The Virus, the Vaccine and Violence

Dr Robin Niblett CMG

Ladies and gentlemen, welcome to this latest Chatham House webinar, but it’s a Chatham House webinar in partnership, very much, with the European Institute of Peace. And on behalf of Patricia Lewis, the Director of our International Security Programme, and all of my colleagues at Chatham House, we’re thrilled to be partnering with EIP on this very well-timed, if challenging, topic of, The virus, the Vaccine and Violence. And I think when we had this idea of holding this event, obviously struck by the very negative impacts of the COVID-19 crisis on conflict and fragile states around the world, encompassing at least a billion of the world’s 7+ billion population, they are often a part of the world that gets less attention at moments when everyone turns in on themselves, as they would naturally do at this moment of crisis, we felt it was particularly important to be able to give real prominence to this topic.

As you saw from the graphic before, Chatham House is celebrating its 100th anniversary this year. We’ve set ourselves three second century goals, goals for our second century, one of which is trying to help promote and get to a world of peaceful and thriving societies, under that whole peace agenda, which gets wrapped up with the SDGs. And the particular SDG 16 is hugely threatened by the impacts of COVID, which even if COVID is not having the, sort of, decimating impact directly from health effects in many of the fragile and conflict parts of the world, it is most definitely undermining them in an economic, political and social sense. As other parts of the world either pullback from being supportive or, quite simply through closing their own economies and having slower growth, end up having disastrous knock-on effects. And, of course, what we’ll be talking about, in particular, today, the way that actors within these countries are taking advantage of this COVID moment.

But, obviously, the optimistic gloss on this is that we are having a series of announcements on the COVID vaccine train, caravan, that is emerging, with the Pfizer/BioNTech announcements a week and a bit ago, the Moderna announcement this morning, announcements about AstraZeneca, real hope that we will be starting to get these vaccines out and into the system in the coming year. But at what pace and where, and will they do something to obviate the very negative impacts of COVID-19 into fragile and conflict zones?

I am the Chair of this meeting. In a minute, I’m going to turn over to our co-host, Michael Keating, the Executive Director of the European Institute of Peace, to say some words, also, of welcome and contextualisation. And then, I’ll be moderating a discussion with our four panellists and other members of our groups who are here and all of you who’ve joined this meeting. So, can I simply remind you this is on the record, it’s actually also being recorded for future use. You are most definitely encouraged to either ask questions, or make comments, so, give us your ideas and your interventions. Please use the ‘Q&A’ function as your way in and we would be very happy to, kind of, get you to ask your questions in person and enable you to unmute. So, please indicate when you put up a Q&A if you’d rather I asked the question or made the comment on your behalf. Otherwise, I will find a way to reach over to you and see if we can get you to engage and join the conversation in person, in some, well, in some virtual form.

And that’s pretty much the thing. I will introduce the speakers in a minute. I don’t want to hold off anymore, I want to bring Michael in. Michael, as I said, is the Executive Director of the European Institute of Peace. As I think most of you here will know, he was the UN’s Special Representative in Somalia, the UN mission in Somalia, through about 2015 to 18. One of those really critical and most challenging of posts, one for which he was hugely well equipped, not only ‘cause of his time prior that as Deputy Special Representative in Kabul, in Afghanistan, having worked in Gaza, Islamabad. But also, he had to work as Associate Director of Chatham House before going over to Mogadishu, which had him very well trained up for all sorts of complex internal conflict. Michael, joking aside, it’s super to see you, great to be doing this event. On behalf of Patricia, myself and all our colleagues at Chatham House, really glad to see EIP and Chatham House partnering on this very important event. Over to you.

Michael Keating

Well, thank you, Robin, and, clearly, my career highlight was, indeed, working with you and for you and I’m glad that we’re slowly coming back to that. So, I just want to thank Chatham House and your colleagues for the partnership on this. This is actually the culmination, although maybe it’ll lead to other things, of, I think, five country-focused meetings we’ve had, where we’ve looked at the impact of the virus on people in conflict-affected countries. We’ve covered places like Yemen and Syria, and Venezuela and Sudan and Afghanistan, not all of them at Chatham House, but several of them at Chatham House.

As you say, this meeting is taking place when there is light at the end of the tunnel, as it were, not only in terms of the vaccine, but the, you know, the COVAX facility, the ACT Accelerator. You have nice words coming out of the G20 Summit yesterday, in which it was decided that, you know, an extensive immunisation must be treated as a global public good with the – global public good approach, which sounds great. And, of course, we have the transition, we hope, in the US and the US being back, as it were.

But, as you have mentioned, the funds available to help people deal with this are not necessarily commensurate in the Global South, least of all in the poorest countries, to deal with the scale of the problem. And we have – you know, which is in contrast to the amount of money that’s been mobilised in richer states, of course. And we have, you know, high introversion in our own societies and perhaps, arguably, despite some of these good signals, we don’t really have a co-ordinated global response yet to addressing the needs of the poorest people and the people in the most difficult circumstances. The – there is a Debt Service Suspension Initiative, there are a few other bits and pieces going on, but there’s nothing like a global approach. And I think the SG’s call for a global ceasefire around the virus was an indication of that, the poor take up, despite a few good examples.

So, I – you know, let me just say how much we’re looking forward to hearing from the speakers. I hope this results in ideas that we can pick up and run with. Clearly, I’m, maybe I’m prejudiced, but I do think there needs to be an internationally supported national level approach to these issues that brings national actors together, not just governments, but authorities in the private sector, supported by the UN and whoever else, is on the ground and in a position to move that forward. And it is going to be particularly challenging in contested areas and poor – and countries in conflict, but it can be done, as I suspect we’re going to hear from Chris Maher and maybe others. You know, there are precedents of reaching people, even in the most difficult circumstances.

So, with that, I’m hugely looking forward to this conversation and to benefit from the wisdom of the great group of people that Chatham House and EIP has assembled for this discussion, thank you. Thank you for…

Dr Robin Niblett CMG

Thank you very much, Michael, that’s super, for setting it up this way and, as you’ve said, we’ve got a great panel. I don’t want to take up any more time and let’s make sure we can swing over, right, and get their perspectives. I’ll introduce while – each person as I go along. Hopefully, you’ve had a chance to, all of you who are participating in this meeting, to see their bios in the invitation pack we sent over to you. But Chris Maher, really pleased to have you with us, a, if you don’t mind me saying so, a true veteran of the World Health Organization and most importantly, of its immunisation programmes, now Senior Advisor to the Director-General, as of last year, and the Director-General of the World Health Organization in Geneva. But given the work you have undertaken on polio eradication around the world, leading a lot of the WHO’s work in this field, not just from Geneva, but also from Manilla, from Jordan, I’m just wondering, to what extent do you see the COVID crisis really, a) getting in the way of the broader immunisation efforts and, therefore, impacting the health security of these conflict prone, or conflict existing, zones, and more importantly, what prospects are there for COVID-19 being controlled in these territories? Will immunisation be possible at a time when developed countries around the world are so determined to make sure that their own societies are taken care of first? Over to you, Chris.

Dr Christopher Maher

Thanks very much, Robin, I hope everyone can hear me well. Thanks very much, also, to Chatham House and to EIP for asking me to become engaged in the discussions. I had to say I jumped at the chance. I think it’s been a very interesting last 18 months for me, last 12 months in particular, as COVID has, sort of, evolved out into the pandemic that it’s become. There’s a lot of territory that seems very familiar to me when I look at it and there’s also a lot of territory that’s very, very uncertain, because it – this is quite an extraordinary situation, I think, for all of us.

I’m certainly not an expert on the economic impacts of COVID in any setting, but my natural assumption is that they are going to be far worse in settings where populations are already fragile economically, or fragile, in terms of personal security, or whatever. The one – yeah, I mean, the health elements, the public health elements of the disease basically fall into two groups, for me. I mean, one is the direct impact of the disease, and I should point out straightaway that we don’t have any evidence that in any human population COVID disease is a – has a different or a lesser impact. We know that wherever – you can be in a security compromised setting or in the middle of a highly developed country, this is a serious disease and we’re not going to get away with nothing happening in security-compromised settings, just because populations are younger, for example. So, I think it’s important for us to accept that straightaway, this is a dangerous disease wherever it’s going to occur.

The second impact is the impact you alluded to on the delivery of other health services, and we’ve already seen that. We’ve seen what’s happened with immunisation programmes, with – I mean, they’re the ones, of course, that are dearest to my heart. So, they’re the ones I follow most, but disruptions to maternal and child healthcare, to cancer treatment, to, you know, control of other non-communicable diseases. You name it, it’s been there.

When I think about humanitarian and conflict settings and again, what our experience has been, and it’s all very recent experience, is that access for just about anything is far more complicated. So, not – it’s not just the interventions associated with the clinical side of the pandemic, we’re looking after patients and try – it’s all of the interventions associated with the non-pharmaceutical side of things, the non-clinical side of things, as well. And one thing that we have learned, or been reminded of, very, very forcefully, in the course of the last 12 months, is the importance of community engagement and risk communication, and in so many of our conflict settings, this is a very, very difficult, complex, area of work. I’m happy to come back to that later in the discussion with some examples, if that’s appropriate.

I would say, just looking at our own experience of what happens when you have to deliver a service and, in particular, when you have to deliver an immunisation service in situations of conflict, this is what’s going to, you know, become more and more critical as vaccine – more and more vaccine becomes available. And how are we, actually, going to be able to use this vaccine in difficult places? And based – my own experience, I would break things down, basically, into four groups. You have the active conflict situation, where you were trying to navigate yourself around a place where people are actually shooting at each other and trying to blow each other up. There is the second situation, in which there are bands or restrictions, or constraints on access, that are instituted by local authorities or local partners to the conflict – parties to the conflict. And I mean, one of the most obvious examples of that at the moment is Afghanistan with its – with the Taliban ban on house-to-house immunisation for polio.

The third area that I would’ve – I would pick out is that situation of general insecurity and I think this is something that Michael would be very familiar with, with – from various aspects of his experience, but certainly from Somalia, where it’s not just so simple that you have these parties in conflict and that there’s some sort of, you know, basic organisation that operates that you can deal with. There is an underlying general insecurity, which complicates the safety of communities and the safety of health workers. And the last, and perhaps the most difficult, element, I think, in conflict settings, is the deliberate targeting of health workers for use as a political weapon. And, you know, again, in the polio experience, we’ve seen that happening in Pakistan, so we know what it can do to an immunisation programme.

I’m very much in danger of going over my time, but I would pick out a couple of quick lessons for us, perhaps, that might come up again later in the discussion. I mean, one is that each of these situations, each conflict setting or humanitarian setting, is, in its own way, a little bit unique. And it’s – although there are common elements, it’s a mistake for us to approach each one the same way and that we really do need to look at the uniqueness of each situation in devising our strategy for access. The second one is, particularly for, say, something like an immunisation programme, to be flexible about how the vaccine is delivered. And all too often we, kind of, paint ourselves into an operational box and this is how we’re going to operate, and this is how we’re going to do things and we can’t afford to do that if we’re going to reach everyone in all settings.

The risk communication and community engagement point I mentioned earlier, you know, honestly, I can’t raise the importance of that enough, particularly in the conflict settings, because we know how easy it is, in these settings, for rumours or false information to become widespread. And, lastly, I would say that right from the beginning, we have to be thinking about what mechanisms we’re going to use to see whether or not we’re actually succeeding in reaching people with our interventions, because again, in conflict, in humanitarian settings, it’s so hard, sometimes, to know what your impact actually is. And my apologies for going over time, on this…

Dr Robin Niblett CMG

No, no, that’s perfect…

Dr Christopher Maher

…topic.

Dr Robin Niblett CMG

…Chris, so, I think you’ve, no, you’ve set the scene very nicely, both laying out the scope of the risks and the problem and, as you said, a few pointers as to how we might think, going ahead. You said you – if you were just to give me, or give us, the two or three, kind of, conflict areas or countries that worry you the most at the moment. You mentioned Afghanistan, in terms of constraints on access for the medical personnel or for people to actually be able to get immunisations laid out, but as you, kind of, take that global look around the world, what – are there certain parts, or even certain countries that are at the top of your watchlist?

Dr Christopher Maher

I think the big concentration of countries in what is WHO’s Eastern Mediterranean region is, to me, the biggest set of risks, Robin. So, Yemen, of course, Syria still, Iraq is – yeah, there’s still gazillions of issues, problems there. Afghanistan and Pakistan in the far West of that region, Somalia, Sudan itself now, as well as Southern Sudan, as we begin to move into the African region. Central African Republic, DRC still, is – and the Eastern part of DRG is still a very, very difficult place to operate, as our colleagues working on Ebola have been demonstrating in the – for the past two or three years. So, yeah, I would pick those automatically.

Dr Robin Niblett CMG

No, it’s helpful, I think, just as we steer the conversation around and, actually, it’s, sadly, a very good segue, Olla, over to Olla Al-Sakkaf. Olla, delighted to have you with us, joining us, actually, from Yemen, and one of the countries that Chris mentioned on his list there. Olla, who is Programme Manager for Youth without Borders Organization for Development and, also, a member of the UN Network of Young Peacebuilders. Olla, thank you very much for joining us and I think I would be very interested to hear, from your, on the ground experience, how COVID-19 is changing the context for you and for the country, and the ability to be able to, a) deal already with a conflict zone and all the challenges that brings to health and security and development, but now, this extra overlay of COVID-19. Over to you.

Olla Al-Sakkaf

Thank you and thank you for having me, glad to be here today with you. So, first, as you know, the situation in Yemen is different from other countries around the world. So, the civilians here in Yemen are facing hardship after another – a decade of economic and political crisis and more than five years of conflict have almost destroyed the country. Thousands of civilians have been killed or injured, at least 3.6 million people have to – were forced to flee their homes, due to the conflict. This conflict involved at least six regional and international powers.

So, the outbreak of COVID-19 and recorded the first case in Yemen in April 2020 as new struggles to the amount of suffering of Yemeni people. The war have affected the infrastructure, including health sectors. Many health – hospitals were destroyed, and people lost their jobs. Many people in Yemen depends on daily income, so it was very difficult for them to stay at home. The out – actually, about 24 million of Yemeni people, out of 30 million, are in need of some form of aid and assistance. The United Nation calls Yemen’s the worst humanitarian crisis. Cholera and other diseases outbreak are common here in Yemen, water is circus, and the healthcare system is crumbling, with only half of the country’s health facilities full operational and with massive medical supply and staff shortages.

So, the outbreak and COVID-19 affected the efforts of peacebuilding badly, with COVID-19 outbreak and the sequences decreased the humanitarian funding for Yemen. Actually, for us, who work in peacebuilding, the situation was very difficult. The first thing that we were first to work online and can you imagine working in line with the weakest internet connection ever? It was very difficult, actually. But we did not stop. Many NGOs and INGOs started to working on projects for – to response to COVID-19. They supported health sectors. Youth actually played an effective role. They volunteered to sanitise some places, raise the awareness of people, distribute high end kits and prevention materials. But our efforts, actually, were not enough. Yemen recorded more than 600 cases of death and we are just not trying to response to coronavirus, but also, to world peace and renormalise the public life and this is make it more difficult for us.

Dr Robin Niblett CMG

It’s interesting, and the points you just made there, Olla, ‘cause they, I think, are very important for the next bit of the conversation, especially on the comment you made about the dependence on daily income, how on Earth, you know, could people isolate themselves in the environment that you’ve just been describing? And so, maybe we’ll come back to that later on, a little bit, in terms of the urgency of being able to get vaccines to countries where people do not have the capacity to self-isolate in any particular shape or form.

On the flipside, you know, again, this is – will reveal my ignorance, I’m afraid, about vaccines and so on, but could one be doubling up? If people – if we are able to get vaccines out there for COVID, could that opportunity also be used to increase health provision to those who come in and be monitored, on some increased basis? Maybe that’s something we can come back to for later on and be able to test, as well, Olla. So, thank you very much for sharing the situation there. We will definitely want to come back to you with some of the answers that are being discussed here, in particular, the ones that Chris put on the table about community engagement, flexibility, on delivery. And, obviously, you know, how we can measure success, if we’re actually achieving it, or not.

I’m going to turn now to Mariano Aguirre. Mariano, I think known to many here from his role as Director of the Norwegian Centre for Conflict Resolution, NOREF, and somebody who also has worked on – with the UN in Colombia. Now an Associate Fellow, as well, of Chatham House and our International Security Programme, which we’re thrilled, Mario, to have somebody with your experience involved with us at the moment. Could you share your thoughts on this crisis, and I suppose, in particular, given your background, in how you see some of the non-state actors, the people involved in the violence, in a way, sort of, instrumentalising this moment and this crisis? For some people a crisis is an opportunity, as negative as it might be more broadly. What insights can you share on that front, in particular, anything else you’d like to raise with us? Over to you, Mariano.

Mariano Aguirre

[Pause] Unmute.

Dr Robin Niblett CMG

Yeah, you’re unmuted, that’s it, yeah.

Mariano Aguirre

Okay.

Dr Robin Niblett CMG

We can hear you.

Mariano Aguirre

Thanks very much, Robin, thank you for the invitation. I think that the COVID-19 crisis has highlighted the deep social inequalities and governance challenges in many countries. The lack of universal health services and many cases their privatisation has become evident and that’s a strong impact on fragile contexts, as some of the – some of that has been mentioned already. For example, in 2017, the World Health Organization and the World Bank stated that at least half of the world’s population cannot obtain essential health services and each year large numbers of households are being pushed into poverty because they must pay for healthcare themselves.

Now, if we turn, for example, to the concept, to the so-called ‘fragile state’, or ‘fragile context’, as the OECD call them, we see that there are most of fivety seven – 57 countries qualify as fragile, that are, in this moment, insufficiently prepared to cope with the spread of the disease and has consequences across the multiple economic, political, social, environmental and human rights dimensions of fragility. And most of the current violent conflicts are intra-states and are happening in this fragile context. Known state actors and criminal organisations operate in many of these conflicts at the national level and with connections to the regional and international worlds.

A recent study, for example, from – by Oliver Kaplan and Jonathan Moyer in the University of Denver, they predict and show that an additional 13 countries are likely to see new conflicts through 2022, due to the coronavirus pandemic and government responses, such as national lockdowns. And also, in relation, I would say it’s very interesting to see and dramatic in relation to peace and conflict, due to the COVID-19, or related to the COVID-19, that some dialogue and mediation operations have been delayed or stopped, complicating ongoing processes in Venezuela, in Yemen, in Syria, Afghanistan, Mali and Libya. And there is another field that I would like to stress, a very harsh reality, is the impact of the pandemic in refugee camps.

Last October, for example, the United Nations High Commission for Refugees reported that globally, 21,000 of the world’s 30 million refugees have tested positive for the virus across 97 countries, including Bangladesh, Lebanon, Palestine and Greece, given the limited testing capacities in these camps. I think that I would like to mention and then, perhaps, we can discuss it later, that the second point I would like to stress is the role of organised crime and organised crime response. Let me just tell you briefly that since the pandemic began, non-state armed actors have taken advantage of the situation, where the state is fully or partly absent, and organised crime has shown a high capacity of adaptation and flexibility to changes in, I would say, their markets. Criminal groups and guerrillas in Latin America have imposed curfews, for example, in the favelas of Brazil, in Mexico, and, also, the ELN in Colombia, exercising greater control over populations and carrying out food distribution in poor neighbourhoods. Perhaps I will leave it here and we can discuss this later, about this role of the non-state armed actors.

Dr Robin Niblett CMG

And thank you very much for pointing out that set of problems and just one – before we talk more about the non-state armed groups, could you just say a word or two, also, about the, kind of, those authoritarian governments, let’s put it that way, or those who are trying to keep countries maybe in a lock? Are you also seeing examples where that’s being instrumentalised, if you see, what I’m saying, on the other side of the ledger, rather than the non-state actors?

Mariano Aguirre

Well, yes, as a matter of fact, to contain the outbreak, many governments across the world have used what we – they call emergency powers, to impose national lockdowns enforced by Police or Armed Forces, and often, in abusive and at least, I would say, questionable ways. This is related to the so-called securitisation of the response by governments in a very broad, I mean, I would say, arc that is going from the Philippines and India, to some countries in Eastern Europe, for example, Hungary. But also, we can see these kind of responses in Central America, immediate and this is a response that not only generated additional risk for the most vulnerable, but it’s just – I think, a very important point to stress is that, you know, deteriorate even more the lack of trust of the citizens in the state. And it’s something that we will need a lot of this kind of trust that is lacking at this point, for example, for the whole global campaign regarding the vaccine.

Dr Robin Niblett CMG

Thank you for – I mean, it’s not good news, but thank you for giving a very comprehensive answer and listing some of the countries and regions where you, in particular, are seeing these risks emerging. Cristina seems very unfair, in some ways, to turn to you now, because we’ve had three presentations about the worries and the problems and the challenges. But your hat, if I can put it that way, and the position you’ve taken up in the Spanish Government since February of this year, as the State Secretary for Foreign Affairs and Foreign – yeah, exactly, Foreign Affairs, and the Ibero-American region in the Spanish Government, it puts you, you know, full square in the answer part of this. And I think the EU and European Member States, in particular, have very much wanted to show themselves as leaders in this space, in particular on the COVAX, you know, fundraising, should we say, for a global vaccine programme. There are a number of EU member states, as well as the EU itself, involved in the G20 conversations that took place yesterday, which Michael mentioned.

And, obviously, being as close as Europe is to Sub-Saharan Africa and to some of those Eastern Mediterranean zones that Chris mentioned in his opening remarks, were the ones he had at the top of his list, could you just share with us how either the Spanish Government and, given the role that you’ve played, also within the European Council, in some of your official roles for the EU, as well, could you give us a feel for how you think Europe is stepping up? Has it got the bandwidth to worry about itself and be worrying about these spill over effects simultaneously? Over to you.

Cristina Gallach

Thank you, Robin, and thanks to all the colleagues that have preceded me, and before entering or trying to reply your question, with a couple of comments, I would like to refer to what Mariano has mentioned, which is the issue of inequalities. There is no doubt that we were in a global situation where inequalities were obvious, difficult to tackle. Many initiatives had been taken place, including the SDGs, the 2030 Agenda, which is as a major driving force to “leave no-one behind.” And what situation do we find in – us in, is the fact that the pandemic has treated people diff – unequally. Those that have access to healthcare, those that have to choose between taking care of their health, or having something to eat, those that find themselves in a situation where the lack of mobility does not allow, definitely, to overcome the tragedy, or those that have been well-protected by the financial support that governments across the world, in particular Western governments, but also, governments in Latin America, have been handed to workers. So, definitely, we will come out of this pandemic more unequal than ever. Therefore, the effort of leaving no-one behind has to be, and will have to be much, much stronger.

And that is why we look at the situation, the situation in which we are now, as the major possibility or a major opportunity to shape a new multilateral vision. It might sound, you know, too ambitious, but I think we have to treat the situation as it is. Mind you, I think a few weeks ago we might have found this even more challenging that it is now, considering the important changings that will be happening very soon, hopefully, in the United State. For us, there are a few steps that are essential. One is to consider the vaccine against COVID a global public good, for a number of key reasons.

First of all, because COVID doesn’t respect boundaries and as long as it exists, COVID exists somewhere, we are all affected. Second, it is a moral imperative, I think we have to take this as a fundamental ethical approach. Third, that this is not a cost, but an investment, absolutely fundamental, this is an investment, public health, at the centre of public policies because it has a direct impact on economic and social development. Third, or – I already mentioned third is the par – is the investment one. Fourth is the global immunisation is a driver for stability. We were talking, I heard some of our colleagues already mention, you know, the tensions that will happen if there is no global immunisation and the destabilising factor that the lack of vaccination will produce in many parts of the world.

How can we make sure that this happens? First of all, global solidarity, multilateral co-operation, these are the keys first steps to defeat the virus. Ensuring the prices of the doses are, you know, what they ought to be, there has to be a balance equation between cost and profit and citizens, companies, governments, have to be at the core of this. We will need a lot of negotiations between governments and companies, no doubt about that and this is a very good way to practice Goal 17 of the 2030 Agenda. This is probably the most global partnership between public and private that we can face. So, it’s a fantastic opportunity and so, we have to take it.

There is a tremendous amount of opportunities for research. We have already seen that a young start-up BioNTech, who was financed by the start-up funds of the European Commission, which are handed over by an agency, not even the Commission core of – but an agency cost met. So, this is really important the type of mobilisation of science and technology research and then, clearly, we need to work on how do we prioritise, in terms of the population? This is a major undertaken – undertaking, not only in our developed countries, but in countries, in particular, in conflict, etc.

Let me mention a couple of things about the EU. The EU was, as it often happens, hard to get its act together. You will remember March/April, countries closing, opening, all sorts of geometries, in terms of action. But the vaccine experience is probably the most solid act together of the European institutions, no doubt about that, and it’s already started. I’m sure Christopher can tell us more about how he saw the relationship between the EU, the Commission and the member states and the WHO. But no doubt that it was the movement at the end of April, the meetings in May, that really opened all of us the eyes that there was no alternative but acting together. And we all saw a number of big events, led jointly by the European Union and Dr Tedros, and some – and not some, of Heads of State and government, extremely active on that. And what we saw yesterday at the G20 was probably an example of the manner in which the thing has been floated and it is true, the G20 didn’t provide yesterday’s specifics and that probably is not – is one of the difficulties of the meeting yesterday, but I think we have a number of initiatives, COVAX, etc., very, very interesting.

Let me mention a couple of things about Spain. I think I should mention it, because tomorrow our government is announcing the national plan for global vaccination. There has been a number of prim – centres for primary health that will be, you know, the network. And not only we are taking care of ourselves, of the Spanish citizens in Spain, but we have actively contributed to, financially, to the Global Initiatives Act and we have also been contributing to CEPI, Gavi, etc. So, our contributions are, we think, commensurate to our determination to ensure there is a multilateral action to this global issue. Some Researchers speak about $38,000 US million needed, in terms of the investment. Again, probably colleagues in the panel can tell us more about this figure but having an impact on the global economy of nine trillion by 2025. So – and, you know, we shouldn’t, you know, give a price tag to every life that we are going to be protecting with a vaccine, but it is important to say that there are – those are enormous opportunities.

So, just as a couple of closing remarks, I think that never before has a lifesaving health intervention against an immediate global threat been made available to people in the Global North and the Global South simultaneously and at such a speed. And I think this should give us the energy and should make us work together, because we have an opportunity to really – it’s – change the current situation, which is dramatic for those in conflict, but also, dramatic in Western Europe, in Eastern Europe, all over the world, that you’d to give a, you know, water. About Latin America, where these are countries trapped in these middle-income etiquette. They were put there several years ago and that was going to be fantastic, but now they are losing much more than many others, because they are not in a solid position financially, economically, socially.

So, I close it, I think it is an absolute and moral imperative and only through global solidarity, co-operation and multilateralism, we are going to be succeeding. Sorry for taking a lot of time, I’m sorry, so sorry, but I will – over to you.

Dr Robin Niblett CMG

Lots of good points were made and I’m – I’ve got a few people I want to bring into the conversation, as well. We’ve got a lot of questions, six or seven questions, already in the ‘Q&A’ line, thank you very much for those. And there’s two people I want to bring in, in particular, just to comment on what they’ve heard initially and maybe what I’ll do is get those points on the table now, because then I can come back to the panellists and maybe cross ask some of the questions, and then I’ll go to the ‘Q&A’ list. We’ve got a good half an hour to go, so, we should have plenty of time for conversation.

But I’m very pleased we’ve got Mark Malloch Brown with us, on this call, I think known to everyone here, Member of the House of Lords. I think, importantly, in the context of this conversation, Co-Chair of the International Crisis Group and, obviously, somebody, from his time in the UN Deputy Security-General, lots of insight into this kind of combination of conflict and global responses. Mark, any comment or question that you might have about the dilemma that we’re dealing with this in this three Vs, of the virus, the vaccine and the violence?

Mark Malloch Brown

Well, thank you, Robin, and greetings to everybody who’s spoken before. It’s one of those exasperating panels where you’re invited in to comment and, you know, Michael’s encouraged me to find something to disagree with you all about and it’s, sort of, impossible. Because, you know, I simply adhere to everything each one of our panellists have said and applaud how strongly and well they’ve said it. I suppose, you know, an obvious point about refugee communities, particularly, is they are unrepresented in global politics, in an effective way. There’s the High Commissioner for Refugees, there are others who do a great job, but they are the world’s stateless people, they have no state to speak up for them. We’ve already talked about how vulnerable they are, just because of the nature of refugee camps and the concentration, but I think it is worth just thinking just a moment beyond that, to, as we’ve just heard, I mean, the impoverishment and growing inequality doesn’t just stop with refugees, it goes to all poor people. And the World Bank estimates 120 million plus driven back into poverty. I suspect it’s considerably higher, in truth, that number, with just the collapse of the informal economy and of the SME sector in so many parts of the world and remittance earnings and tourism and service sector earnings and other things.

So, you know, these vulnerable communities, either refugees or those in conflict states, are caught in this broader meltdown of significant parts of the Global South. And so, the challenge of protecting them and making sure they get some kind of equitable access to vaccines, etc., you know, is made doubly hard when the whole Global South is in trouble, so to speak. And so, I think the challenge is, you know, how on Earth do we try and ensure some degree of secured protection politically and, therefore, translated into support for vaccines and other health treatments in an effective way? And, you know, I think the G20 was a start, but it was a pretty modest start. Lots of good words expressed, but no real commitments and so, I think that’s a challenge, going forward, how do we build a strategy, which has got some real enforcement force to it and some real political will behind it? Let me stop there, Robin, thank you.

Dr Robin Niblett CMG

Thanks very much, Mark, a very important points about the, as you said, the many, many more that have been pushed into – back into poverty and, therefore, their vulnerability to this conflict. And I wanted to bring, as well, my colleague, Patricia Lewis, in, who was instrumental in organising this meeting as well and has been participating in some of the other dynamics, in the context of our peaceful thriving society’s work. Patricia, any points you want to raise, in particular? Then what I’m going to do is just go back, I think, to each of our panellists and ask the question, just so you’re ready, that Dina Mufti has asked and has gone to the top of our list of questions, which is, you know, “What conflict sensitive approaches have worked in the past and what haven’t?” So, what are you looking for, you, as experts in the field, that you think could be done this time, from lessons in the past, that would make a difference? ‘Cause we could spend a lot of time describing the problem here and describing it extremely well, but I’m sure that all of us and the folks joining this call would love to think about answers. So, Chris, just warning that I’ll be coming to you shortly to help start providing the answers. But first, to my colleague, Patricia.

Patricia Lewis

Thanks, Robin, thanks very much and thanks for the excellent presentations and particularly, thanks to Michael and his team at EIP for all their hard work. So, as we are seeing, COVID-19 is really exposing inequalities within our societies and across all of our countries. And I want to examine, for a moment, the impact of disinformation, the potential impact of disinformation, or what we might call, in other days, fake news, about vaccines. And I think the polio vaccine programme has quite a lot to offer in this regard and particularly in the way that certain pieces of disinformation about what that vaccine might do to children, were propagated and how WHO, others, Rotary International, UNICEF, etc., all worked very hard to overcome this fake news, but it was a real struggle. And I think we’ve seen this, also, with other vaccines in our – in many other countries, as well, and, you know, we need to be really prepared for this. It’s already happening, certainly, in Europe, and I’m sure it’s happening in the US, it’s bound to happen in many other countries where people don’t have access to the sort of information that we all have access to, which can, at least, present the scientific side. So, how can we address this now and prior to the, in particular, prior to the vaccine rollout, so that we don’t increase the inequalities that we’re already seeing in our societies and, you know, just make everything in conflict prone societies even worse?

Dr Robin Niblett CMG

Thanks, Patricia, very important points and, as you said, back on this, kind of, lessons learned, also from the polio experience. Chris, I’m going to start off with you, as we’re still on the big question from Dina about conflict sensitive approaches that have worked in the past and some that haven’t. How would you be – yeah, or how are you, advising, let’s say, the World Health Organization, others, to integrate these into the response this time?

Dr Christopher Maher

I think, Robin, actually, as far as strategies or approaches for how do you do these kinds of things in conflict settings? We’re in pretty good shape. I mean, we have recent experience in a lot of places where very successful immunisation activities and large-scale activities were carried out quite frequently, despite high levels of conflict. And, I mean, many of the countries that we were talking about before spring immediately to mind. I mean, even in Syria, in the middle of the war, in Somalia, in Afghanistan and the recent ban has been the longest period of disruption we’ve faced there. But before that, prior to that, there were many shorter periods of disruption, which were negotiated through and strategized through, to, you know, return a basic level of activity.

So, I think that, you know, I’m relatively confident that the conflict in humanitarian crisis settings don’t present an insurmountable obstacle to introducing an effective vaccine for COVID. We do come back to those same points, though, and some of our previous speakers have made them so eloquently. I mean, engaging communities is critical in these settings.

Dr Robin Niblett CMG

Let me ask you just one quick follow-up bit before I come to Olla, then, Chris. There was a question here by Suvi Parahunganus, and she, or he, I’m sorry, Suvi, I don’t know your name, because I’m asked to read it, in any case, asked, “How vulnerable are COVID-19 vaccines to be weaponised by some of the armed non-state actor groups?” You know, how could they be co-opted or co-operated with? And I’m wondering, Chris, when you say we’ve done this before, I imagine it must’ve been done, in many cases, in some type of collaboration with non-state armed groups. What’s your experience on that front?

Dr Christopher Maher

Oh, yeah, very much so. I mean, you – in many of these settings it would not have been possible to carry out activities without the, at least, the, very least, the neutrality of local authorities, of whatever hue they were. There is always a risk with any sort of an intervention, which you can have a – people will try to use it in some way, shape or form, politically, or whether we wish to use the term ‘weaponised’ or not, that’s there. But, again, I would say that experience has been that we have been able, in many, many difficult settings, to ensure that that did not happen, through a wide range of engagements, activities with non-state armed groups, with the state – the states itself and with communities. So, I do believe we have capacity to do that in most situations.

Dr Robin Niblett CMG

Okay, well, no, I’m going to come – keep pushing on it and maybe come back to you later on, but I want to get some other questions on the table. But I will come back to the issue of whether, let’s say, donor governments, in a way, need to give some of that permission to various groups to get these medicines out, sometimes through the non-state armed groups that are having to be partnered with. But, Olla, let me come to you, ‘cause Paul Sellis has a question specifically for you, asking, “What opportunities there are for community-based interventions where the state is too weak?” And he’s just wondering whether you have some examples, in particular, from the experience of Yemen, “is it community-based organisations that are having to step in, and what can donor countries and others do to make sure they’re engaging with those community-based organisations?” Over to you, Olla.

Olla Al-Sakkaf

Yeah, actually, the response to COVID-19, lastly, we – people here in Yemen used to depend on the NGOs. We did not have government, actually we had more than one government, but they are not really working as governments. So, people started to depends on the NGOs and international NGOs, even when COVID-9 – on the outbreak of COVID-19, we depended on them to start working on the effects of COVID-19, and they did, actually. We didn’t see a lot of efforts from our governments, although they tried to do a few things, but they – that was not useful. But NGOs and international NGOs helped a lot and response to the COVID, but their efforts are not enough because of the situation in Yemen. It’s very hard situation, it’s very difficult. This is five years of ongoing war, everything is almost destroyed, so what they are trying to do is, yeah, it helps, but not that much. So, people here in Yemen start – just continued their life. Some of them died because of COVID-19 and other reasons and the other continue living their lives, as they don’t have chance or other choices.

Dr Robin Niblett CMG

It’s a desperately difficult situation, Olla, thank you for that point. I’m going to keep – we’ve got so many questions, I want to make sure I get to them, as many as possible. We’ve got a very active participants’ group this time, which is fantastic. I’m going to do hop down to Bia – if you can pronounce your name right, Biana Nurum. As you’ve done two questions, I’m going to ask them on your behalf, to try and speed things along here a little bit. But I think a very good one to go to you, Mariano, on, “To what extent are you finding that the access to the vaccine has been used as a, sort of, negotiating power tool in some countries, and are we even finding that it’s being used as a tool to try to mobilise against the distribution of vaccines and the, kind of, a Boko Haram, Taliban type of example in polio?” What are you finding about the vaccine being used already or the likelihood of it and what is your worry about it being used, as a negotiating tool in a conflict zone?

Mariano Aguirre

Yes, thanks for the question. I think that, first of all, it would depend on the different situations in different countries and regions. I would say that, as a point of entry, we could say that the armed groups, or the non-state armed groups, they will try to use vaccination, they will – as a, I would say, as an instrument to consolidate and to expand its power. It’s – there are perhaps possibilities that they could, I would say, con – co-operate with the central authorities. For example, a case that I know well in Colombia, it’s very interesting that there are some cases, it’s not black or white, there are some cases in which you have a full presence of the state in Colombia, areas of Colombia. And there are areas where you have no state at all, no state presence, but there are also the grey areas where you have what we can call a shared sovereignty of the local authorities that are generally very weak. But at the same time that they, through constant daily negotiations, they are sharing their authority with the arm – the different non-state actors and armed groups. So, in this particular case, perhaps some kind of deal could be reached.

But I would say, as a general principle, is the moment, although it’s extremely difficult in the fif – at least in these 57 states that I’ve mentioned a fragile context, it’s impossible to think that in few months, now the state will be expanded. But having said that, I think that it’s extremely important to use the vaccine as an instrument, with the help of the international community and with the governments that are willing to do it, to expand the state as far as they can. And to expand means not just the security sector, it’s to expand security, but in a broader sense.

For example, let me just finish with one point that is extremely important, every time that we talk about fragility of the state, we always think, or we tend to think, that we need security forces intervening in the areas where the lack is abs – where the state is absent. But, you know, it’s very interesting talking with the people on the field, I don’t know, the experience of other colleagues here, people is looking, also, for justice, for example, not only services. They want justice, they want security, they want justice in their daily life because either the justice is provided by the state or it’s provided by the armed groups. So, I would say it’s impossible to provide justice in a few months, but this is also a moment for an opportunity and for a reflection, not only for some government, but also for what we can call, normally, the donor community.

Dr Robin Niblett CMG

Thank you, very important points. Cristina, there’s a question that was in there for you, as well, I think I got it right, it popped off the list. But there’s a question about the Canary Islands and the, kind of, flows of refugees and the question went on, this was a follow-up from Biana Nurum, “Are you seeing any impacts on flows of refugees since COVID-19, either from the Spanish Government standpoint or from your knowledge, more broadly, in the EU? How do you think COVID-19 and the refugee flow is interlacing at the moment?” Cristina, that’s to you.

Cristina Gallach

Good question. It is true that we are having, for the last four or five weeks, an increase, a very substantial increase, of persons arriving to the Canary Island, refugees, migrants, that want to move onto the peninsula. And they – the analysis of this population is that they come from the countries in the Maghreb region and it is clear that the type of individuals that arrive are individuals that truly seek a solution to their very difficult economic situation, and this is because of COVID. Mobility has been forced to close the tourism industries in Morocco, which were engaging young people, already trained, some of them professionals already, for several years. And we are noticing that the arrivals are more of this type of population and that is definitely an impact of COVID. And this is the same of Algerian population that has been moving up to the Balearic Island or to the Peninsula, Murcia, etc. So, there is clearly an impact, in terms of the numbers that are coming because of COVID.

We have seen less numbers from the Sub-Saharan region. You know that Atlantic line has always been very much the Sub-Saharan region moving to Europe through the Atlantic. But the biggest increase comes from the Maghreb region. So, definitely, there is an impact and people don’t have the mobility they need in order to make ends meet. Or, in the case of the professionals that are crossing illegally, are entering Spain, is because they – there is no jobs and their economic situation of some of those countries is very difficult and we mentioned before, they don’t have the type of social protection that we do.

Now that you have given me the floor, if you allow me, I just like to make a comment on – from Patricia’s, on Patricia’s issue relating to misinformation, or disinformation, or fake…

Dr Robin Niblett CMG

Yes, please, go ahead and do that. That’d be a…

Cristina Gallach

I thought…

Dr Robin Niblett CMG

This’d be a good moment to come in on it.

Cristina Gallach

I few days ago there was an unofficial public opinion poll, which was conducted by media in Spain, which, to my mind, was extremely interesting. It mentioned that over 47% of the population of Spain would not voluntarily get the vaccine. So, there is a lot of rumourology about the question of vaccinating and not being, you know, the right thing to do. It – although we have seen in Spain the collapse of, in particular, certain areas around the first wave, of our sanitary institution, loads of people sadly passing away because of the illness, and now we are semi-confined in certain parts of our country. So, despite these, there is a big number of our population, according to that public opinion poll which I just mentioned, should mention again is not an official one, but quite an important media carried on. So, I think there is the – as the – has been mentioned, a lot of misinformation around and when vaccine campaign has to start, we really have to work on all these clarifications.

Dr Robin Niblett CMG

Great, thank you very much for following up on that point from Patricia’s and our ISPT, we’re doing a lot of work on disinformation, in general, and, obviously, of course, COVID-19 is a whole another level. Chris, there was a question early on, which I have been asked to ask on this person’s behalf, which I think sits in your bailiwick, Chris, about – from Rob May, about the WHO and whether it’s been able to, as he put it, kind of, “learn from some of its failures in the past?” I’m just looking up here at the question. Yeah, it was quite long. But it – that it’s “been left struggling to assert and delegate its authority, in recent years. If so, and if political decisions will decide who lives and who dies, how can the WHO overcome political instincts to bring states and communities together?” This sense that WHO is being slightly behind the curve, given the strength of the role that member states play within this organisation. Do you see COVID-19, kind of, cracking this, at all, or is it – any case, you answer it as you want to. I’m sure you had a chance to see that question from Rob.

Dr Christopher Maher

I think – yeah, yeah, I did see Rob’s question, Robin, and I think you – to paraphrase Joanne [inaudible – 67:43], I think it’s “a little bit early to tell.” You know, it’s one of those things where we’re not yet 12 months into a pandemic, which is something that is certainly going to change perceptions of global public health and it’s going to change a lot of – has changed, and will continue to change, a lot of attitudes on co-ordination, co-operation, internationally, to achieve a public health goal, and co-ordination between countries, to have an impact on the thing. I don’t doubt that there will be, you know, knock-on effects for WHO for many years to come in how WHO operates with member states and how we learn about what we did right and what we did wrong with the response to the pandemic. So, I think it’s going to be a long process, Rob. In answer to your question, I don’t think it’s a short one, hmmm.

Dr Robin Niblett CMG

Okay, hopefully, we can pick and learn off this one. There was a question from Lucy Fagan, who’s not in a position, background noise and so on, to ask it herself. So, I’ll ask this question for her, as well, about whether there’s “an opportunity to see COVID-19 as a, kind of, an opportunity for positive responses?” In other words, could we – is this a moment to overcome conflict environments and situations? And I’m just wondering, if I could throw that to you first, Cristina, to you. I mean, I’m wondering – and, actually, I want – keep looking for an opportunity to bring Michael Keating in and we’ve only got five or seven minutes to go. And Michael actually helped kick off a project at Chatham House about how you thought of resource conflicts not as conflicts, but as an opportunity, actually, to break a conflict. And I’m wondering, Michael, if I can invert the question to you and whether you think COVID-19 actually might provide opportunities to break conflict situations? And Cristina, whether you have any thoughts on this, first, while Michael gets ready for my throw at him on this. So, Cristina, any thoughts, from an EU standpoint, can you see the COVID moment as a chance for the EU and other, let’s call them donor states, or welfare states, to step in and try to be constructive in dealing with a conflict or a fragile situation? And Mariano, I’m going to come to you on the gender one in a minute.

Cristina Gallach

It’s me or it’s Michael?

Dr Robin Niblett CMG

It’s you first, Cristina…

Cristina Gallach

Me first.

Dr Robin Niblett CMG

…and then Michael.

Cristina Gallach

Okay, what comes to my mind is real Palestinian. At the very beginning of COVID, there was a good co-operation, although there were so many issues, which kept the two totally apart, in particular, in those relate – in relation to salaries, in relation to dues, long-time dues from Israel to Palestine. There were quite good aspects of co-operation. This is the first conflict in which managing COVID has brought some elements of co-operation. Of course, in other issues, in particularly, you know, the questions related to Gaza, etc., this situation is extremely negative, but there has been some co-operation.

Dr Robin Niblett CMG

Great, and Michael, a chance for you to come in here and use your creative gene on this one.

Michael Keating

Well, you know, I mentioned the SG’s call for a global ceasefire and there are many reasons why that didn’t get as much traction and not the main one by any means, but something that would’ve helped, is if it had been linked to a plan and it seems to be the vaccine rollout provides an opportunity for a plan. I mean, calling for ceasefires, unless it’s a ceasefire for something, reduces the chances of ceasefires actually succeeding. So, you know, maybe there is still time to think about what that might look like in a number of places.

I do want to go back, and it’s still answering your question, I think, Robin, to the point that Mark made about refugees and, of course, there’s also internally displaced people and, you know, the – all the world’s internally displaced people are in the Global South and 80% of the refugees of the world are in the Global South. And the idea that attending to their particular needs should be prioritised, I think is a great one, because it’s an entry point, it’s an entry point. You cannot address the needs of refugees – and by the way, Chris’s long list of countries, Robin, when you asked him, you know, “Which countries are” – they’re all either refugee host countries or refugee generating countries. Well, they all have large IDP populations and the idea that you prioritise refugees and IDPs would have immediate consequences, in terms of how you engage with host populations and how you engage with host, you know, health authorities and so on, because, you know, countries that have IDPs and refugees are not going to allow them to be privileged over other populations. So, you know, if that can be used as a, sort of, way in, that would be fantastic.

I mean, and the other thing, you asked for a big idea and, you know, I wish I had one, but it does seem to me that there is scope for a much more systematic approach by members of the Security Council and, I would argue, the G20 countries, to look at some of the worst – you know, the most egregious situations in which people are worst affected and to be more deliberate, in terms of figuring out how you persuade parties to a conflict and their sponsors to get behind an effort to ensure that the vaccine does reach everyone. And I take Chris’s point, by the way, I think it’s a very good one, that, you know, you didn’t say this, but sometimes too much political attention can mess things up. I mean, and quiet conversations with non-state actors can be more effective than making a hullabaloo about it. But you do need a more deliberate approach, I think, than exists at the moment and there needs to be more systemic engagement with Security Council members and G20 countries on these things.

Dr Robin Niblett CMG

Michael, thank you, and we’re really coming up to the close of the meeting and I want to get at least three questions in. I’m going to go to Mariano first, this is a very important question, and, Olla, I’ll come to you, as well, on this question in a second. I’m just wondering whether, Mariano, in addition to the question I’m going to ask you, whether you want to note, at all, on these moments of opportunity, do you see what I’m saying, rather than just moments of negativism? But the question I want to ask both you and Olla is from Sophie de Schmidt, “Could we talk for a minute about the gender specific risks, the opportunities for access to the vaccine for women and girls and the extent to which we should really be prioritising that dimension in conflict environments?” So, Mariano, if you want to hook, at all, on Michael’s points, and others, about the opportunities here to use COVID-19 and then something on the gender, and I’ll come to you, Olla, as well, after it. So – and…

Mariano Aguirre

Yes, okay.

Dr Robin Niblett CMG

…Cristina, you’ll have a last word, as well. Mariano?

Mariano Aguirre

Yes, thank you very much for your question. I think it’s important to see that, regarding the violent impact on civilians, that COVID-19 had already, it’s very important to see that there has been a growing number of murders of women, as well as sexual and domestic violence, particularly, for example, in Latin America and, also, in some countries, for example, in Sub-Saharan Africa. And, also, it’s very important to see, on the other hand, that the closure of the schools that had been affecting more than 200 million primary school aged children in fragile context, went in parallel to the increase in recruitment of children and young people by criminal groups in some countries.

In the both fields, we find that women is, I would say, is also – their impact on women is really very strong and thank you, also, for this question. Now, regarding opportunities, I would say, very much, in this field that we are discussing, it’s important to – that the international community, the – with the different kind of responses that it will take in the short and mid-term, will consider, also, this aspect of gender and we’ll consider this aspect, I would call it inside the framework of protection of civilians, how to address this issue, also, of the impact on women.

Dr Robin Niblett CMG

Fantastic, thank you. Olla, a last comment from you and then I’ll come to Cristina, and I’ve got a last question for Chris, that’ll be the close on my screen. But Olla, first, on any point you want to come in, but maybe this one, also, on the challenges for women and girls getting access to vaccines, and so on.

Olla Al-Sakkaf

Yeah, I guess women and girls were affected more than other community groups. Even the amount of violence cases has increased during the outbreak of COVID-19. A lot of women were killed, or they were forced to many kind of violence during the outbreak of COVID-19, maybe because of the pressures on people. So, they – women are weak, so they usually, yeah, yeah, they are affected more and they don’t have a lot of chances to access to resources like men, especially here in country like Yemen, because of the traditions, which forces women to stay at homes most of the time. Most of women are not educated, they need – they are not aware of how they can get their rights, so, yeah, they are affected most than other – more than other community groups.

Dr Robin Niblett CMG

Thank you very much for that point. Cristina, last comment from you, then I’m going…

Cristina Gallach

Yeah.

Dr Robin Niblett CMG

…to go to Chris.

Cristina Gallach

Very briefly, because the issue of women and girls has been central to our activities in the multilateral organisations in – along these months. And we launched and got 80 co-sponsorships for UN General Assembly Resolution, which was approved two weeks ago, which exactly does what you mention, put the focus on women and girls, as, of course, victims, but also, as drivers of resilience and drivers of change. We were very pleased, it was very hard, you know, the situation, in terms of some countries being extremely reluctant to address the gender related issues in the UN system, made it very difficult, but we have it. It’s a Security – it’s not a Security Council Resolution, a General Assembly, but we are all there because it was agreed by consensus and we are going to ensure that we get it mobilised and bring to very practical actions. Thank you.

Dr Robin Niblett CMG

Thank you very much for that point. Chris, a last comment from you? We’ve done very well, actually, we’ve taken a huge number of questions and my apologies for those few that we didn’t get to at the end of all of this. But, Chris, I wanted to – any last comment you wanted to make? But can I tack in Agnes Kigotho’s question about, “What could the World Health Organization be doing to avoid the risk of counterfeit medicines?” I think Mariano referred, and others referred, to criminal organisations getting involved here.

Dr Christopher Maher

Yeah.

Dr Robin Niblett CMG

And specifically, this could become a huge risk, with a massive spread out here of new vaccines and, yeah, we know what’ll happen with criminal organisations and counterfeits. Over to you.

Dr Christopher Maher

Yeah, and there is always a risk of that, Robin, and I think that there is still very, very heavy reliance on national regulatory mechanisms to police things like, you know, vaccines and biologicals, which I think, in most settings, is very appropriate. One of the positive things, I suppose, for a lot of the places that we’re most concerned about now, whether they are conflict settings or humanitarian settings, is that we’re going to be talking about vaccines coming from particular sources, whether it’s a vaccine that come through the UN system or come through the – whatever mechanism the Act sets up through Gavi support, or whatever. So, the vaccines that will come in, the actual vaccines will be of known good quality, there’ll be good things. The difficulty will be, of course, ensuring that no-one is doing anything in a garden shed and pretending that that’s a vaccine. It’s a little bit difficult to do, though. You know, in many of the conflict affected settings, it’s pretty hard to come up with substitutes that look anything – look like they’re real, put it that way.

Dr Robin Niblett CMG

Thanks for that point. Look, I feel we’ve – well, as always, in an hour and a quarter, the best we can do is scratch the surface of this massive topic, but I think there – the diversity of views we’ve had from each of our panellists, and with the contributions from Michael Keating, my colleague, Patricia Lewis, and Mark Malloch Brown, as well, kind of, at the beginning, have really captured, yes, the big risks of COVID-19 into fragile and conflict contexts of societies and for the most vulnerable in those countries, as well. But I think it does feel to me like there is so much better knowledge of what the risks are than before and at least an emergent appearance of a desire to try to work together on the solution. I know it’s not particularly well co-ordinated yet, references to the G20 and the WHO, in that sense, but I think stepping in the right direction.

The last two closing comments I wanted to make, from both Michael and Patricia to me in the chatline, Michael Keating reminding us of the critical role the private sector will need to play in these answers and engaging them in the process right from the beginning, to make sure that the spread of these vaccines is effectively done, to somehow incentivise or engage them in this process. So, they can be, as they often do, provide a valuable community role in some of the most fragile places, where states can’t always reach with all of the social services they need.

And Patricia wanted me to mention, which I think makes a lot of sense, we are fortunate at Chatham House to be running a big multi-year project called ‘Xcept’ X-c-e-p-t, that’s funded by the Foreign, Commonwealth and Development Office, FCDO, looking at, kind of, war economies, cross-conflict integration of risks. And, obviously, we’re now bringing COVID-19 and the responses into that mix, both how it can be used by the negative players, but also, how one can use the response to try to crack their stranglehold on some of these war economies, as we call them. But, hopefully, I did that justice, Patricia, but otherwise, do follow-up on our Xcept project on that front.

So, my closing words, we’re a bit over time, we’ve still kept the bulk of our participants, which is fantastic. Big thank you to all of those who joined. Thank you for some great comments and questions. Sorry for those that we didn’t get to, but I know everyone had a chance to read your comments and questions, even if we couldn’t answer them. Thank you to our colleagues and friends at EIP. Michael, thank you very much with – great to be partnering with you on this, and, Patricia, thanks for, on our Chatham House behalf, to be leading on our side, and then, Cristina, Olla, Mariano, Chris, super panel. Mark, good to have you with us, as always. Thank you very much, everyone, and yeah, let’s keep working on this and, as they say, part of the Build Back Better agenda, if we all pull together on it, we’ll get there. Thank you very much indeed.

Michael Keating

See you all soon.

Dr Robin Niblett CMG

Bye.