00:54:51,280
other and further pandemics

1636
00:54:51,280 --> 00:54:54,160
so i think um i think this message must

1637
00:54:54,160 --> 00:54:55,520
not get lost but i

1638
00:54:55,520 --> 00:54:58,000
certainly have a real uh have a real

1639
00:54:58,000 --> 00:54:59,280
sense of optimism

1640
00:54:59,280 --> 00:55:01,599
that we can learn and galvanize this

1641
00:55:01,599 --> 00:55:03,280
energy now

1642
00:55:03,280 --> 00:55:04,960
great well thank you johanna so we we

1643
00:55:04,960 --> 00:55:06,240
have less than a minute left i'm going

1644
00:55:06,240 --> 00:55:06,880
to ask

1645
00:55:06,880 --> 00:55:09,040
one question from the slido that i think

1646
00:55:09,040 --> 00:55:10,160
is a cool question but

1647
00:55:10,160 --> 00:55:12,960
um we'll need very a very quick response

1648
00:55:12,960 --> 00:55:14,480
most public health intervention is

1649
00:55:14,480 --> 00:55:16,000
focused on changing the behavior of the

1650
00:55:16,000 --> 00:55:17,040
populations

1651
00:55:17,040 --> 00:55:18,160
rather than the governments or

1652
00:55:18,160 --> 00:55:20,319
regulators how can we improve

1653
00:55:20,319 --> 00:55:22,559
martin noted pressure from from brussels

1654
00:55:22,559 --> 00:55:23,760
as as one way

1655
00:55:23,760 --> 00:55:26,000
i only have time to let one of you uh

1656
00:55:26,000 --> 00:55:27,440
one of the rest of you answer anybody

1657
00:55:27,440 --> 00:55:30,400
anybody want to take that on francesca

1658
00:55:30,400 --> 00:55:31,680
johanna gabriel

1659
00:55:31,680 --> 00:55:34,880
yeah i think uh i think no i mean it's

1660
00:55:34,880 --> 00:55:36,960
the issues of changing population

1661
00:55:36,960 --> 00:55:39,839
behavior individual behavior is one part

1662
00:55:39,839 --> 00:55:40,400
of uh

1663
00:55:40,400 --> 00:55:42,319
of the equation but there is obviously

1664
00:55:42,319 --> 00:55:44,480
an important role of uh

1665
00:55:44,480 --> 00:55:46,960
of governments and you know making sure

1666
00:55:46,960 --> 00:55:48,559
that this is addressed more at

1667
00:55:48,559 --> 00:55:50,240
collective levels so a collective

1668
00:55:50,240 --> 00:55:52,319
population level and i think the two

1669
00:55:52,319 --> 00:55:53,200
must

1670
00:55:53,200 --> 00:55:56,079
must come together um because for some

1671
00:55:56,079 --> 00:55:57,520
individuals also

1672
00:55:57,520 --> 00:55:59,680
uh making you know the good healthy

1673
00:55:59,680 --> 00:56:02,319
choices is not necessarily the easier

1674
00:56:02,319 --> 00:56:04,319
choice to make or is not necessarily the

1675
00:56:04,319 --> 00:56:06,240
cheaper also choice to make so there are

1676
00:56:06,240 --> 00:56:06,880
obviously

1677
00:56:06,880 --> 00:56:08,799
things the governments need to do to

1678
00:56:08,799 --> 00:56:10,640
make sure that those healthy choices

1679
00:56:10,640 --> 00:56:11,040
here

1680
00:56:11,040 --> 00:56:12,960
becomes the easier choicer for

1681
00:56:12,960 --> 00:56:14,880
individuals so there is really a need

1682
00:56:14,880 --> 00:56:15,440
for both

1683
00:56:15,440 --> 00:56:18,000
it's changing individual behavior on the

1684
00:56:18,000 --> 00:56:18,799
one hand

1685
00:56:18,799 --> 00:56:21,040
but also facilitating that change

1686
00:56:21,040 --> 00:56:23,359
through government interventions

1687
00:56:23,359 --> 00:56:25,520
all right well on that note um we'll

1688
00:56:25,520 --> 00:56:26,400
we'll wrap up

1689
00:56:26,400 --> 00:56:28,240
uh thanks thanks to you francesca and

1690
00:56:28,240 --> 00:56:30,640
johanna for for joining us online

1691
00:56:30,640 --> 00:56:32,400
martin gabriela thanks for thanks for

1692
00:56:32,400 --> 00:56:34,319
being here in person likewise to our

1693
00:56:34,319 --> 00:56:34,880
audience

1694
00:56:34,880 --> 00:56:37,200
um thanks for being here in person and

1695
00:56:37,200 --> 00:56:39,520
online and for those of you who are here

1696
00:56:39,520 --> 00:56:40,480
in person

1697
00:56:40,480 --> 00:56:42,640
um coming up next in the habsburg room

1698
00:56:42,640 --> 00:56:44,319
where we are at 10 35

1699
00:56:44,319 --> 00:56:46,160
we have a session called strategic

1700
00:56:46,160 --> 00:56:48,240
autonomy versus global supply how to

1701
00:56:48,240 --> 00:56:49,520
secure value chains

1702
00:56:49,520 --> 00:56:51,359
also definitely a factor in this in this

1703
00:56:51,359 --> 00:56:52,559
health discussion

1704
00:56:52,559 --> 00:56:54,720
um and during the break in this room

1705
00:56:54,720 --> 00:56:55,920
we'll be live streaming

1706
00:56:55,920 --> 00:56:58,240
what's happening on the marietta stage

1707
00:56:58,240 --> 00:56:59,280
with a session called

1708
00:56:59,280 --> 00:57:01,280
towards the eu that delivers that'll

1709
00:57:01,280 --> 00:57:02,880
have state secretaries

1710
00:57:02,880 --> 00:57:04,960
of the ministers of foreign the foreign

1711
00:57:04,960 --> 00:57:06,400
affairs ministers from france and

1712
00:57:06,400 --> 00:57:07,440
slovakia so

1713
00:57:07,440 --> 00:57:10,240
lots of good choices thanks everybody

1714
00:57:10,240 --> 00:57:13,839
thank you

1715
00:57:15,000 --> 00:57:22,480
[Music]