WEBVTT 00:00:00.375 --> 00:00:01.980 align:middle line:84% Of all the products in the world you 00:00:01.980 --> 00:00:05.280 align:middle line:84% don't want to use market-based prioritisation, 00:00:05.280 --> 00:00:08.790 align:middle line:90% it's got to be vaccines. 00:00:08.790 --> 00:00:10.890 align:middle line:84% There's no technology known to man now 00:00:10.890 --> 00:00:14.107 align:middle line:90% that is faster than mRNA. 00:00:14.107 --> 00:00:17.370 align:middle line:84% Because of this monopoly or duopoly position 00:00:17.370 --> 00:00:19.080 align:middle line:84% that the sellers are in, it tends 00:00:19.080 --> 00:00:21.720 align:middle line:84% to have a high amount of market power and ability 00:00:21.720 --> 00:00:23.392 align:middle line:90% to get higher prices. 00:00:23.392 --> 00:00:28.200 align:middle line:84% Vaccines save two to three million lives every year. 00:00:28.200 --> 00:00:30.960 align:middle line:84% But bringing them to market involves huge investments, 00:00:30.960 --> 00:00:36.040 align:middle line:84% complex science, and secretive contracts. 00:00:36.040 --> 00:00:38.650 align:middle line:84% Before the Covid-19 pandemic, few people 00:00:38.650 --> 00:00:42.160 align:middle line:84% paid attention to the business models behind vaccines. 00:00:42.160 --> 00:00:47.480 align:middle line:84% The global pharmaceutical market was worth $1.3tn in 2019. 00:00:47.480 --> 00:00:49.750 align:middle line:84% Vaccines made up just 3 per cent of that, 00:00:49.750 --> 00:00:52.870 align:middle line:84% generating around $33bn of revenue. 00:00:52.870 --> 00:00:57.600 align:middle line:84% That compared to $142bn from cancer drugs. 00:00:57.600 --> 00:01:00.300 align:middle line:84% So how do the economics of vaccines work? 00:01:00.300 --> 00:01:01.320 align:middle line:90% Who funds them? 00:01:01.320 --> 00:01:03.600 align:middle line:90% How profitable are they? 00:01:03.600 --> 00:01:06.990 align:middle line:84% And will the Covid-19 pandemic and new technology 00:01:06.990 --> 00:01:08.850 align:middle line:84% disrupt the vaccine market forever? 00:01:16.500 --> 00:01:18.240 align:middle line:84% Until recently, there have really 00:01:18.240 --> 00:01:21.180 align:middle line:84% only been four main players in the vaccine market - 00:01:21.180 --> 00:01:25.230 align:middle line:84% GlaxoSmithKline, Merck, Pfizer, and Sanofi. 00:01:25.230 --> 00:01:28.410 align:middle line:84% They represented 90 per cent of the vaccine industry revenues 00:01:28.410 --> 00:01:30.360 align:middle line:90% in 2019. 00:01:30.360 --> 00:01:33.090 align:middle line:84% Even for these market leaders developing a vaccine 00:01:33.090 --> 00:01:35.790 align:middle line:84% is a costly and time-consuming gamble. 00:01:35.790 --> 00:01:38.820 align:middle line:84% The process often takes a decade. 00:01:38.820 --> 00:01:42.240 align:middle line:84% Work on infectious diseases is often very obscure 00:01:42.240 --> 00:01:45.030 align:middle line:84% because the burden is so much out of sight 00:01:45.030 --> 00:01:48.510 align:middle line:84% in the rich countries and where the deep scientific 00:01:48.510 --> 00:01:50.347 align:middle line:90% and manufacturing power is. 00:01:50.347 --> 00:01:53.220 align:middle line:84% Government is the main funder of the science. 00:01:53.220 --> 00:01:54.270 align:middle line:90% And that's critical. 00:01:54.270 --> 00:01:56.920 align:middle line:84% And in all of the benefits we have today, 00:01:56.920 --> 00:02:00.120 align:middle line:84% if you think about the sequence analysis or the mRNAs 00:02:00.120 --> 00:02:03.450 align:middle line:84% and the biotechnology, the new manufacturing, all of that 00:02:03.450 --> 00:02:06.585 align:middle line:84% came out of investments in basic science. 00:02:06.585 --> 00:02:08.910 align:middle line:84% As you go into phase 1 trials these 00:02:08.910 --> 00:02:10.680 align:middle line:90% are taken over by industry. 00:02:10.680 --> 00:02:13.320 align:middle line:84% Maybe one in every 10 vaccines and a phase 1 trial 00:02:13.320 --> 00:02:15.960 align:middle line:84% goes on to be approved, while 50 per cent 00:02:15.960 --> 00:02:19.260 align:middle line:84% to 70 per cent of vaccines in phase 3 trials 00:02:19.260 --> 00:02:20.775 align:middle line:90% end up being approved. 00:02:20.775 --> 00:02:24.240 align:middle line:84% They will only invest once the market and the chances 00:02:24.240 --> 00:02:25.650 align:middle line:90% of success are well known. 00:02:25.650 --> 00:02:27.150 align:middle line:84% This doesn't mean there's zero risk. 00:02:27.150 --> 00:02:30.000 align:middle line:84% But largely what we see is that the public sector 00:02:30.000 --> 00:02:31.477 align:middle line:90% takes on most of that. 00:02:31.477 --> 00:02:33.810 align:middle line:84% But indeed, this is what allows the business of vaccines 00:02:33.810 --> 00:02:35.850 align:middle line:90% to operate. 00:02:35.850 --> 00:02:38.550 align:middle line:84% The cost of creating a vaccine varies widely. 00:02:38.550 --> 00:02:41.160 align:middle line:84% On average, it ranges from several million 00:02:41.160 --> 00:02:44.460 align:middle line:90% to a few billion dollars. 00:02:44.460 --> 00:02:46.570 align:middle line:84% Supply, demand, and pricing for vaccines 00:02:46.570 --> 00:02:49.150 align:middle line:84% are determined by a small number of actors. 00:02:49.150 --> 00:02:52.060 align:middle line:84% On the buyer side, national governments and organisations 00:02:52.060 --> 00:02:55.120 align:middle line:84% like Gavi, the Vaccine Alliance, and Unicef are among 00:02:55.120 --> 00:02:57.260 align:middle line:90% the biggest purchasers. 00:02:57.260 --> 00:03:00.620 align:middle line:84% On the seller side are the pharma companies. 00:03:00.620 --> 00:03:03.170 align:middle line:84% Because the development costs and regulatory barriers 00:03:03.170 --> 00:03:06.530 align:middle line:84% for vaccines are high, companies can maintain their monopolies 00:03:06.530 --> 00:03:08.170 align:middle line:90% for longer. 00:03:08.170 --> 00:03:11.210 align:middle line:84% It tends to have a high amount of market power and ability 00:03:11.210 --> 00:03:13.520 align:middle line:84% to get higher prices than, let's say, 00:03:13.520 --> 00:03:18.410 align:middle line:84% a generic small molecule drug, or even a vaccine for which you 00:03:18.410 --> 00:03:20.720 align:middle line:90% have lots of competitors. 00:03:20.720 --> 00:03:24.500 align:middle line:84% Up until Gavi was created, the global alliance for vaccines, 00:03:24.500 --> 00:03:28.190 align:middle line:84% in the year 2000, there was no purchasing power 00:03:28.190 --> 00:03:32.750 align:middle line:84% to get those new vaccines to the kids who needed them most. 00:03:32.750 --> 00:03:36.080 align:middle line:84% So that was this great irony that, for example, rotavirus 00:03:36.080 --> 00:03:40.610 align:middle line:84% and pneumococcus vaccines that now save millions 00:03:40.610 --> 00:03:43.370 align:middle line:84% of young children's lives, they weren't getting out 00:03:43.370 --> 00:03:44.315 align:middle line:90% in these countries. 00:03:44.315 --> 00:03:46.790 align:middle line:84% Normally, what happens is when vaccines come out, 00:03:46.790 --> 00:03:49.610 align:middle line:84% they come out at a high price in a low volume. 00:03:49.610 --> 00:03:52.850 align:middle line:84% And over time, as the yield goes up, 00:03:52.850 --> 00:03:55.370 align:middle line:84% as other manufacturers begin to produce it, 00:03:55.370 --> 00:03:56.990 align:middle line:90% prices come down dramatically. 00:03:56.990 --> 00:04:00.620 align:middle line:84% To give an example, our vaccines that are the WHO 00:04:00.620 --> 00:04:04.940 align:middle line:84% approved vaccines cost over $1,300 00:04:04.940 --> 00:04:06.560 align:middle line:84% if you look at it in the US model. 00:04:06.560 --> 00:04:08.980 align:middle line:90% And we pay $27 for those. 00:04:08.980 --> 00:04:11.105 align:middle line:84% So it's a pretty dramatic difference. 00:04:11.105 --> 00:04:12.920 align:middle line:84% Gavi typically negotiates procurement 00:04:12.920 --> 00:04:16.100 align:middle line:84% on behalf of 60 per cent of the world's children. 00:04:16.100 --> 00:04:18.709 align:middle line:84% They try to ensure low and middle income countries pay 00:04:18.709 --> 00:04:22.205 align:middle line:84% significantly less for vaccines than rich countries do. 00:04:22.205 --> 00:04:24.440 align:middle line:84% If the disease is in the rich world, 00:04:24.440 --> 00:04:28.880 align:middle line:84% one of the western companies will invent a new vaccine 00:04:28.880 --> 00:04:31.840 align:middle line:90% with huge R&D investments. 00:04:31.840 --> 00:04:34.840 align:middle line:84% They'll charge a reasonably high price as much as, say, 00:04:34.840 --> 00:04:37.180 align:middle line:90% $100 in western markets. 00:04:37.180 --> 00:04:39.190 align:middle line:84% And then eventually, either they'll 00:04:39.190 --> 00:04:47.140 align:middle line:84% make a cogs-oriented version or the Indian or other developing 00:04:47.140 --> 00:04:49.870 align:middle line:84% country manufacturers will come in. 00:04:49.870 --> 00:04:52.780 align:middle line:84% By prioritising high volumes at low prices, 00:04:52.780 --> 00:04:55.660 align:middle line:84% the Serum Institute of India has become the world's largest 00:04:55.660 --> 00:04:58.330 align:middle line:90% vaccine manufacturer by volume. 00:04:58.330 --> 00:05:02.380 align:middle line:84% It typically produces more than 1.5bn doses of vaccines every 00:05:02.380 --> 00:05:06.190 align:middle line:84% year, which are used in 170 countries. 00:05:06.190 --> 00:05:08.080 align:middle line:84% This year it has increased capacity 00:05:08.080 --> 00:05:10.870 align:middle line:84% and is aiming to manufacture at least one billion doses 00:05:10.870 --> 00:05:13.990 align:middle line:84% of Covid-19 vaccines alone after signing deals 00:05:13.990 --> 00:05:16.555 align:middle line:90% with AstraZeneca and Novavax. 00:05:16.555 --> 00:05:19.600 align:middle line:84% It is more expensive to make a vaccine in the US and Europe. 00:05:19.600 --> 00:05:23.650 align:middle line:84% Traditionally, those companies haven't had large facilities 00:05:23.650 --> 00:05:27.260 align:middle line:84% because the volumes that they sell at are much lower, 00:05:27.260 --> 00:05:28.330 align:middle line:90% but at a very high price. 00:05:31.690 --> 00:05:33.340 align:middle line:84% Well, these are proprietary products 00:05:33.340 --> 00:05:37.540 align:middle line:84% that the companies have spent lots of money in high risk 00:05:37.540 --> 00:05:39.460 align:middle line:90% in order to go through trials. 00:05:39.460 --> 00:05:41.070 align:middle line:84% They have to recover all of those 00:05:41.070 --> 00:05:43.720 align:middle line:84% and make their profit from the rich world 00:05:43.720 --> 00:05:46.150 align:middle line:84% market and the middle income market, 00:05:46.150 --> 00:05:49.330 align:middle line:84% knowing that those Gavi markets are not going to give them 00:05:49.330 --> 00:05:51.895 align:middle line:90% any meaningful margin. 00:05:51.895 --> 00:05:55.460 align:middle line:84% But returns on investment are not straightforward. 00:05:55.460 --> 00:05:58.690 align:middle line:84% The lack of transparency around each company's production costs 00:05:58.690 --> 00:06:02.260 align:middle line:84% makes it difficult to assess a vaccine's profitability. 00:06:02.260 --> 00:06:05.620 align:middle line:84% We do know that at the top end Pfizer's pneumococcal vaccine, 00:06:05.620 --> 00:06:07.930 align:middle line:84% Prevnar, which works against pneumonia, 00:06:07.930 --> 00:06:12.555 align:middle line:84% generated $5.8bn in revenue in 2019. 00:06:12.555 --> 00:06:14.805 align:middle line:84% If you've invested maybe a few hundred million dollars 00:06:14.805 --> 00:06:19.582 align:middle line:84% in the R&D 10, 15, 20 years ago and you have a captive market, 00:06:19.582 --> 00:06:21.540 align:middle line:84% then you're going to make a pretty good profit. 00:06:21.540 --> 00:06:23.070 align:middle line:90% A very, very healthy profit. 00:06:23.070 --> 00:06:25.035 align:middle line:84% Some would even say an excessive profit. 00:06:25.035 --> 00:06:27.540 align:middle line:84% At the other end of the spectrum are well-established, 00:06:27.540 --> 00:06:30.270 align:middle line:84% low-cost children's vaccines, like measles. 00:06:30.270 --> 00:06:32.460 align:middle line:84% Low profits drove several producers out 00:06:32.460 --> 00:06:35.310 align:middle line:84% of the market in the 1970s and 80s. 00:06:35.310 --> 00:06:38.160 align:middle line:84% In the past decade an increase in vaccines for adults 00:06:38.160 --> 00:06:40.620 align:middle line:84% and those taken annually, like the flu vaccine, 00:06:40.620 --> 00:06:43.240 align:middle line:84% have helped make the market more profitable. 00:06:43.240 --> 00:06:46.470 align:middle line:84% But for governments, the health, societal, and economic returns 00:06:46.470 --> 00:06:48.720 align:middle line:90% are much greater. 00:06:48.720 --> 00:06:52.380 align:middle line:84% Gavi estimates a $21 return for every dollar invested 00:06:52.380 --> 00:06:55.230 align:middle line:84% in vaccine programmes for the 73 countries it typically 00:06:55.230 --> 00:06:56.430 align:middle line:90% supports. 00:06:56.430 --> 00:06:59.670 align:middle line:84% Well, the most salient number is that in the year 00:06:59.670 --> 00:07:05.470 align:middle line:84% 2000 over 10m children under the age of five died every year. 00:07:05.470 --> 00:07:10.690 align:middle line:84% By 2016, that number was under 5m per year. 00:07:10.690 --> 00:07:11.980 align:middle line:90% That's per year. 00:07:11.980 --> 00:07:14.990 align:middle line:90% That's millions. 00:07:14.990 --> 00:07:17.180 align:middle line:90% This is the way things work. 00:07:17.180 --> 00:07:18.170 align:middle line:90% Then came the pandemic. 00:07:23.640 --> 00:07:26.910 align:middle line:84% The outbreak of Covid-19 brought China and then Europe 00:07:26.910 --> 00:07:28.620 align:middle line:90% to a standstill. 00:07:28.620 --> 00:07:32.220 align:middle line:84% As the novel coronavirus spread to the US and across the globe, 00:07:32.220 --> 00:07:33.900 align:middle line:84% it wasn't long before governments 00:07:33.900 --> 00:07:36.870 align:middle line:84% were betting billions of dollars on developing vaccines 00:07:36.870 --> 00:07:38.710 align:middle line:90% to fight the pandemic. 00:07:38.710 --> 00:07:42.030 align:middle line:84% A new vaccine market was about to emerge where demand 00:07:42.030 --> 00:07:44.970 align:middle line:84% was unlimited, and governments would do everything 00:07:44.970 --> 00:07:46.845 align:middle line:90% in their power to secure doses. 00:07:53.000 --> 00:07:57.860 align:middle line:84% The total amounts involved relative to normal vaccine R&D, 00:07:57.860 --> 00:07:59.750 align:middle line:84% it's tens of billions of dollars, maybe 00:07:59.750 --> 00:08:03.200 align:middle line:90% a total of $25bn or so. 00:08:03.200 --> 00:08:06.020 align:middle line:84% That's gigantic in the world of vaccines. 00:08:06.020 --> 00:08:10.200 align:middle line:84% Now relative to the economic damage of the pandemic, 00:08:10.200 --> 00:08:13.580 align:middle line:84% which is in the trillions, it's truly a rounding error. 00:08:13.580 --> 00:08:16.340 align:middle line:84% This is the best money that's been spent by governments 00:08:16.340 --> 00:08:17.585 align:middle line:90% during this pandemic. 00:08:17.585 --> 00:08:19.700 align:middle line:84% The public sector, governments collectively, 00:08:19.700 --> 00:08:22.070 align:middle line:84% have really de-risked and subsidised 00:08:22.070 --> 00:08:25.280 align:middle line:84% the R&D process every step of the way from the earliest 00:08:25.280 --> 00:08:28.990 align:middle line:84% stages of R&D, oftentimes to the scale-up of manufacturing 00:08:28.990 --> 00:08:31.603 align:middle line:90% and, of course, purchasing. 00:08:31.603 --> 00:08:33.770 align:middle line:84% Other big funders include the Bill and Melinda Gates 00:08:33.770 --> 00:08:35.390 align:middle line:90% Foundation and CEPI. 00:08:35.390 --> 00:08:38.240 align:middle line:84% The Coalition for Epidemic Preparedness Innovations 00:08:38.240 --> 00:08:39.919 align:middle line:84% is a public private partnership that 00:08:39.919 --> 00:08:43.940 align:middle line:84% supports vaccine development to stop future epidemics. 00:08:43.940 --> 00:08:46.070 align:middle line:84% One recipient of a small grant from CEPI 00:08:46.070 --> 00:08:48.290 align:middle line:84% at the start of the pandemic was Moderna, 00:08:48.290 --> 00:08:52.680 align:middle line:84% a biotech company that had yet to bring a product to market. 00:08:52.680 --> 00:08:56.340 align:middle line:84% By the end of 2020, US federal funding for Moderna's vaccine 00:08:56.340 --> 00:09:00.985 align:middle line:84% had swelled into the billions, and it was approved for use. 00:09:00.985 --> 00:09:04.780 align:middle line:84% So Moderna took a huge amount of public money - up to $4bn 00:09:04.780 --> 00:09:06.430 align:middle line:90% from the US government. 00:09:06.430 --> 00:09:09.655 align:middle line:84% And that helped them build this proof of concept. 00:09:09.655 --> 00:09:13.270 align:middle line:84% The vaccine uses messenger RNA technology which the company 00:09:13.270 --> 00:09:16.600 align:middle line:90% spent a decade developing. 00:09:16.600 --> 00:09:21.160 align:middle line:84% We invested around $3bn in the last 10 years 00:09:21.160 --> 00:09:23.440 align:middle line:84% to get the technology to this place. 00:09:23.440 --> 00:09:25.870 align:middle line:84% The pandemic has accelerated the company 00:09:25.870 --> 00:09:28.180 align:middle line:84% turning into a commercial company by three 00:09:28.180 --> 00:09:30.550 align:middle line:90% to maybe four years. 00:09:30.550 --> 00:09:34.480 align:middle line:84% The first vaccine approved in a western country also used mRNA. 00:09:34.480 --> 00:09:37.390 align:middle line:84% It was made by US pharmaceutical giant Pfizer 00:09:37.390 --> 00:09:39.190 align:middle line:90% and Germany's BioNTech. 00:09:39.190 --> 00:09:41.650 align:middle line:84% While Pfizer did not take public funding to develop 00:09:41.650 --> 00:09:46.240 align:middle line:84% and manufacture its vaccine, it did have an initial $1.95bn 00:09:46.240 --> 00:09:49.900 align:middle line:84% advance purchase agreement through Operation Warp Speed. 00:09:49.900 --> 00:09:52.720 align:middle line:84% The US government's COVID-19 investment programme has 00:09:52.720 --> 00:09:57.550 align:middle line:84% surpassed $10bn, most of which has been spent on vaccines. 00:09:57.550 --> 00:10:01.090 align:middle line:84% It's not the only country that placed huge bets on vaccines. 00:10:01.090 --> 00:10:04.330 align:middle line:84% China and Russia funded their own vaccine candidates. 00:10:04.330 --> 00:10:08.935 align:middle line:84% And the German government gave BioNTech $445m. 00:10:08.935 --> 00:10:14.380 align:middle line:84% The UK government contributed £65.5m to Oxford university. 00:10:14.380 --> 00:10:17.320 align:middle line:84% And its vaccine manufacturing partner, AstraZeneca, 00:10:17.320 --> 00:10:21.640 align:middle line:84% received up to $1.2bn for trials in manufacturing from the US 00:10:21.640 --> 00:10:22.480 align:middle line:90% government. 00:10:25.450 --> 00:10:28.870 align:middle line:84% Well, there was no point in us generating a vaccine in January 00:10:28.870 --> 00:10:31.193 align:middle line:84% of last year if it wasn't going to be able to take it 00:10:31.193 --> 00:10:32.860 align:middle line:84% all the way through clinical development 00:10:32.860 --> 00:10:34.870 align:middle line:84% and into emergency use licensure. 00:10:34.870 --> 00:10:37.810 align:middle line:84% And as a university we are able to do 00:10:37.810 --> 00:10:40.570 align:middle line:84% much of the early clinical development 00:10:40.570 --> 00:10:42.818 align:middle line:84% and get that taken quite a long way, 00:10:42.818 --> 00:10:44.860 align:middle line:84% but we were never going to be able to manufacture 00:10:44.860 --> 00:10:48.865 align:middle line:84% a vaccine that was going to be used as a licenced product. 00:10:48.865 --> 00:10:51.820 align:middle line:84% The unprecedented public funding helped these companies develop 00:10:51.820 --> 00:10:54.040 align:middle line:90% vaccines in less than a year. 00:10:54.040 --> 00:10:56.830 align:middle line:84% Until now, the fastest vaccine ever created 00:10:56.830 --> 00:11:00.860 align:middle line:84% was a mumps vaccine developed by Merck in four years. 00:11:00.860 --> 00:11:03.990 align:middle line:84% The pandemic demanded an urgent response, 00:11:03.990 --> 00:11:06.090 align:middle line:84% but that also led to questions about the prices 00:11:06.090 --> 00:11:09.135 align:middle line:90% of Covid-19 vaccines. 00:11:09.135 --> 00:11:11.110 align:middle line:84% We have a high degree of secrecy. 00:11:11.110 --> 00:11:13.470 align:middle line:84% We have governments really desperate for access 00:11:13.470 --> 00:11:16.020 align:middle line:84% to vaccine supplies and willing to sometimes 00:11:16.020 --> 00:11:17.640 align:middle line:90% pay very, very high prices. 00:11:17.640 --> 00:11:19.290 align:middle line:84% And things are happening very quickly 00:11:19.290 --> 00:11:20.470 align:middle line:90% under emergency conditions. 00:11:20.470 --> 00:11:22.830 align:middle line:84% So it's, unfortunately, a perfect storm 00:11:22.830 --> 00:11:27.030 align:middle line:84% where the risk of abusive pricing or unfair pricing 00:11:27.030 --> 00:11:28.940 align:middle line:90% is quite high. 00:11:28.940 --> 00:11:32.207 align:middle line:84% I think pharma did hold a lot of power in this negotiation. 00:11:32.207 --> 00:11:34.290 align:middle line:84% But I also think that they could have gone higher. 00:11:34.290 --> 00:11:35.760 align:middle line:84% Plenty of investors actually would 00:11:35.760 --> 00:11:39.097 align:middle line:84% have liked them to go higher and didn't make a secret of that. 00:11:39.097 --> 00:11:42.420 align:middle line:84% Prices for Covid-19 vaccines very widely. 00:11:42.420 --> 00:11:46.110 align:middle line:84% The Oxford-AstraZeneca vaccine is about $3 to $4 a dose. 00:11:46.110 --> 00:11:48.120 align:middle line:84% Along with Johnson & Johnson they 00:11:48.120 --> 00:11:50.850 align:middle line:84% have committed to selling their vaccine on a non-profit basis 00:11:50.850 --> 00:11:52.440 align:middle line:90% during the pandemic. 00:11:52.440 --> 00:11:54.960 align:middle line:84% AstraZeneca say they will do so in perpetuity 00:11:54.960 --> 00:11:57.480 align:middle line:84% for low and middle income countries. 00:11:57.480 --> 00:12:00.210 align:middle line:84% Moderna said it has charged the US government as little 00:12:00.210 --> 00:12:05.220 align:middle line:84% as $16.50 per dose to return some money to taxpayers. 00:12:05.220 --> 00:12:09.690 align:middle line:84% But smaller orders for other customers range from $32 to $37 00:12:09.690 --> 00:12:12.090 align:middle line:90% per dose. 00:12:12.090 --> 00:12:16.120 align:middle line:84% We invested $3bn in this technology since the beginning. 00:12:16.120 --> 00:12:18.000 align:middle line:84% We've never made a penny of profit. 00:12:18.000 --> 00:12:19.740 align:middle line:84% We thought it was not appropriate not 00:12:19.740 --> 00:12:20.940 align:middle line:90% to make a small profit. 00:12:20.940 --> 00:12:23.940 align:middle line:84% The value that we are asking for the product 00:12:23.940 --> 00:12:26.640 align:middle line:84% is way undervalued to the healthcare system. 00:12:26.640 --> 00:12:31.590 align:middle line:84% If you just look at the saving in just hospitalisation costs, 00:12:31.590 --> 00:12:33.870 align:middle line:84% they run much, much higher per inhabitant. 00:12:33.870 --> 00:12:35.760 align:middle line:84% It's very difficult to actually come up 00:12:35.760 --> 00:12:39.060 align:middle line:84% with an evidence-based judgement on the fairness of any price 00:12:39.060 --> 00:12:40.987 align:middle line:84% or the fairness of any profit margin. 00:12:40.987 --> 00:12:43.930 align:middle line:84% Companies want to play countries off against each other 00:12:43.930 --> 00:12:46.710 align:middle line:84% and so aren't very incentivised to want to make 00:12:46.710 --> 00:12:49.050 align:middle line:90% these contracts transparent. 00:12:49.050 --> 00:12:51.810 align:middle line:84% And democratic governments often don't want their public 00:12:51.810 --> 00:12:53.850 align:middle line:84% to know that they've gotten a bad deal, 00:12:53.850 --> 00:12:55.410 align:middle line:84% or they don't want rival countries 00:12:55.410 --> 00:12:57.160 align:middle line:84% to know that they've gotten a good deal. 00:12:57.160 --> 00:12:59.220 align:middle line:84% And so there's not very much incentive 00:12:59.220 --> 00:13:00.660 align:middle line:90% for making these public. 00:13:00.660 --> 00:13:02.760 align:middle line:84% Before the pandemic US pharma companies 00:13:02.760 --> 00:13:05.850 align:middle line:84% were under pressure over high prices for drugs. 00:13:05.850 --> 00:13:09.840 align:middle line:84% The industry looked ripe for reform. 00:13:09.840 --> 00:13:12.120 align:middle line:84% So then we come into the pandemic 00:13:12.120 --> 00:13:16.410 align:middle line:84% and you have a situation where some companies say, look, 00:13:16.410 --> 00:13:19.530 align:middle line:84% this shows how important it is to invest in innovation. 00:13:19.530 --> 00:13:23.132 align:middle line:84% So you should pay us a good amount of money. 00:13:23.132 --> 00:13:24.840 align:middle line:84% But then on the other hand some companies 00:13:24.840 --> 00:13:27.000 align:middle line:84% said, ah, this is our opportunity 00:13:27.000 --> 00:13:30.360 align:middle line:84% to make a contribution by saying we'll offer these vaccines 00:13:30.360 --> 00:13:32.165 align:middle line:90% on a non-for-profit basis. 00:13:32.165 --> 00:13:34.740 align:middle line:84% I think it's reasonable to allow companies 00:13:34.740 --> 00:13:37.320 align:middle line:84% to make a profit from the high income countries having put 00:13:37.320 --> 00:13:40.860 align:middle line:84% such a huge effort into this work, 00:13:40.860 --> 00:13:43.200 align:middle line:84% and also make sure that it will be 00:13:43.200 --> 00:13:46.680 align:middle line:84% available for low and middle income countries in perpetuity 00:13:46.680 --> 00:13:48.195 align:middle line:90% without profit. 00:13:48.195 --> 00:13:52.590 align:middle line:84% Moderna said it expects to make $18.4bn from its Covid-19 00:13:52.590 --> 00:13:54.480 align:middle line:90% vaccine sales this year. 00:13:54.480 --> 00:13:56.100 align:middle line:84% It has not revealed the profit margin 00:13:56.100 --> 00:13:57.930 align:middle line:90% for its Covid-19 vaccine. 00:13:57.930 --> 00:14:01.710 align:middle line:84% Pfizer said it expects to make about $15bn with a profit 00:14:01.710 --> 00:14:03.810 align:middle line:90% margin of more than 20 per cent. 00:14:03.810 --> 00:14:07.500 align:middle line:84% The profits will be split 50/50 with BioNTech. 00:14:07.500 --> 00:14:09.180 align:middle line:84% These forecasts have partly shaped 00:14:09.180 --> 00:14:12.150 align:middle line:84% the company's varied share price performances in the past year. 00:14:15.750 --> 00:14:18.720 align:middle line:84% In previous pandemics, including Sars, the outbreak 00:14:18.720 --> 00:14:21.750 align:middle line:84% ended before companies could develop a vaccine. 00:14:21.750 --> 00:14:25.110 align:middle line:84% Those who invested in the endeavour made a loss. 00:14:25.110 --> 00:14:29.070 align:middle line:84% But Covid-19 is widely expected to become endemic. 00:14:29.070 --> 00:14:31.860 align:middle line:84% Analysts predict the annual vaccine market for the virus 00:14:31.860 --> 00:14:34.800 align:middle line:84% could reach $10bn a year, or more 00:14:34.800 --> 00:14:37.755 align:middle line:84% as producers tailor vaccines for new strains. 00:14:37.755 --> 00:14:39.540 align:middle line:84% If the vaccines aren't very successful 00:14:39.540 --> 00:14:42.600 align:middle line:84% but they do provide a very meaningful contribution 00:14:42.600 --> 00:14:44.220 align:middle line:84% to the fight against Covid, then we're 00:14:44.220 --> 00:14:46.053 align:middle line:84% likely to move to something like a flu model 00:14:46.053 --> 00:14:48.270 align:middle line:84% where we sell more vaccines for the flu 00:14:48.270 --> 00:14:51.450 align:middle line:84% than we do for every other vaccinated illness 00:14:51.450 --> 00:14:52.290 align:middle line:90% in the world. 00:14:52.290 --> 00:14:54.720 align:middle line:84% Then the question will be, are there so 00:14:54.720 --> 00:14:57.420 align:middle line:84% many competitors in the market that the price falls? 00:14:57.420 --> 00:14:59.880 align:middle line:84% Or the price may go up because it 00:14:59.880 --> 00:15:03.120 align:middle line:84% will be more of a natural normal market where people will 00:15:03.120 --> 00:15:06.360 align:middle line:84% perhaps choose a particular vaccine because it has a higher 00:15:06.360 --> 00:15:08.820 align:middle line:84% efficacy rate rather than a market 00:15:08.820 --> 00:15:12.825 align:middle line:84% where it's controlled by these gigantic government contracts. 00:15:12.825 --> 00:15:14.470 align:middle line:84% One big question is whether governments 00:15:14.470 --> 00:15:17.520 align:middle line:84% should have demanded more in these deals for subsidising 00:15:17.520 --> 00:15:19.710 align:middle line:84% development and guaranteeing sales. 00:15:19.710 --> 00:15:22.200 align:middle line:84% It does feed into a larger debate that was already 00:15:22.200 --> 00:15:25.500 align:middle line:84% happening about what happens when governments fund science, 00:15:25.500 --> 00:15:27.390 align:middle line:84% especially really basic research. 00:15:27.390 --> 00:15:29.490 align:middle line:84% It goes on into the private sector, 00:15:29.490 --> 00:15:31.590 align:middle line:84% and it makes the private sector a lot of money, 00:15:31.590 --> 00:15:35.205 align:middle line:84% but not much of that flows back to the government. 00:15:35.205 --> 00:15:37.570 align:middle line:84% For governments of low and middle income countries 00:15:37.570 --> 00:15:39.330 align:middle line:84% the return on investment calculation 00:15:39.330 --> 00:15:41.430 align:middle line:90% is entirely different. 00:15:41.430 --> 00:15:45.120 align:middle line:84% They are battling just to secure supplies of Covid-19 vaccines 00:15:45.120 --> 00:15:48.060 align:middle line:84% amid a flurry of bilateral deals between rich countries 00:15:48.060 --> 00:15:51.300 align:middle line:84% and vaccine producers, and global disputes about controls 00:15:51.300 --> 00:15:53.670 align:middle line:90% over vaccine supply chains. 00:15:53.670 --> 00:15:55.290 align:middle line:84% Of all the products in the world you 00:15:55.290 --> 00:15:58.590 align:middle line:84% don't want to use market-based prioritisation, 00:15:58.590 --> 00:16:02.940 align:middle line:84% it's got to be vaccines because if you went that way 00:16:02.940 --> 00:16:04.970 align:middle line:84% the rich people in the rich countries 00:16:04.970 --> 00:16:08.330 align:middle line:84% would buy all the output for quite a while, 00:16:08.330 --> 00:16:10.790 align:middle line:84% and it wouldn't be assigned according to who's 00:16:10.790 --> 00:16:13.460 align:middle line:84% at risk of dying, for example, getting 00:16:13.460 --> 00:16:16.647 align:middle line:84% to the elderly and the healthcare workers. 00:16:16.647 --> 00:16:18.500 align:middle line:84% Gavi, the World Health Organization, 00:16:18.500 --> 00:16:21.710 align:middle line:84% and CEPI set up the COVAX programme to mitigate this 00:16:21.710 --> 00:16:24.410 align:middle line:84% and provide equitable distribution for Covid-19 00:16:24.410 --> 00:16:26.060 align:middle line:90% vaccines. 00:16:26.060 --> 00:16:29.090 align:middle line:84% The COVAX advanced market commitment, or AMC, 00:16:29.090 --> 00:16:34.430 align:middle line:84% has raised $6.3bn and aims to distribute 2bn doses this year, 00:16:34.430 --> 00:16:37.850 align:middle line:84% with two-thirds of those subsidised for 92 lower income 00:16:37.850 --> 00:16:39.395 align:middle line:90% countries. 00:16:39.395 --> 00:16:42.020 align:middle line:84% We also hoped that by having global supply 00:16:42.020 --> 00:16:44.540 align:middle line:84% it would reduce the number of bilaterals. 00:16:44.540 --> 00:16:47.390 align:middle line:84% And it looked like that might have helped for a while. 00:16:47.390 --> 00:16:52.700 align:middle line:84% But there really has been a global panic seeing doses being 00:16:52.700 --> 00:16:54.500 align:middle line:84% rolled out, people hoarding doses, 00:16:54.500 --> 00:16:57.370 align:middle line:84% and also the new variants have made people nervous. 00:16:57.370 --> 00:16:59.120 align:middle line:84% There are some governments that have said, 00:16:59.120 --> 00:17:01.430 align:middle line:84% yes, we politically support COVAX, 00:17:01.430 --> 00:17:04.190 align:middle line:84% we will put money into COVAX, we will subsidise other countries 00:17:04.190 --> 00:17:05.263 align:middle line:90% through COVAX. 00:17:05.263 --> 00:17:06.680 align:middle line:84% They are the very same governments 00:17:06.680 --> 00:17:11.060 align:middle line:84% that have turned around and said we are going to basically eat 00:17:11.060 --> 00:17:13.250 align:middle line:84% up most of the world's existing volume 00:17:13.250 --> 00:17:15.169 align:middle line:84% through advanced purchase commitment. 00:17:15.169 --> 00:17:16.970 align:middle line:84% Any head of state is going to think about, 00:17:16.970 --> 00:17:18.260 align:middle line:90% I have to protect my people. 00:17:18.260 --> 00:17:20.150 align:middle line:90% That's the natural instinct. 00:17:20.150 --> 00:17:23.130 align:middle line:84% And that may be true in a normal situation. 00:17:23.130 --> 00:17:25.400 align:middle line:84% But in a global pandemic you're only 00:17:25.400 --> 00:17:29.000 align:middle line:90% as safe as everyone is safe. 00:17:29.000 --> 00:17:32.360 align:middle line:84% Covid-19 has turbocharged normal market forces, 00:17:32.360 --> 00:17:35.600 align:middle line:84% from funding to the speed at which vaccines were developed, 00:17:35.600 --> 00:17:38.900 align:middle line:84% and the subsequent international scramble to buy them. 00:17:38.900 --> 00:17:41.270 align:middle line:84% But are there more fundamental ways the virus 00:17:41.270 --> 00:17:42.620 align:middle line:90% will change the vaccine market? 00:17:46.715 --> 00:17:49.430 align:middle line:84% I think the Covid-19 pandemic will completely 00:17:49.430 --> 00:17:51.780 align:middle line:90% shake up the vaccine market. 00:17:51.780 --> 00:17:55.190 align:middle line:84% And that's because of these new technologies like messenger RNA 00:17:55.190 --> 00:17:56.480 align:middle line:90% and viral vectors. 00:17:56.480 --> 00:17:58.610 align:middle line:84% By accelerating them so fast they've 00:17:58.610 --> 00:18:02.240 align:middle line:84% completely shaken up who's on top, who has the potential 00:18:02.240 --> 00:18:03.950 align:middle line:90% to create the next vaccine. 00:18:03.950 --> 00:18:07.290 align:middle line:84% The fastest vaccine ever had been four years. 00:18:07.290 --> 00:18:09.710 align:middle line:84% The Ebola vaccine was around five years. 00:18:09.710 --> 00:18:15.665 align:middle line:84% And the fact that this happened in 303 days is extraordinary. 00:18:15.665 --> 00:18:17.630 align:middle line:84% The pandemic was an opportunity to prove 00:18:17.630 --> 00:18:21.410 align:middle line:84% that mRNA, or messenger ribonucleic acid technology, 00:18:21.410 --> 00:18:23.480 align:middle line:90% could work. 00:18:23.480 --> 00:18:25.810 align:middle line:84% The synthetic mRNA delivers instructions 00:18:25.810 --> 00:18:28.870 align:middle line:84% to cells in the body to produce the viral protein, which 00:18:28.870 --> 00:18:31.300 align:middle line:90% stimulates an immune response. 00:18:31.300 --> 00:18:35.440 align:middle line:84% The success of Pfizer, BioNTech, and Moderna's mRNA vaccines 00:18:35.440 --> 00:18:37.180 align:middle line:84% mean the technology could be applied 00:18:37.180 --> 00:18:40.045 align:middle line:84% to a wide range of other vaccines and drugs. 00:18:40.045 --> 00:18:43.780 align:middle line:84% The mRNA platform, we're going to push that to the limit. 00:18:43.780 --> 00:18:46.390 align:middle line:84% And we should get a lot more vaccines. 00:18:46.390 --> 00:18:50.560 align:middle line:84% And a malaria vaccine, or an HIV vaccine, or a TB vaccine 00:18:50.560 --> 00:18:51.940 align:middle line:90% are miraculous things. 00:18:51.940 --> 00:18:55.690 align:middle line:84% That's measured in saving millions of lives, not 00:18:55.690 --> 00:18:57.010 align:middle line:90% some economic thing. 00:18:57.010 --> 00:19:00.175 align:middle line:90% That is about life itself. 00:19:00.175 --> 00:19:02.140 align:middle line:84% The speed at which mRNA vaccines can 00:19:02.140 --> 00:19:05.470 align:middle line:84% be tweaked to respond to new variants and then mass produced 00:19:05.470 --> 00:19:07.820 align:middle line:84% could also make vaccines more profitable. 00:19:07.820 --> 00:19:10.990 align:middle line:84% We're going to end up having technologies like mRNA 00:19:10.990 --> 00:19:14.080 align:middle line:84% enabling a new vaccine that is going to be best in class 00:19:14.080 --> 00:19:17.440 align:middle line:84% and first in class, that are going to be able to maintain 00:19:17.440 --> 00:19:18.977 align:middle line:90% a high profitability. 00:19:18.977 --> 00:19:20.810 align:middle line:84% I think platform technologies for the future 00:19:20.810 --> 00:19:23.480 align:middle line:84% of vaccine development, and messenger RNA is one of them. 00:19:23.480 --> 00:19:26.380 align:middle line:84% We haven't really seen messenger RNA vaccines widely 00:19:26.380 --> 00:19:28.420 align:middle line:90% used at all before 2020. 00:19:28.420 --> 00:19:29.920 align:middle line:84% And in the last year they've gone 00:19:29.920 --> 00:19:33.460 align:middle line:84% from being something of a niche research area 00:19:33.460 --> 00:19:35.200 align:middle line:90% into having massive impact. 00:19:35.200 --> 00:19:38.320 align:middle line:84% I believe we will end up with Moderna having the vaccine that 00:19:38.320 --> 00:19:42.100 align:middle line:84% will have a combination of a seasonal boost for flu 00:19:42.100 --> 00:19:44.860 align:middle line:84% and the new variant for SARS-CoV-2 00:19:44.860 --> 00:19:46.600 align:middle line:90% And it's going to be one shot. 00:19:46.600 --> 00:19:49.640 align:middle line:84% So how is that going to compete with a vaccine that's 00:19:49.640 --> 00:19:51.190 align:middle line:90% only the seasonal flu? 00:19:51.190 --> 00:19:54.820 align:middle line:84% I believe those vaccines will have no future. 00:19:54.820 --> 00:19:57.370 align:middle line:84% There are also reasons to be cautious about the future 00:19:57.370 --> 00:19:58.525 align:middle line:90% of mRNA. 00:19:58.525 --> 00:20:01.360 align:middle line:84% Just because mRNA and the viral vector vaccines 00:20:01.360 --> 00:20:03.280 align:middle line:84% have been pretty successful for Covid 00:20:03.280 --> 00:20:05.980 align:middle line:84% doesn't mean they're going to be successful for everything else. 00:20:05.980 --> 00:20:07.480 align:middle line:84% And so I think that there will still 00:20:07.480 --> 00:20:10.270 align:middle line:84% be a debate inside some of these big vaccine players, 00:20:10.270 --> 00:20:13.120 align:middle line:84% like GSK, Sanofi, and Merck about to what extent 00:20:13.120 --> 00:20:16.450 align:middle line:84% they should rush towards this new shiny object, 00:20:16.450 --> 00:20:17.950 align:middle line:84% and to what extent they should rely 00:20:17.950 --> 00:20:21.745 align:middle line:84% on their own reliable proprietary platforms. 00:20:21.745 --> 00:20:24.010 align:middle line:84% I do think for the next pandemic we 00:20:24.010 --> 00:20:28.840 align:middle line:84% will be able to solve the problems of the mRNA platform. 00:20:28.840 --> 00:20:32.950 align:middle line:84% That is we'll fix the thermal stability, 00:20:32.950 --> 00:20:37.630 align:middle line:84% we'll fix the scalability, and we'll fix the cost. 00:20:37.630 --> 00:20:42.422 align:middle line:84% We kind of caught mRNA halfway to prime time. 00:20:42.422 --> 00:20:45.670 align:middle line:84% Analysts predict that 2021 vaccine sales from Moderna 00:20:45.670 --> 00:20:48.850 align:middle line:84% and Novavax will outpace those from three of the biggest 00:20:48.850 --> 00:20:52.390 align:middle line:84% vaccine producers who dominated the market before Covid-19 - 00:20:52.390 --> 00:20:55.810 align:middle line:90% Merck, GSK, and Sanofi. 00:20:55.810 --> 00:20:59.122 align:middle line:84% All three have yet to bring a Covid-19 vaccine to market. 00:20:59.122 --> 00:21:00.580 align:middle line:84% With new players in charge, they've 00:21:00.580 --> 00:21:02.170 align:middle line:90% got a lot of capital, Investors. 00:21:02.170 --> 00:21:04.690 align:middle line:84% Are really backing them, and they can go into new markets, 00:21:04.690 --> 00:21:06.160 align:middle line:90% most obviously, flu. 00:21:06.160 --> 00:21:08.650 align:middle line:84% The big question, the billion dollar question 00:21:08.650 --> 00:21:10.960 align:middle line:84% is, how many of those firms are going 00:21:10.960 --> 00:21:13.240 align:middle line:84% to find a business model that allows 00:21:13.240 --> 00:21:18.400 align:middle line:84% them to scale up production and global distribution? 00:21:18.400 --> 00:21:20.680 align:middle line:84% Could the pandemic propel the vaccine segment 00:21:20.680 --> 00:21:23.410 align:middle line:84% into becoming a much bigger part of the global pharmaceutical 00:21:23.410 --> 00:21:24.467 align:middle line:90% market? 00:21:24.467 --> 00:21:28.030 align:middle line:84% Vaccines probably saved more lives than any other tool. 00:21:28.030 --> 00:21:30.280 align:middle line:84% If we can take vaccines and apply them 00:21:30.280 --> 00:21:34.240 align:middle line:84% more in the area of cancer, then that just changes the numbers 00:21:34.240 --> 00:21:38.240 align:middle line:84% completely because the cancer market is, 00:21:38.240 --> 00:21:43.840 align:middle line:84% it's over 10 times the R&D, over 10 times the spend, 00:21:43.840 --> 00:21:45.430 align:middle line:90% potential for growth. 00:21:45.430 --> 00:21:48.250 align:middle line:84% I do not think that we're going to see the entire pharma 00:21:48.250 --> 00:21:50.530 align:middle line:84% industry switch to focusing on vaccines. 00:21:50.530 --> 00:21:53.260 align:middle line:84% It's still a business where you often sell to governments, 00:21:53.260 --> 00:21:55.870 align:middle line:84% where they're often very large contracts and not 00:21:55.870 --> 00:22:00.310 align:middle line:84% that much competition, and not that much growth. 00:22:00.310 --> 00:22:04.690 align:middle line:84% With more than 113m cases of coronavirus confirmed globally 00:22:04.690 --> 00:22:09.100 align:middle line:84% and 2.5m known deaths, vaccines are widely seen as the key 00:22:09.100 --> 00:22:11.460 align:middle line:90% to ending the pandemic. 00:22:11.460 --> 00:22:13.140 align:middle line:84% Public investment in vaccines are 00:22:13.140 --> 00:22:17.330 align:middle line:84% dwarfed by the economic costs of this global health crisis. 00:22:17.330 --> 00:22:22.160 align:middle line:84% An estimated $6tn in economic output was lost to 2020, 00:22:22.160 --> 00:22:27.165 align:middle line:84% and another $4.4tn will be lost this year. 00:22:27.165 --> 00:22:28.790 align:middle line:84% Public health experts have been telling 00:22:28.790 --> 00:22:30.860 align:middle line:84% governments and politicians for years 00:22:30.860 --> 00:22:35.120 align:middle line:84% that vaccine supply is a huge global strategic priority, 00:22:35.120 --> 00:22:36.710 align:middle line:90% and that you should protect it. 00:22:36.710 --> 00:22:38.360 align:middle line:84% I think they've finally woken up. 00:22:38.360 --> 00:22:40.190 align:middle line:84% Traditionally, when governments have 00:22:40.190 --> 00:22:41.850 align:middle line:84% tried to invest in that infrastructure 00:22:41.850 --> 00:22:43.340 align:middle line:90% it's not worked out very well. 00:22:43.340 --> 00:22:45.990 align:middle line:84% It's always been the private players in the private sector 00:22:45.990 --> 00:22:48.290 align:middle line:84% that's been able to succeed, scale up 00:22:48.290 --> 00:22:50.180 align:middle line:84% because of the entrepreneurship and freedom 00:22:50.180 --> 00:22:52.160 align:middle line:84% that a private sector company would have. 00:22:52.160 --> 00:22:53.660 align:middle line:84% SETH BERKLEY: Obviously, if you want 00:22:53.660 --> 00:22:57.140 align:middle line:84% to have manufacturing facilities ready to go that are there 00:22:57.140 --> 00:22:58.640 align:middle line:84% in case of an outbreak, you're going 00:22:58.640 --> 00:23:00.440 align:middle line:84% to need to make sure that there's financing 00:23:00.440 --> 00:23:02.720 align:middle line:84% for that because from a for-profit company 00:23:02.720 --> 00:23:05.180 align:middle line:84% the idea that you would have facilities that 00:23:05.180 --> 00:23:08.030 align:middle line:84% are available that are not being optimally used 00:23:08.030 --> 00:23:09.950 align:middle line:84% might not make business sense, but they 00:23:09.950 --> 00:23:11.180 align:middle line:90% may make public health sense. 00:23:11.180 --> 00:23:14.810 align:middle line:84% So I see this as a partnership between government 00:23:14.810 --> 00:23:16.895 align:middle line:90% and the private sector. 00:23:16.895 --> 00:23:22.340 align:middle line:84% I'm very enthused that vaccines, all the standby capacity 00:23:22.340 --> 00:23:25.430 align:middle line:84% that we will have on for the next pandemic, 00:23:25.430 --> 00:23:30.080 align:middle line:84% we may be able to use that when there's not a pandemic going on 00:23:30.080 --> 00:23:32.480 align:middle line:84% to create lots of low cost supply 00:23:32.480 --> 00:23:35.830 align:middle line:90% capacity for the entire world. 00:23:35.830 --> 00:23:38.450 align:middle line:84% Imagine that you'd have a vaccine you know back 00:23:38.450 --> 00:23:42.932 align:middle line:84% in the summer, you would have saved millions of lives. 00:23:42.932 --> 00:23:45.850 align:middle line:84% Covid-19 has already changed the vaccine market, 00:23:45.850 --> 00:23:48.900 align:middle line:90% potentially irreversibly.