Seth Berkley has seen our pandemic future

[upbeat music] I don't know about you, but the COVID-19 pandemic occupies a really weird place in my brain. On one hand, it's probably one of the most significant historical events I've ever experienced firsthand. It fundamentally changed the politics and culture around me. It was the overarching context into which my first child was born. On the other hand, it's a very surreal thing to look back on, almost like it happened in a parallel universe or a different lifetime. I think that's reflected in how we look back on COVID at a societal or institutional level. We did not learn the lessons of the pandemic in a straightforward way. The experience got warped and refracted through all these different filters, and it could be hard to figure out exactly what has changed in global health and how, and whether it's for the better or the worse. Very early in the pandemic, there was someone who had a pretty good idea about how parts of it were going to play out. Seth Berkley was the head of Gavi, the Vaccine Alliance, and he became one of the key architects of COVAX, the global initiative to deliver COVID vaccines to lower income countries. Way back in February 2020, before a vaccine even existed, Berkley was warning publicly that lower income countries were going to have a problem accessing vaccine doses. He was right, and COVAX was his attempt to overcome those structural inequities. Last year, Berkley published a book. It's called Fair Doses: An Insider's Story of the Pandemic and the Global Fight for Vaccine Equity. It's an important record of lessons that should not be forgotten, also of some amazing successes that we shouldn't forget either. It's also an incredible reintroduction to the strangeness and complicated history of vaccines, which we talked about quite a bit. We recorded this interview before the World Health Organization declared the Ebola outbreak in DRC and Uganda a public health emergency. But a lot of the things we talked about, including past Ebola outbreaks, are extremely relevant to this response and to the inevitable future outbreaks we will face. On that last point, future threats, this conversation ended up in a place I did not expect and that I am still worrying about. Here's Seth Berkley. Seth Berkley, welcome to the podcast.

Thanks for having me.

Um, so I took a lot of things away from your book, um, which published last year. We're gonna, uh, talk a bit about that, talk about some of your, your more recent writing as well, um, talk about what you are seeing in the current state of global health and pandemic preparedness. Um, but one of the things that jumped out to me in the book that you recently published, um, that I wonder if you'd be willing to, to say a little bit more about, is that you once tried to train a racehorse that you adopted from a racetrack. Is there anything else you can share with us about that experience?

That is correct, and it was crazy. A green rider to a green horse. But, um, I, um, I actually love horses and, um, had learned to ride. I grew up in New York City, so it wasn't exactly the perfect place to learn how to ride, although they did until recently have horses in New York and great, great