>> We have to consider this problem as a global problem.

This virus does not respect borders.

It doesn't respect nationalities or religion or age or anything like that.

♪♪ >> Hello and welcome to "GZERO World."

I'm Ian Bremmer, and today we're talking vaccines and the state of distribution globally.

Spoiler alert for you.

It could be a lot better.

Not in the United States, but for just about everyone else.

And public health experts are warning that nations need to get more shots into arms before dangerous new strains of the virus spread further.

My guest is a global leader in public health and the Chief Scientist at the World Health Organization, Dr. Soumya Swaminathan.

Later, a new graphic novel that's teaching kids the ABCs of vaccines.

And then it's puppets.

>> Once upon a time, there was a very troubled kingdom.

>> But first, a word from the folks who help us keep the lights on.

>> Major corporate funding provided by founding sponsor First Republic.

At First Republic, our clients come first.

Taking the time to listen helps us provide customized banking and wealth-management solutions.

More on our clients at firstrepublic.com.

Additional funding provided by... ...and by... >> I'm guessing it's been a while since you've been on an airplane.

Me too.

But you remember that safety instruction from your flight attendant -- "put your own oxygen mask on first before assisting others."

Sound advice at 30,000 feet.

But here on the ground, that approach is causing some turbulence.

I'll explain.

After record-breaking developments last year, not one, not two, but more than a dozen COVID-19 vaccines have been fully approved or currently in early use globally.

Since last December, over half a billion shots have gone into arms.

But when you dig down into those numbers, the rollout has been really, really uneven.

The World Health Organization reports, as of the end of March, 76% of those vaccinations have been given in just 10 countries.

The United States and China are half that total.

That leaves plenty of nations, unsurprisingly among the world's poorest, who have yet to distribute any vaccine at all.

COVAX, the global initiative started last year by the World Health Organization and other partners, is pushing for equitable access to vaccines, trying to ensure it's not just the wealthy countries who get their shots.

While plenty of dough has been pledged to COVAX, including $4 billion from the Biden administration alone, it's doses that are needed right away, >> COVAX is ready to deliver.

But we can't deliver vaccines we don't have.

>> Vaccine nationalism is that line from your flight attendant.

Vaccinate your own population before donating supply abroad.

So what's wrong with that?

Well, first, there's the humanitarian angle.

Many public health experts don't want to repeat mistakes made during the AIDS epidemic, when low-income countries waited years for lifesaving drugs that were readily available elsewhere.

There's a practical reason too.

>> As long as there's outbreaks anywhere in the world, everywhere in the world is in danger.

>> As new mutations and variants of COVID spread around the world, scientists warn we're in a race to get shots in arms before the virus outsmarts the vaccines.

The WHO and other global health organizations say leaders should be prioritizing vulnerable populations everywhere -- healthcare workers, the elderly, and those with comorbidities -- before giving vaccines to everyone else.

That'll save a lot more people.

Meanwhile, stockpiles in wealthy countries continue to grow.

For example, the United States already has commitments to buy far more doses than it has people to inject.

>> If we have a surplus, we're going to share it with the rest of the world.

>> But when and how?

For more on the race to vaccinate the planet and the next phase of this pandemic, here's my conversation with the World Health Organization's top scientist.

Dr. Soumya Swaminathan.

She is Chief Scientist at the World Health Organization.

Thanks so much for joining us on "GZERO World."

>> Thank you, Ian.

Nice to be with you.

>> So let me start with a quote from you.

You recently said, "We cannot win the battle against this virus one country at a time," and that the gap in vaccine inequality worldwide is "becoming more grotesque every day."

What's the state of the global race to vaccinate, in your view right now?

>> Yes, I mean, you call it a race.

It is a race against the virus.

We should not look at it as a race between countries.

A large number of countries, about 42, I believe, still have not started vaccinating their people, even their high-risk groups like healthcare workers and the elderly.

And three quarters of those countries are low-income or low-middle-income countries.

So you begin to see here the real inequity between a few countries.

They are high-income countries and vaccine-manufacturing countries that are moving very rapidly towards vaccinating their entire adult population.

That's the targets that they have.

And a significant number of other countries, you know, that account probably for more than two thirds or three fourths of the world's population, where even if they have received vaccines, it's very small volumes.

They've only started vaccinating the very highest risk groups, and they really need to scale up rapidly in order to bring down deaths.

You know, we've seen in the last few weeks the global epidemiology again changing.

There's been, unfortunately, an uptick in cases in all the WHO regions with also increasing deaths.

And this is very, very concerning, particularly since we now have tools, we have diagnostics, we know how to treat people better than we knew last year, and we have vaccines that we didn't have last year.

And yet we are back to the levels, you know, that we had last year of cases and deaths.

>> If you were advising some of the leaders of these wealthy countries, you obviously understand the pressures that they want to get their citizens vaccinated first.

What is the right thing for them to have done for them to be doing that they're not doing right now?

>> I think because it's a pandemic, we have to consider this problem as a global problem.

And yes, political leaders are answerable and responsible for their own populations.

But this virus does not respect borders.

It doesn't respect nationalities or religion or age or anything like that.

It just spreads where it has an opportunity to spread.

It only recognizes human beings.

And so what we should have done and what we've been advocating for, as the WHO, is, in the first instance, to prioritize the high-risk groups so that we can bring down deaths.

We've seen now in countries what a huge impact vaccines can have on reducing severe illness, hospitalization, and deaths -- tremendous.

And the news from the vaccine is really encouraging.

It's reducing deaths, it's reducing hospitalizations, and it's even reducing infections.

So as we're learning more about the vaccines, we're getting more and more encouraged.

But in some countries, you see death rates climbing every day because they don't have enough people vaccinated in those high-risk groups.

So if we were to approach this as one global community, we would share the available vaccine supplies, which are no doubt limited.

So for the first half of the year, at least, supplies are definitely not going to be enough to meet all demands everywhere.

If we could share those limited supplies in a way that everyone in all countries who is at highest risk of dying if they get the infection is protected first, then, when the supplies are more, we could actually start vaccinating more of the adult population, which is where we want to get to eventually.

To control this infection, we probably have to vaccinate 70%, 80% of the population of all countries.

>> We're probably in a situation where the entirety of the United States, the United Kingdom, Israel, other countries get vaccinated before many countries even get started, even get their first vaccine.

That's what we're looking at right now.

Aside from the fact that that means a lot more people will die, what does that also mean in terms of real-time spread of variants, the difficulty of actually fighting this pandemic globally?

>> That is the other real concern, that if we allow the virus to spread and multiply unchecked in some parts of the world, the more the virus replicates, the higher the chances of it accumulating these mutations, because this only happens when the virus is reproducing or replicating.

So there will be then these variants emerging that have already emerged and will continue to emerge in some parts of the world.

And eventually we've seen all these variants actually spread across the world.

There is no way to keep those geographically confined.

And so a new variant that is less susceptible to the immunity that's brought about by vaccines or that's more transmissible or makes people more ill, could easily then spread back and infect people in parts of the world where there have been large numbers of people vaccinated and where they think that they are then immune.

So I think there is -- it makes epidemiological sense as well to distribute these tools that we have fairly across the world so that you're damping down transmission in all parts of the world at the same time and not in an unequal manner as is happening now.

>> So many people now, as they are getting vaccinated that are watching this show -- I know we're learning more every day -- but how comfortable should people feel?

They've gotten their jab, their second jab in the case of Moderna and Pfizer.

They've waited their two weeks.

You know, at this point, do you think people can go back to pretty much living their lives or not and where would you make exceptions?

>> Well, I don't think that any country is at the point where they can say, "Let's go back to living lives as we were before the pandemic," even in those countries which have vaccinated, you know, 40%, 50% of their adult population.

Most of them have had a single dose.

And unless you get both your doses and a significant number of people in the population have had two doses and you know that you've got that population level immunity, you can begin to relax a little bit.

But I would say that for the majority of us at this time, whether we've had the vaccine or not, we still need to maintain the guidelines.

We still need to wear a mask when we are in a crowded place or with a group of people, try to maintain physical distancing as much as possible.

>> You know I'm going to ask you about the new WHO report that just came out that was looking into the origins of COVID-19 and hopefully shedding some light on that.

What can you tell me that we have learned on the back of that report?

>> I haven't read the 300-page report, and it's obviously very, very detailed and comprehensive.

It involved a lot of in-depth work that was done by the international scientists, along with their Chinese counterparts when they went to China earlier this year.

And basically they looked at every possible hypothesis on how this virus could have made that jump into humans and begin to spread from from human to human.

And then they laid out the likelihood of each of those potential scenarios.

And while they could not come to a conclusion on the origin of the virus, basically, which means that they have laid out a plan for more research and more work that needs to be done.

But looking at the most likely scenario that this came from bats, because the betacoronavirus is very, very common in bats and there's a lot of genetic similarity between the SARS-CoV-2 virus and many of the viruses in the Rhinolophus bat species.

And so a lot more work needs to be done.

But how and where it moved from bats into humans and what that intermediate animal was -- most likely, they believe there was an intermediate animal, like the civet cat for the SARS, the original SARS virus and the camel for the MERS coronavirus.

So those are still open questions.

>> I'm sure you've seen that the former U.S. CDC director, Robert Redfield, has come out and said that he believes that this virus initially emanated from a bio lab in Wuhan in China.

Is that definitively not a theory that the WHO finds plausible right now?

>> It was the least likely.

I told you that there were many different theories that were considered.

Everything was on the table, but that was considered the least likely of the possibilities.

>> We all know that the WHO is the most important international organization that's tasked with coordination and education and fighting pandemics.

We also know that the Biden administration has recommitted American cooperation with your organization.

But there has been a lot of you guys in the crosshairs, both from Trump saying that you are basically an arm of the Chinese government to now Secretary of State Tony Blinken criticizing the WHO pretty directly for influence of China on this report.

I mean, you're a scientist.

You're not a political figure.

How do you react when the Secretary of State from the United States levels those allegations that your report was influenced by the Chinese government?

>> No, as you say, Ian, I'm a scientist, and I've been trying really to work on the science side of things, and that's been a truly rich and amazing experience to just see where we've come, you know, in a matter of 12 to 13 months from when we first found out the genetic sequence of this virus, thanks to the Chinese scientists who posted it publicly on the 10th of January last year, which enabled all of these amazing vaccines, as well as diagnostics to be developed, to all the other research that's been done where we are today in a position where we understand the disease, the virus, the epidemiology, the transmission and the modes of control so much better.

And we have so many tools.

So I've really been focusing on that and not on the politics.

So I don't want to comment really on what anyone said.

But it is true the WHO is a member-state-driven organization.

And so I think, again, it's for the member states that formed the WHO in 1948 to think about its future and how it should be funded and given -- empowered, really, so we can do even a better job than what we do today.

>> So before we close, let me ask you a little bit just about long-term trajectory.

One is the children.

I mean, you've seen that we have millions of kids that are out of school and some that aren't going to be returning as a consequence.

I wonder, given the scientific consensus that appears to be that COVID is not widely transmitted at schools, why hasn't the WHO recommended that all students return to school worldwide?

>> I think that's a really good question, and, you know, the evidence on this has been very mixed.

Unfortunately, there haven't been very many good studies done on transmission in schools.

And the evidence that's come from different settings has been mixed.

And the reason for that is that schools don't exist as an island in themselves.

They are part of the community.

And whatever happens in the community is going to be reflected in the schools.

So if you have a raging outbreak in the community, it is likely that you will have a lot of infections if you keep schools open.

So that's why we've always said that, you know, we need an approach to schools where we prioritize schools.

We've always said schools must be prioritized over other things like shopping malls or cinema halls or pubs and things like that, that we've advised governments, please prioritize schools.

>> When do you think the World Health Organization will be in a position to recommend that children should be vaccinated?

>> So, the trials have started.

Many vaccines are now being tested in children down to the age of six or even lower.

I think they're going to be looking at safety, they're looking at dosing, and they are looking at the immune response.

So as soon as there's data, as you know, we've put guidelines out for four vaccines so far.

We have policy as well as we have the emergency-use listing.

And as soon as we have data on children, we will update those to include children.

>> You've said recently that better vaccines are coming.

You can even see vaccines without needles.

Can you talk a little bit about that?

>> Yes, there are a number of vaccines in development that are being given either through the nasal route as a spray, and that would have a lot of advantages because it would generate local mucosal immunity in addition to systemic immunity.

There are oral vaccines that are being developed, and there are also vaccines that could be given through the skin through transdermal application.

So there all of these innovative vaccine designs coming through.

There are single-dose vaccines coming as well, vaccines that can be stored at room temperature.

And that's why I'm so optimistic that eventually we are going to have a range of vaccines.

>> Have you learned personally more in the last year than at any other time in your life?

>> Absolutely.

There's no doubt.

You know, I've worked on tuberculosis, and I'm appalled that we make so little progress in tuberculosis.

It takes a decade to do a clinical trial and get a new drug as part of the regimen for TB.

It takes 30 years to get a vaccine from phase one into phase three.

And it's been very depressing.

And just seeing what's happened with COVID gives me renewed hope that we can address some of our other public health challenges with the kind of global collaboration that we've been able to bring, you know, to address this problem of COVID-19.

It's a question of having that mission and that goal.

And scientists around the world agreed to work together.

It was just an unsaid commitment that people had, and that's what resulted in where we are today.

So I hope we can do this for some of the other big killers like TB and malaria, hopefully HIV as well.

>> Dr. Soumya Swaminathan, thank you so much for joining me today.

>> Thank you.

>> Shortly after my interview with Dr. Swaminathan, the Director-General of the WHO issued a statement about that report on the origins of the COVID virus and made it clear the investigation continues.

He said in part, "Although the team has concluded that a laboratory leak is the least likely hypothesis, this requires further investigation.

As far as WHO is concerned, all hypotheses remain on the table."

In recent weeks, both Pfizer and Moderna have announced early phases of vaccine trials in children.

Johnson & Johnson also plans to start soon.

If you know a kid who wants to learn about vaccines, how they work, why we need them, this next story is just what the doctor ordered.

>> I'm Don Brown.

I'm a writer/illustrator.

I've been doing kids books for nearly 20 years.

I write stories about real people who did real things.

For the last five years, I've been doing graphic nonfiction on big historical events.

I've done a graphic nonfiction on Hurricane Katrina and the drowning of New Orleans.

I've done a graphic nonfiction on the history of the Earth, a geology book.

I've done a graphic nonfiction on the Spanish influenza.

And it was that book that led me to be interested in the history of vaccines and microbiology.

"Shot in the Arm!"

is narrated by Mary Montagu.

Now, she was an English lady who ended up in the Ottoman Empire when her husband was a diplomat for the British Empire.

There she learned about a vaccine or a way to protect yourself against smallpox.

Now, for virtually everyone on the planet alive, we have no experience with smallpox.

But at the time and for thousands of years, it was a killer.

It killed up to 30% of the people it afflicted.

Now, Ms. Montagu found a way where if you infected yourself with a mild case of smallpox, then you would be forever immune to it, because after you have smallpox once, you'll never get it again.

And she used that opportunity to vaccinate one of her children.

And it became all the rage of England when they heard about it and it went around the world.

It had already existed in Asia and the Middle East and even in Africa.

In the United States, in the Massachusetts colony, a smallpox epidemic flared up.

Cotton Mather, one of the colony's fathers, wanted to do something about it.

And what he learned from one of his people, who he enslaved, was a way to protect yourself by way of variolation, where you give yourself a small, mild version of the diseased to protect yourself from a full-blown version of the disease.

And this enslaved person ended up saving thousands of people in Massachusetts.

Certainly the story of vaccine speaks to me personally because I'm old enough to remember the horror of polio epidemics.

When I was a small child, my parents would be devastated, frightened beyond belief.

Thank God we don't have to worry about that right now.

And that's because of a vaccine.

I think I'd like kids to take away the idea of the power and importance of science and knowledge and information and how that can benefit everybody and that we shouldn't be ruled by hearsay, rumor, conspiracy.

That isn't what's important in this world.

We live in a scientific world and science is not the enemy.

Science can be a great benefit and friend to all of us.

>> And on "Puppet Regime" today, our world leaders have a children's book of their own to share.

Roll that tape.

♪♪ >> Once upon a time, there was a very troubled kingdom where all of the princes argued with each other, especially the Italians.

>> This made a certain wolf living next to the kingdom very happy.

You see, Wolf was sad and jealous because long ago he had a big, scary empire of his own.

>> Now, some of the princes wanted to leave the kingdom.

And one of them actually did.

>> Well, Wolf made friends with many of princes in this troubled kingdom.

This helped a lot when one day Wolf ate Ukraine.

>> I will never forgive the wolf for that.

>> Sure, you will.

You depend on Wolf for many, many special potion.

>> Ah!

Anyway, one day a friendly kingdom across the western sea fell under the control of a scary, scary king who was very mean.

>> Please, totally fake fairy tale, okay?

Your kingdom is a freeloading sham and everybody knows it.

>> Man, he is not in character.

Our kingdom must become the chevalier in shining armor to save itself.

>> Ah, come on, man.

There's a new king in town, you see?

And just like that, America is back.

>> But is that something we even want?

>> No, not me.

>> Enough!

Look, after 16 years of casting spells to keep this kingdom together, a certain fairy godmother got fed up with all of this and left.

And do you know what happened to the kingdom next?

>> "Puppet Regime"!

>> You don't like green eggs?

Do you know what will happen to you if you do not eat the green eggs?!

>> That's our show this week.

Come back next week, and if you like what you see and you've been vaccinated or you're thinking about it and you want to and you can't wait, check us out at gzeromedia.com.

♪♪ ♪♪ ♪♪ ♪♪ >> Major corporate funding provided by founding sponsor First Republic.

At First Republic, our clients come first.

Taking the time to listen helps us provide customized banking and wealth-management solutions.

More on our clients at firstrepublic.com.

Additional funding provided by... ...and by...