Dr. David Nabarro:

First, Deputy Clarke asked when the tipping point is, given the prediction that poorer countries will only be immunised in 2023. Speaking as a public health professional, as well as an envoy for the WHO, the tipping point is now. There is no time down the road. We are watching extraordinary and dramatic damage occurring to the fabric of human society everywhere as a result of Covid. It is very active now; there are a lot of issues all over the world, including deepening inequities and real frustration and anxiety on the part of millions of people. Now is the time when the leaders in the rich world must take the initiative and must focus on equity. All that has been said by Dr. McMahon, Dr. Harkin and Ms Byanyima is so right. I say do not wait.

The second point is how many countries are doing what New Zealand has done in terms of actually taking advantage of their skills in dealing with Covid and postponing an option they have got on a vaccine? I have not heard of any others and it is time we had a vaccine solidarity challenge where heads of government, through their legislators, are invited to indicate what are the circumstances under which they will be ready to share. Of course, they will all say they are worried about variants but the whole world is worried about variants. Variants can affect poor countries just as badly as they can affect rich ones. The key thing is to protect those who are most at risk. The responsibilities of occupiers, as was brought out by Deputy Clarke, and the responsibilities of governments are well set out. Dr. McMahon is much better qualified than me to talk about it but again, as a public health professional, I am really concerned when groups of people inside a national border are denied, for some reason or other, an opportunity to access a vaccine and I am sure that those who have occupational responsibilities will do everything possible to be transparent about how they are dealing with it.

Senator Craughwell raised many points and I got five of them down. I feel I have the responsibility to deal with the third question, on vaccine sharing. I stress that one of the things we all must work on at the moment is vaccine hesitancy. There are people who are not quite sure about whether they want to take the vaccine. It is really important that in all societies they are given a second, third or fourth chance if they are uncertain when first asked. Thus I am kind of advocating for a really tolerant approach and for offering people, as I said, a chance to think about things and not requiring them to make a decision now on the basis that otherwise they will not get a chance.

On testing, I stress that while there are concerns about the reliability and positive predictive value of some of the antigen tests available, the committee should watch this space. I believe that more reliable rapid tests will come on stream. That will make such a difference. We do not talk so much about testing. I believe that access to rapid and reliable tests is absolutely key to an equitable response.

On the question of the definition of "front-line personnel", countries could really take advantage of the opportunities they have in the international system through the UN to debate these things.

The Chairman said something that is very important about the money that is needed. The Chairman asked where the impetus will come from for a real initiative in this regard. There have been calls for a vaccine summit involving the new US Administration and perhaps involving the G7. It is very important that we go beyond just saying there needs to be a summit. World leaders have got to come together in a constant format to deal with this crisis as a global crisis now. It cannot be dealt with by individual national leaders working on their own, which is bound to cause terrible problems. The kinds of issues we are discussing today need solidarity in the responses. The WHO and the UN Secretary-General are constantly asking for greater and more joined-up leadership by leaders. I propose not just a summit but a global Covid response programme that deals with all of the issues such as access to tests, access to treatment, access to vaccines, travel issues, the problems of obligations of occupiers and all the other problems we are talking about. This needs ongoing attention now because we do not know what a failure to deal with Covid in a joined-up way worldwide will lead to. We do know that 2020 was a year like no other. Who knows what will happen in 2021 and 2022 if we do not deal with this as the global emergency that it is?