Transcript: Pandemics in Developing Countries | May 07, 2020

Steve sits in a room with white walls, a low slanted ceiling and several framed pictures on the walls including one of George Drew and one of Walter Kronkite. He's slim, clean-shaven, in his fifties, with short curly brown hair. He's wearing a white shirt and a gray plaid tie.

A caption on screen reads "Pandemics in developing countries. @spaikin, @theagenda."

Steve says WHILE COUNTRIES WITH HIGHLY ADVANCED HEALTH CARE SYSTEMS SUCH AS CANADA STRUGGLE TO BEAT BACK THIS COVID-19 CRISIS, MANY OTHER COUNTRIES FACE A MUCH TOUGHER FIGHT. WITH US NOW ON THE ENORMOUS PUBLIC HEALTH TASK CONFRONTING DEVELOPING NATIONS, WE WELCOME: DR. WENDY LAI, AN EMERGENCY PHYSICIAN AND PRESIDENT OF THE BOARD AT DOCTORS WITHOUT BORDERS CANADA...

Wendi is in her thirties, with graying black hair in a bob. She's wearing a black blazer and a golden necklace.

Steve continues AND STEVEN HOFFMAN, PROFESSOR OF GLOBAL HEALTH, LAW, AND POLITICAL SCIENCE, AND DIRECTOR OF YORK UNIVERSITY'S GLOBAL STRATEGY LAB... AT YORK UNIVERSITY...

Steven Hoffman is in his thirties, with short, receding brown hair and a stubble. He's wearing glasses, a black suit and a white shirt.

Steve continues THEY ARE BOTH IN THE PROVINCIAL CAPITAL IN THEIR HOMES TONIGHT, AND WE ARE HAPPY TO WELCOME YOU BOTH TO TVO. HOW ARE THINGS GOING, EVERYBODY.

Steven Hoffman says THINGS ARE GOING WELL.

Steve says EVERYBODY HANGING IN?

Steven Hoffman says WHAT AN EXTRAORDINARY TIME WE'RE ALL LIVING IN RIGHT NOW.

Steve says ISN'T IT? WE THINK IT'S EXTRAORDINARY FOR US BUT OF COURSE WE'RE JUST IMAGINING WHAT IT'S LIKE IN THE DEVELOPING WORLD WHERE THEY MAY NOT HAVE SOME OF THE NICETIES WE HAVE HERE. STEVEN, MAYBE YOU COULD START US OFF ON THAT. WHAT ARE SOME OF THE THINGS THAT WOULD MAKE OTHER COUNTRIES VULNERABLE TO PANDEMICS THAN WE ARE?

The caption changes to "Steven Hoffman. York University."

Steven Hoffman says THERE ARE THREE FACTORS TO HOW A COUNTRY CAN RESPOND TO AN OUTBREAK LIKE THIS. THE FIRST IS A PUBLIC HEALTH CAPACITY A COUNTRY HAS TO IDENTIFY AND QUICKLY CONTAIN AN OUTBREAK. THE SECOND IS HOW MUCH HEALTH CARE CAPACITY THEY HAVE TO TREAT PEOPLE THAT GET THE VIRUS. AND THE THIRD ARE THE BROADER SOCIAL PROTECTIONS AVAILABLE WITHIN A COUNTRY TO DEAL WITH THE CONSEQUENCES OF THE VIRUS, BUT ALSO THE DOWNSTREAM CONSEQUENCES OF THE PUBLIC HEALTH MEASURES PUT INTO PLACE. AND SO WHEN YOU THINK OF A COUNTRY LIKE CANADA, WE HAVE A GREAT PUBLIC HEALTH SYSTEM, A GREAT HEALTH CARE SYSTEM, WE HAVE SOCIAL PROTECTIONS. BUT IN MOST PLACES AROUND THE WORLD, IT'S NOT LIKE THAT. SO, FOR EXAMPLE, 55 percent OF PEOPLE WHO LIVE ON THIS PLANET HAVE ACCESS TO NO GOVERNMENT SOCIAL PROTECTION. SO THAT MEANS THAT IF SOMEONE LOSES THEIR INCOME, IT'S NOT ONLY DEVASTATING, AS IT WOULD BE ANYWHERE, BUT IT'S ACTUALLY, IN MANY PLACES, A LIFE-OR-DEATH OUTCOME. SO MOST COUNTRIES AROUND THE WORLD ARE DEFINITELY NOT AS LUCKY AS CANADA, AND THE VULNERABILITY THAT'S POSED BY THAT LACK OF CAPACITY AND LOWER INCOMES AND THE GREATER VULNERABILITY IS QUITE STARK.

Steve says DR. LAI, LET'S DO A REAL EXTREME EXAMPLE, SHALL WE? WE'LL TAKE THE WESTERN HEMISPHERE. CANADA IS ONE OF THE RICHEST COUNTRIES IN THE WESTERN HEMISPHERE. HAITI IS ONE OF THE POOREST IF NOT THE POOREST COUNTRY IN THE WESTERN HEMISPHERE. HOW DO FEARS AND WORRIES ABOUT COVID-19 DIFFER IN, SAY, CANADA VERSUS HAITI?

The caption changes to "Wendy Lai. Doctors Without Borders."

Wendy says WHEN I THINK ABOUT HAITI, I THINK ABOUT A NUMBER OF PARTICULAR VULNERABILITIES, AND THIS MAY HAVE OCCURRED TO MANY OF YOUR VIEWERS ALREADY. IN HAITI, WE WORRY IN PARTICULAR ABOUT THINGS LIKE CROWDING, THAT THERE ARE MANY PEOPLE IN THE HOUSEHOLD, AND HOMES ARE MUCH SMALLER, SO THESE MECHANISMS OF PHYSICAL DISTANCING BECOME MUCH MORE DIFFICULT. WE WORRY ABOUT ACCESS TO WATER, SANITATION, AND HYGIENE, AND IN FACT, YOU KNOW, IN MANY PLACES, INCLUDING HAITI, MUCH OF WHAT WE'RE TREATING IS DIARRHEA, AND THE REASON IS THERE'S DIFFICULTY TO HAVE ACCESS TO WATER IN ORDER TO A WASH ONE'S HANDS. WE WORRY ABOUT ECONOMIC RESERVES, SO IF PEOPLE ARE NOT ABLE TO LEAVE THE HOME IN ORDER TO WORK, THAT THERE MAY NOT BE A LOT FOR THEM TO FALL BACK ON IN TERMS OF SAVINGS. AND THEN OF COURSE THERE'S THIS WHOLE QUESTION OF, WHAT IS THE HEALTH SYSTEM'S CAPACITY TO RESPOND IN TERMS OF MASSIVELY RAMPING UP THEIR SERVICES IN TERMS OF BEING ABLE TO SUPPORT A LARGE NUMBER OF PEOPLE WHO ARE SERIOUSLY ILL ALL AT ONCE, AND THEN THE PUBLIC HEALTH ASPECTS OF IT AS WELL, TESTING AND TRACING AND ISOLATION ARE ALSO MUCH MORE DIFFICULT.

Steve says SO TELL US THEN... I MEAN, WE UNDERSTAND THAT WHEN WE'RE TOLD HERE WHAT THE PROTOCOLS ARE AND TO SHELTER IN PLACE, THE VAST MAJORITY OF PEOPLE DO IT. MAYBE THEY GRUMBLE A BIT, BUT THEY DO IT. HOW DO THEY DO IT IN A PLACE LIKE HAITI? DO THEY TELL PEOPLE, JUST EVERYBODY STAY HOME AND MAKE THE BEST OF IT, OR HOW DOES IT WORK?

Wendy says WELL, I THINK IT'S GOING TO END UP BEING DIFFERENT IN DIFFERENT KINDS OF CONTEXTS, AND I HAVE NOT HEARD SPECIFICALLY ABOUT WHAT HAITI IS FINDING ITSELF ABLE TO DO, BUT WHILE THE PUBLIC HEALTH CONCEPTS REMAIN THE SAME, THAT WE WANT TO REDUCE AS MUCH AS POSSIBLE OUR INTERACTION WITH OTHER PEOPLE IN ORDER TO REDUCE THE SPREAD OF THE ILLNESS, THAT MAY PHYSICALLY LOOK DIFFERENT. YOU KNOW, HERE IN TORONTO WHERE PEOPLE ARE TOLD NOT TO LEAVE THEIR HOUSES, YOU KNOW, UNLESS ABSOLUTELY NECESSARY, THAT'S GOING TO BE MORE DIFFICULT. SO ARE THEY GOING TO BE MORE RELIANT ON THINGS LIKE TRYING TO MASK? THAT'S POSSIBLE. ARE THEY GOING TO HAVE TO ARRANGE THE WAY THAT PEOPLE ACCESS MARKETS AND WATER POINTS, ET CETERA? ALSO POSSIBLE. IN FACT, I THINK IT'S GOING TO BE VERY DIFFICULT FOR HEALTH AUTHORITIES IN PLACES LIKE HAITI TO MANAGE THAT, BECAUSE THE TOOLS ARE PROBABLY MORE LIMITED. AND YET THERE MAY ALSO BE TOOLS THAT WE ACTUALLY HAVEN'T THOUGHT ABOUT HERE OR HAVEN'T RELIED ON AS MUCH HERE THAT MAY KIND OF COME INTO BETTER USAGE IN A PLACE LIKE HAITI. I CERTAINLY HEARD IN WEST AFRICA, FOR EXAMPLE, THERE'S A LOT OF FOCUS ON TRYING TO FIND ACCESS FOR PEOPLE TO HAVE, YOU KNOW, CLOTH MASKS AND FOR THEM TO WEAR THAT IN PUBLIC. AS YOU KNOW, THAT'S BEEN RELATIVELY A LATER STAGE IN TERMS OF HOW WE'RE MANAGING IT HERE. BUT BECAUSE OF THE ISSUES WITH DISTANCING, THEY MAY BE RELYING ON THINGS LIKE THAT MORE.

Steve says STEVEN, LET ME ASK YOU ABOUT THE WORLD FOOD PROGRAMME WHICH IS DESIGNED, AS THE TITLE SUGGESTS, TO FEED THE HUNGRY AROUND THE WORLD. THEY HAVE WARNED AT THAT ORGANIZATION THAT THE WORLD IS ON THE BRINK OF A HUNGER PANDEMIC, QUOTE, OF BIBLICAL PROPORTIONS BECAUSE OF THIS COVID-19 CRISIS. WHAT KINDS OF FLAWS DO YOU THINK THE GLOBAL SUPPLY CHAIN HAVE BEEN REVEALED IN THE GLOBAL SUPPLY CHAIN AS A RESULT OF THIS PANDEMIC?

Steven Hoffman says WELL, I THINK WE SHOULD FIRST SAY THAT THE GLOBAL FOOD SYSTEM HAS BEEN FAR FROM OPTIMAL FOR A LONG TIME IN THE SENSE THAT WE'VE SEEN OVER THE COURSE OF THE LAST DECADES THAT EVEN SMALL CHANGES IN FOOD PRICES CAN SUDDENLY THROW ENTIRE POPULATIONS AROUND THE WORLD INTO SITUATIONS OF FOOD INSECURITY AND FAMINE. AND SO AS A RESULT, WE'RE LOOKING AT A PRETTY UNSUCCESSFUL GLOBAL FOOD SYSTEM, FRANKLY, THAT NOW, WITH THE ADDITIONAL SHOCK OF COVID-19, IS REALLY GOING TO BE CAUSING ENORMOUS CONSEQUENCES. INDEED, IT'S QUITE LIKELY THAT MORE PEOPLE ARE GOING TO DIE AROUND THE WORLD FROM A LACK OF BEING ABLE TO COPE WITH THE BROADER SOCIAL CONSEQUENCES THAT COVID-19 HAS CAUSED, SUCH AS INCREASED FOOD PRICES, SUCH AS DECREASED FOOD AVAILABILITY, THAN ACTUALLY THE VIRUS ITSELF. AND SO IN THAT RESPECT, WHAT WE'RE SEEING IS UNPRECEDENTED LEVELS OF HUNGER AND MALNUTRITION AROUND THE WORLD ALREADY IN SOME OF THE COUNTRIES THAT WERE ALREADY FACING THE LEAST AMOUNT OF FOOD SECURITY. SO IT'S REALLY QUITE A CHALLENGE...

Steve says SORRY, STEVEN. JUST REMIND ME FOR A SECOND BECAUSE I THINK I READ SOMETHING THE OTHER DAY ABOUT... WAS IT LEBANON WHERE PEOPLE JUST STREAMED INTO THE STREETS, OBVIOUSLY NOT PHYSICALLY DISTANCING, OUTRAGED AT THE SKYROCKETING COST OF FOOD, AND ONE WONDERS, YOU KNOW, I WANT TO BE CAREFUL HOW I SAY THIS BUT, YOU KNOW, ONE WONDERS IF THEY'RE MORE WORRIED ABOUT DYING OF HUNGER THAN THEY ARE OF COVID-19 BECAUSE THEY CLEARLY WEREN'T FOLLOWING ANY PROTOCOLS BUT THEY'VE GOT TO EAT.

Steven Hoffman says THAT'S RIGHT. PEOPLE HAVE TO EAT. PEOPLE HAVE TO LIVE. AND IN MANY JURISDICTIONS, GOING TO WORK IS AN ACT OF LIFE OR DEATH, RIGHT, IN THE SENSE THAT IF PEOPLE DON'T GO TO WORK AND IF THEY DON'T HAVE MONEY SAVED, IF THEY'RE MAKING ONE DOLLAR A DAY, WHAT THAT MEANS IS THEY NEED TO HAVE INCOME IN ORDER TO PUT FOOD ON THEIR TABLE FOR THEIR FAMILIES. AND SO AS A RESULT, WHAT IT MEANS IS WHEN YOU HEAR STATISTICS LIKE THAT THIS PANDEMIC HAS BEEN ESTIMATED TO HAVE CAUSED 500 MILLION MORE PEOPLE GOING INTO POVERTY OVER THE COURSE OF THIS OUTBREAK, THAT'S THE CURRENT BEST GUESS, THAT'S SHOCKING IN TERMS OF HOW MUCH IT ROLLS BACK SOME OF THE PROGRESS THAT WE'VE MADE OVER THE LAST YEARS IN REDUCING GLOBAL POVERTY. ADDITIONALLY, WHEN YOU HEAR OF THINGS LIKE THAT ON AVERAGE GLOBAL COMMODITY PRICES HAVE GONE UP BY 20 percent... SORRY, GONE DOWN BY 20 percent, WHAT THAT MEANS IS THAT THERE'S A LOT OF PEOPLE WHO AREN'T GETTING AS MUCH INCOME FROM SELLING THEIR COMMODITIES, AND AS A RESULT, ARE NOT ABLE TO HAVE THE SAME INCOME TO PURCHASE FOOD. IT'S A BIG CHALLENGE AND WHEN WE THINK ABOUT FOOD ACCESS, YES, IT'S ABOUT OUR IMMEDIATE NEEDS OF TODAY AND FROM A NUTRITION PERSPECTIVE, HEALTHY DEVELOPMENT FOR TOMORROW. BUT IT'S ALSO ABOUT SOCIAL STABILITY. AND ONE OF THE FIRST THINGS THAT WOULD CAUSE SOCIETY TO BECOME UNSTABLE, WITH ALL THE CONSEQUENCES THAT FLOW FROM THERE, WOULD BE WHEN FOOD PRICES GO UP AND WHEN FOOD AVAILABILITY GOES DOWN.

Steve says DR. LAI, I'D BE INTERESTED IN YOUR VIEW ON THAT. I MEAN, AS A MEDICAL PERSON, YOU OBVIOUSLY CAN'T LIKE PEOPLE TEEMING INTO THE STREETS TO PROTEST IN CLOSE PROXIMITY TO ONE ANOTHER ABOUT ANYTHING, BUT THIS IS FOOD. HOW DO YOU NEGOTIATE YOUR WAY AROUND THAT IN YOUR HEAD?

Wendy says WELL, INDEED, STEVE, I HAVE TO AGREE WITH DR. HOFFMAN HERE. IN MANY PLACES, WORKING IS EATING, THAT PEOPLE ARE LIVING VERY DIRECTLY FROM THE INCOME THEY'RE ABLE TO MAKE ON A PARTICULAR DAY AND THEIR ABILITY TO PUT FOOD ON THEIR FAMILY'S TABLE THAT EVENING. I THINK WE HAVE TO REMEMBER THAT WITH COVID, EVEN THOUGH IT'S TAKEN, YOU KNOW, ALL OF OUR ATTENTION FROM PROBABLY EVERYTHING ELSE, THE OTHER PROBLEMS THAT WE WERE ADDRESSING BEFORE HAVE NOT GONE AWAY. SO, FOR EXAMPLE, YOU MAY HAVE HEARD ABOUT IN EAST AFRICA, THERE'S A LOCUST INFESTATION, AND IT WAS ALREADY PREDICTED TO HAVE MAJOR CONSEQUENCES IN TERMS OF PEOPLE'S FOOD SECURITY IN THAT REGION BECAUSE IT'S DECIMATING CROPS. WELL, SO NOW, THERE'S STILL A LOCUST INFESTATION, AND IN FACT PEOPLE'S ABILITY TO BE ABLE TO DEAL WITH IT ARE LIMITED BECAUSE OF LIMITED MOVEMENT AND TRANSPORTATION, ET CETERA. SO THAT'S STILL THERE. ITS CONSEQUENCES ON THE ABILITY TO GROW AND HARVEST CROPS IS EVEN MORE ACUTE, AND THEN THERE'S AN ECONOMIC SIDE TO IT AS WELL. WE RESPONDED IN I BELIEVE IT WAS 2011 TO A NUMBER OF COUNTRIES THAT WERE ALL AFFECTED BY THE CHANGE IN FOOD PRICES AT THAT TIME. THERE WERE RIOTS IN HAITI BUT ALSO, AS I RECALL, IN THE CENTRAL AFRICAN REPUBLIC AND I THINK IT WAS... I'M NOT TOO SURE ABOUT THIS... BUT I THINK IT WAS INDONESIA AS WELL. AND THAT KIND OF RISK OF CIVIL UNREST, WELL, IT ALSO HAS HEALTH CONSEQUENCES AND AFFECTS OUR ABILITY TO BE ABLE TO RESPOND APPROPRIATELY. THE OTHER THING I WOULD SAY IS, SPEAKING OF THE OTHER THINGS THAT WE WERE ADDRESSING ALREADY BEFORE ALL OF OUR ATTENTION CAME TO BE FOCUSED ON COVID IS, WELL, I MEAN, ALREADY DEALING WITH MALNUTRITION CRISES, ALREADY, YOU KNOW, HAVING THE NEEDS THAT THERE WERE FOR MATERNAL AND CHILD HEALTH CARE, THERE WERE VACCINATION PROGRAMS THAT NEEDED ATTENDING TO, CURRENTLY THERE'S A MEASLES EPIDEMIC IN THE CONGO AND THE VACCINATION WE WOULD NORMALLY BE DOING HAS BEEN DELAYED, AND THAT MEANS THAT THE MEASLES CAMPAIGN AND THE MEASLES OUTBREAK WAS GETTING CONSIDERABLY WORSE.

Steve says STEVEN, LET'S TALK ETHICS FOR A MOMENT HERE. WE KNOW THERE ARE MANY PLACES AROUND THE WORLD WORKING ON A VACCINE AT THE MOMENT. MANY OF THE LARGEST ECONOMIES IN THE WORLD ARE COMPETING TO FIND A VACCINE. BUT I AM CURIOUS AS TO HOW CONCERNED YOU ARE THAT IF AND WHEN THEY FINALLY GET ONE, THE DISTRIBUTION OF IT IS AS EQUITABLE AS POSSIBLE. I IMAGINE YOU'RE CONCERNED THAT IT WON'T BE.

Steven Hoffman says WELL, THAT'S THE THING THAT I THINK KEEPS ME UP AT NIGHT BECAUSE I THINK WE ARE VERY LIKELY, UNFORTUNATELY, TO SEE A SITUATION THAT THOSE COUNTRIES THAT ARE ABLE TO DEVELOP AND MANUFACTURE A VACCINE WILL, BECAUSE OF PUBLIC DEMAND, TRY TO MAKE SURE IT'S AVAILABLE WITHIN THEIR OWN COUNTRIES BEFORE SHARING IT WITH THE REST OF THE WORLD. AND I THINK RECENTLY... JUST RECENTLY WE SAW A BIG PLEDGING CONFERENCE FROM WORLD LEADERS WHERE EACH OF THEM IDENTIFIED THIS NEED. WE HAVE TO MAKE SURE THAT WE NOT ONLY DEVELOP A VACCINE BUT THAT IT'S AVAILABLE TO THE WORLD. YET AT THE SAME TIME ALL OF THOSE GOVERNMENTS HAVE BEEN TAKING STEPS TO SECURE SUPPLY CHAINS AND SUPPLY LINES FOR THEIR OWN COUNTRIES FIRST. IT REALLY HIGHLIGHTS THAT WE NEED A DIFFERENT PARADIGM WHEN IT COMES TO THESE TYPES OF OUTBREAKS, AND THE VARIOUS KINDS OF TECHNOLOGIES THAT WE'RE DEVELOPING IN ORDER TO ENSURE THAT WE CAN ADDRESS THEM. AND ONE GOOD THING IS I THINK ORGANIZATIONS LIKE DOCTORS WITHOUT BORDERS, MEDICINS SAN FRONTIERES ARE ADVOCATING FOR THIS. WE NEED TO BE SUPPORTING THOSE MESSAGES. IF WE END UP IN A SITUATION WHERE ONLY THE RICH HAVE ACCESS TO THE LIFE-SAVING PRODUCTS AND THE POOR DON'T, NOT ONLY DOES THAT REFLECT ON THE KIND OF WORLD WE LIVE IN BUT ACTUALLY PUTS ALL OF US AT FURTHER RISK BECAUSE THIS VIRUS WILL CONTINUE TO SPREAD UNTIL WE HAVE FULL ACCESS TO THESE TECHNOLOGIES FOR EVERYBODY.

Steve says DR. LAI, HOW SERIOUS ARE YOUR DOUBTS ABOUT THIS VACCINE IF AND WHEN IT'S DEVELOPED BEING EQUITABLY DISTRIBUTED AROUND THE WORLD?

Wendy says YOU KNOW, I SHARE THE SAME CONCERNS THAT DR. HOFFMAN HAS ABOUT THIS. AND I REALLY HOPE THAT WE, AS THE INTERNATIONAL COMMUNITY, LEARN THE LESSONS FROM THE WAY THAT THE EBOLA VACCINE WAS DEVELOPED. THAT WAS A VACCINE, AS YOU MAY KNOW, THAT WAS DEVELOPED HERE IN CANADA ON PUBLIC FUNDS, AND I UNDERSTAND THAT PUBLIC FUNDS ALSO ALLOWED FOR THE CLINICAL TRIALS TO DEMONSTRATE ITS SAFETY AND EFFICACY, AND YET THERE'S BEEN A WHOLE PROBLEM BECAUSE THE VACCINE IS CURRENTLY OWNED BY A FOR-PROFIT PHARMACEUTICAL COMPANY THAT HAS LIMITED ITS AVAILABILITY AND ITS AVAILABILITY TO COUNTRIES THAT ARE ABLE TO PAY FOR IT, AND YET... AND YET GIVEN ALL THE PUBLIC FUNDING THAT WENT INTO A REALLY IMPORTANT SCIENTIFIC DEVELOPMENT, THERE IS REALLY THIS CONCERN, THAT THE PEOPLE WHO NEED IT MOST AND NEED IT MOST URGENTLY MAY NOT HAVE ACCESS. AND SO AS THE WORLD RACES TOWARDS TRYING TO FIND EFFECTIVE TREATMENTS FOR COVID AND TRYING TO FIND AN EFFECTIVE VACCINE FOR COVID, I REALLY THINK WE NEED TO HAVE THAT IN MIND. THERE'S A SCIENCE QUESTION, FOR SURE, AND THAT IS URGENT, AND I FEEL VERY HEARTENED BY THE FACT THAT THERE HAS BEEN ACTUALLY SO MUCH TRANSPARENCY IN THE SCIENTIFIC COMMUNITY IN TERMS OF SHARING WHAT THEY KNOW ABOUT THE SEQUENCE AND THE TRANSMISSIBILITY, ET CETERA. SO I REALLY HOPE THAT TRANSPARENCY ALSO TRANSLATES INTO THEIR UNDERSTANDINGS OF TREATMENT AND VACCINE DEVELOPMENT AS THEY GO FORWARD, AND SO THAT ALL OF THIS PUBLIC MONEY WHICH IS GOING INTO THE BASIC RESEARCH NECESSARY TO DO THAT, THAT AS IT GOES THROUGH THE STAGES OF TRIALING AND PRODUCING IT IN LARGE QUANTITIES, THAT WE CONTINUE TO, AS A WHOLE GLOBALLY, BENEFIT FROM THE FRUITS OF THAT LABOUR.

Steve says STEVEN HOFFMAN, LET'S JUST TAKE A LOOK BACK AT HISTORY TO PRESENT DAY. HOW WOULD YOU RATE THE RECORD OF THE WORLD HEALTH ORGANIZATION IN ADEQUATELY ADDRESSING THE NEEDS OF THE DEVELOPING WORLD?

Steven Hoffman says YEAH. SO I THINK THAT THE KIND OF WORLD HEALTH ORGANIZATION THAT WE HAVE IS THE ONE THAT COUNTRIES AROUND THE WORLD HAVE DECIDED FOR IT TO BE. A LOT OF W.H.O.'S ABILITY TO RESPOND AND SUPPORT DEVELOPING COUNTRIES AS WELL AS THE WEALTHIEST COUNTRIES IN THE WORLD IS VERY MUCH DEPENDENT ON WHAT KIND OF RESOURCES AND MANDATES COUNTRIES ARE ABLE TO GIVE OR DO CHOOSE TO GIVE TO THE AGENCY AT THE UNITED NATIONS. WHAT WE'RE SEEING IS A VASTLY INCREASING NUMBER OF REQUESTS THAT GO TO THE WORLD HEALTH ORGANIZATION TO HELP THE WORLD'S HEALTH, BUT NOT A CORRESPONDING INCREASE IN RESOURCES. AND SO WHAT WE SEE IS A SITUATION WHERE WE LOOK TO THE W.H.O. FOR EVERYTHING, AND YET NOT ABLE TO ACTUALLY FOR THEM TO ALWAYS DELIVER IN THE WAY THAT WE'D LIKE. BUT THAT BEING SAID, WHEN WE LOOK AT W.H.O.'S RESPONSE TO THE CURRENT OUTBREAK, I WOULD SAY THIS IS ACTUALLY ONE OF THE STRONGEST RESPONSES WE'VE SEEN FROM THAT AGENCY. LOTS OF LESSONS WERE LEARNED, SOME VERY HARSH LESSONS WERE LEARNED FROM HOW THE WORLD HEALTH ORGANIZATION RESPONDED TO THE EBOLA OUTBREAK IN WEST AFRICA. IT WAS WIDELY CRITICIZED FOR A NUMBER OF REASONS. THEY'VE MADE SOME MAJOR CHANGES, AND AS A RESULT, THE CURRENT RESPONSE HAS BEEN MUCH MORE VIGOROUS AND I THINK QUITE EFFECTIVE. IT'S NOT PERFECT. NO RESPONSE TO A PANDEMIC IS PERFECT. BUT THE KIND OF CRITICISM I THINK THAT WE'RE ALL SEEING RIGHT NOW DIRECTED AT W.H.O. IS MUCH MORE POLITICS THAN REALITY. OF COURSE, THEY NEED TO DO A POST MORTEM TO MAKE SURE THAT THEY LEARN EVERYTHING THEY CAN FOR THE NEXT INEVITABLE FUTURE PANDEMIC THAT WE HAVE, BUT OVERALL MY ASSESSMENT IS THEY'VE BEEN DOING A PRETTY GOOD JOB. THIS IS THE TIME WE SHOULD BE SUPPORTING THEM NOW MORE THAN EVER.

Steve says WENDY, HOW ABOUT YOU ON HOW WELL THE W.H.O. HAS DONE WITH THE MOST VULNERABLE COUNTRIES IN THIS WORLD?

Wendy says I THINK THE W.H.O. PLAYS A UNIQUE ROLE IN THE WORLD IN TERMS OF THE MANDATE THAT IT HAS TO WORK WITH MEMBER COUNTRIES ON MEDICAL ISSUES OF GLOBAL SIGNIFICANCE, AND I THINK THAT IT IS THE ONLY BODY IN THE WORLD THAT CAN DO THAT. IT HAS A MANDATE TO DO THAT. IT HAS THE CAPACITY TO DO THAT. AND THAT IS NECESSARY, I THINK, ALSO IN AN ECOSYSTEM, RECOGNIZING THAT THERE IS ALSO VALUE IN HAVING OTHER ORGANIZATIONS WITH INDEPENDENCE OF FUNDING AND INDEPENDENCE IN TERMS OF OUR ABILITY TO ASSESS AND REACT TO A PARTICULAR SITUATION. THERE ARE ROLES FOR EACH OF US IN THAT, AND I THINK TOGETHER THAT ACTUALLY CONSTITUTES A GLOBAL RESPONSE.

Steve says WENDY, WHILE YOU'VE GOT THE FLOOR, TACKLE THIS ONE AS WELL, IF YOU WOULD? ONE OF THE THINGS THAT I GUESS WE WANT TO UNDERSTAND BETTER AND LEARN AS A RESULT OF THIS PANDEMIC IS HOW MUCH DO WE REALLY CARE ABOUT IT IF IT DOESN'T TOUCH OUR BORDERS? YOU KNOW, IF A GLOBAL PANDEMIC IS ONLY OVER THERE AS OPPOSED TO OVER HERE, DO WE CARE AS MUCH? WHAT DO YOU THINK WE'VE LEARNED ABOUT THAT SCORE SO FAR?

Wendy says IN SOME WAYS I THINK THIS IS ONE OF THE THINGS THAT'S BEEN INTERESTING ABOUT COVID, BECAUSE I THINK THERE'S BEEN MORE OF A RECOGNITION FOR COVID THAN PERHAPS FOR OTHER OUTBREAKS, LIKE THE WEST AFRICAN EBOLA OUTBREAK. BUT THERE'S BEEN MORE OF AN UNDERSTANDING THAT WE ARE ALL... I MEAN, ESSENTIALLY IN THIS TOGETHER. TO ME, THERE'S TWO WAYS THAT THIS COULD GO: ONE IS A RECOGNITION OF A UNITY OF PURPOSE AND A SOLIDARITY AROUND THE WORLD, RIGHT, AND RECOGNIZING THAT WE'RE FACED WITH A COMMON CHALLENGE AND THEREFORE BE ABLE TO LEARN WITH EACH OTHER AND COOPERATE WITH EACH OTHER AND RECOGNIZE AS WELL THAT THERE'S AN INTEREST IN BEING ABLE TO GET IT UNDER CONTROL GLOBALLY BECAUSE AS FAST AS IT HAS EMERGED GLOBALLY, ONCE IT'S UNDER CONTROL IN SOME PLACES, IF IT'S NOT UNDER CONTROL IN OTHER PLACES, IT CAN OBVIOUSLY COME BACK EXTREMELY QUICKLY. AND THAT MEANS THEREFORE FOCUSING ON VULNERABLE POPULATIONS, BOTH FOR THOSE POPULATIONS THEMSELVES, I HOPE, BUT EVEN IF THAT'S NOT WHAT YOU CARE ABOUT, THAT RECOGNIZING THERE IS A SENSE OF SELF-INTEREST IN THERE AS WELL. SO THIS IS THE DIRECTION THAT I HOPE THAT WE GO IN. BUT THERE'S ANOTHER POTENTIAL POSSIBILITY, WHICH IS... AND THIS IS A WORRY THAT I HAVE... THAT, YOU KNOW, WE MAY INSTEAD DECIDE TO BECOME MORE INSULAR AND MORE ISOLATIONIST AND BE AFRAID OF OTHER PEOPLE COMING FROM OUTSIDE BRINGING ILLNESS, AND THEN ALSO, YOU KNOW, BLAMING THESE OUTSIDERS FOR BRINGING IN ILLNESS, AND I REALLY HOPE THAT THE GLOBAL COMMUNITY IS NOW KIND OF MATURE ENOUGH TO HAVE THAT INSIGHT THAT THIS COMMON CHALLENGE THAT WE'RE ALL FACING, IT WILL BE DIFFERENT IN DIFFERENT PLACES, IT'S GOING TO MANIFEST ITSELF DIFFERENTLY, AND OF COURSE AS YOU SEE IN THE TIMING IN TERMS OF THE EPIDEMIC HAS BEEN DIFFERENT, BUT THERE IS A REAL CHOICE HERE TO BE MADE.

Steve says I WANT TO GO ON A BIT OF A TANGENT HERE. I'M GOING TO CALL AN AUDIBLE AND I HOPE YOU WON'T TAKE OFFENCE AT THIS QUESTION, DR. LAI. YOU KNOW, I AM CURIOUS. YOU'RE AN ASIAN CANADIAN, AND I WONDER IF YOU HAVE FELT EYES BURNING ON YOU IN A WAY THAT OTHERS HAVEN'T IN PART BECAUSE A LOT OF PEOPLE, INCLUDING THE PRESIDENT OF THE UNITED STATES, WERE QUITE ADAMANT ABOUT REFERRING TO THIS THING AS THE CHINESE VIRUS OR THE WUHAN VIRUS OR SOMETHING LIKE THAT?

Wendy says I MEAN, I'VE CERTAINLY BEEN PAYING ATTENTION TO THOSE REPORTS, STEVE, AND THERE ARE SOME EXTREMELY ALARMING REPORTS OF RACE-BASED VIOLENCE IN A VARIETY OF PLACES AROUND THE WORLD, SOME AGAINST ASIANS, BUT I THINK THIS IS ACTUALLY A MANIFESTATION OF THIS FEAR OF OUTSIDERS, AND THAT'S WHY I'M SAYING THAT THERE IS A REAL CHOICE HERE TO BE MADE. YOU MAY ALSO HAVE HEARD STORIES IN CHINA WHERE IT SEEMS THEY'RE PERSECUTING AFRICAN IMMIGRANTS, EVEN THOUGH, OF COURSE, THE VIRUS EMERGED IN CHINA. WE DON'T HAVE A GOOD UNDERSTANDING ABOUT ITS EFFECT CURRENTLY ON THE AFRICAN CONTINENT BECAUSE AFRICA DOES NOT CURRENTLY SEEM TO BE A HOT SPOT AND YET, AGAIN, THERE'S THAT REACTION OF SAYING, OH, YOU KNOW, IT'S PEOPLE WHO DON'T LOOK LIKE US THAT ARE THE SOURCE OF THE PROBLEM HERE. AND I THINK BECAUSE ONE OF THE THINGS THAT THE COVID OUTBREAK HAS DONE IS REALLY DEMONSTRATED THAT THE PLACES WHERE THE OUTBREAK IS LIKELY TO BE WORSE AND HAVE THE WORST CONSEQUENCES ARE IN THOSE PLACES WHERE PEOPLE ARE MOST VULNERABLE. WHATEVER ARE THOSE VULNERABILITIES IN A PARTICULAR SOCIETY, WHETHER IT'S LONG-TERM CARE CENTRES, WHETHER IT'S PRISONS, HOMELESS SHELTERS, WHETHER IT'S A REFUGEE OR DISPLACED PERSON'S CAMP, AND, AS I SAID, WE CAN EITHER RECOGNIZE THE VULNERABILITY AND CARE FOR THOSE PEOPLE, OR TREAT THOSE PEOPLE LIKE SOME FOREIGN ENTITY AND BLAME THEM FOR HARBOURING ILLNESS, AND THAT'S THE CHOICE THAT IS THERE TO BE MADE. I'M FORTUNATE BEING HERE IN TORONTO, WHICH AS WE KNOW IS QUITE A MULTICULTURAL SOCIETY. I'VE ONLY BEEN OUTSIDE OF MY HOUSE TO WORK IN THE HOSPITAL SO I'VE BEEN FORTUNATE IN THE SENSE OF NOT HAVING RACIALLY TARGETED COMMENTS TOWARDS ME, BUT WE NEED TO RECOGNIZE THAT THAT RISK IS THERE AND THAT MEANS THAT THE MESSAGING AND THE LEADERSHIP IS EXTREMELY IMPORTANT.

Steve says THANK YOU FOR INDULGING MY CURIOSITY ON THAT. PROFESSOR HOFFMAN, I SHOULD GO BACK TO YOU WITH THE ORIGINAL QUESTION THAT I ASKED DR. LAI, GET US BACK ON THE PATH HERE, I THINK IT'S INDISPUTABLE TO SAY WE CERTAINLY CARE MORE ABOUT COVID-19 THAN EBOLA WHICH ONLY STRUCK WESTERN AFRICA. BUT NOW THAT WE HAVE EXPERIENCED THIS PANDEMIC, DO YOU EXPECT IT WILL MAKE US ANY MORE EMPATHETIC WHEN THERE ARE WEST AFRICAN VIRUSES IN THE FUTURE OR ONLY ASIAN VIRUSES IN THE FUTURE OR WHATEVER?

Steven Hoffman says I CERTAINLY HOPE SO. I THINK WHAT THIS HIGHLIGHTS IS INVESTING IN PUBLIC HEALTH CAPACITY AROUND THE WORLD IS NOT ONLY THE RIGHT THING TO DO, IT'S THE SMART THING TO DO. AND THAT'S BECAUSE VIRUSES, LIKE THE ONE THAT CAUSES COVID-19, THAT DOESN'T CARRY A PASSPORT, IT DOESN'T RESPECT BORDER OFFICIALS EVEN IF THEY ASK THOSE VIRUSES NOT TO COME IN, AND AS A RESULT, WE IN CANADA AND CITIZENS IN THE WEALTHIEST COUNTRIES ARE ONLY AS HEALTHY AND AS PROTECTED AS THEIR FELLOW CITIZENS AROUND THE WORLD. AND SO I THINK WHAT WE CAN DO, WHAT OUR ROLE IS AS BEING CITIZENS IN THE WEALTHIER COUNTRIES IS CLEARLY TO BE INVESTING OF COURSE NOT ONLY IN OUR PUBLIC HEALTH SYSTEM, BUT ENSURING THAT THERE'S A GREAT GLOBAL HEALTH SYSTEM TO RESPOND TO THESE OUTBREAKS AND OTHER KINDS OF HEALTH THREATS THAT INEVITABLY FACE US. AND I THINK OUR VIEW OF RECEDING INTO OUR OWN BORDERS IS ONE THAT JUST HASN'T WORKED. AND COVID-19 IS JUST THE BEST EXAMPLE AND THE MOST RECENT EXAMPLE THAT HIGHLIGHTS THE TRAGEDY WHEN WE DON'T TAKE A MORE GLOBAL PERSPECTIVE AND WHEN WE DON'T PREPARE FOR GLOBAL CHALLENGES WITH GLOBAL SOLUTIONS.

Steve says I'VE GOT ABOUT A MINUTE TO GO HERE. LET ME JUST ASK YOU, PROFESSOR HOFFMAN, TO FINISH US UP ON THIS. EVERYBODY IS LOOKING FOR A SILVER LINING IN THIS THING AND ONE WONDERS WHETHER THE SILVER LINING COULD BE MORE EMPATHY BETWEEN COUNTRIES, THE POSSIBILITY OF BUILDING BRIDGES BETWEEN WEALTHIER AND POORER COUNTRIES AROUND THE WORLD? DO YOU SEE ANY OF THAT HAPPENING RIGHT NOW?

Steven Hoffman says I SEE A LITTLE BIT OF IT, BUT I HOPE THAT THIS OUTBREAK CAN RESULT IN A BIT OF A SILVER LINING, WHICH IS THAT SHOCK THAT OUR CURRENT WAY OF DOING GLOBAL GOVERNANCE, OF MANAGING THESE BIG GLOBAL CHALLENGES, WHETHER IT'S VIRUSES OR CLIMATE CHANGE OR GLOBAL INEQUALITY, OUR CURRENT APPROACHES JUST HAVE NOT BEEN ENOUGH. WE NEED NEW WAYS OF WORKING TOGETHER ACROSS COUNTRIES. WE NEED A SCIENCE OF GLOBAL STRATEGY AS TO HOW WE SOLVE THESE COLLECTIVE ACTION PROBLEMS, AND IF THIS IS THE SHOCK THAT WILL ALLOW US TO LOOK TO NEW SOLUTIONS, THEN THAT WOULD BE A VERY POSITIVE LEGACY FROM AN EVENT THAT OF COURSE HAS BEEN VERY DEVASTATING.

The caption changes to "Producer: Preeti Bhuyan, @preetibhuyan."

Steve says DR. WENDY LAI AND STEVEN HOFFMAN, IT'S REALLY GOOD OF BOTH OF YOU TO JOIN US ON TVO TONIGHT. AS WE LIKE TO SAY, STAY SAFE OUT THERE, KEEPING WASHING YOUR HANDS, AND HOPEFULLY WE'LL SEE YOU AGAIN SOON.

Steven Hoffman says THANKS FOR HAVING US.

Watch: Pandemics in Developing Countries