Thread by @JeremyFarrar

Pleasure to join #GrandChallengesAnnualMeeting2020 thank you @drpennyheaton for the introduction. Quick summary.

People will be writing,discussing,considering COVID19 in 100yrs as we discuss pandemic 1918 now. We are living through history as it is being made. When read history books can seem romantic. It never is. It is tragic, confused,trade offs,painful,difficult & frightening. As now.

This is the reality of COVID19 & will continue to be so. Focus on the drivers and perspective from the last 20 years.

We have had multiple warnings from Nipah in 1999 to SARS-1, H5N1, Ebola, MERS, Zika, Chik, H1N1 & others. Many common drivers-Ecological change, changes in human:animal interactions, urbanisation, travel & trade. And in times of neglect of public health & geopolitical tensions.

These are & will remain common in the 21stC hence these challenges have and will be more frequent, more complex & inter-related.

Such challenges impact across four concentric circles - 1) Direct Health consequences. 2) All other health concerns. 3) Inequality, Jobs, Livelihoods, Trust, Economies, trust between governed & the governing. Amplifying fault lines in all societies. wellcome.org/news/our-respo…

Need to understand & address all these drivers and the consequences, not just the symptoms.

I believe that means 1) Investment prior to crisis contributes to capacity to prevent, prepare & respond. A shift from efficiency to resilience 2) Partnerships matter, partnerships forged over years, inclusive & equitable and providing value & benefits before a crisis.

3) Multilateralism matters, will & can deliver. We have looked into the abyss of nationalism, & chose another path. 4) Global & national institutions, well governed, transparent & trusted - matter. We need to challenge them yes, but also protect & value them.

5) Science matters but has to be broader,inclusive, transparent. How we do things matters as much as what we do. Research culture & environment matters.6)Science does not exist in a vacuum, it is sustained by communities & society it must be an integral part of not detached from.

7) Science is part of political discourse and cannot be isolated from it. That can be a difficult. Pay tribute to all those who have stood up & be counted, arguing for truth, transparency, equity despite often personal cost & as some suffered threats & public vilification.

Science has rarely been so in public eye for good & bad. Must acknowledge what science can do & what its limitations are. Humility is a central part of science. This will be true as we come thru current crisis & science will need to look critically at itself & be challenged

8) Crisis has also shown what progress can be made by breaking down barriers, thru open sharing data & results, across borders & specialities. It is possible to disrupt traditional methods & not cut corners.We can speed up science,R&D, innovation & access. We can catalyse change.

9) I remember the Grand Challenges meeting in London Oct 2016, just before another US election. To all American friends & colleagues, think of course of USA when you vote, but also think of Americas & your role in the world.

10) The world is better, we are all better for an engaged, committed, creative USA, for your leadership, your generosity and your partnership. In recent years that has been harder, we have missed you & look forward to a new dawn.

Finally, thank you to all colleagues & friends @gatesfoundation, Bill, Melinda, Trevor, Chris K, Penny, Kedest, Lynda, Mark, Chris E & many more. We value our great colleagues & a great partnership with you. Thank you for bringing us together #GrandChallengesAnnualMeeting2020

And a huge thank you to all the technical teams that made this virtual #GrandChallengesAnnualMeeting2020 possible. With you, it would not have been possible. Thank you. Look forward to Boston2021.