@BillGates Agree 100%- next gen vaccines with sterilising immunity. 2nd question: What are the current challenges in reaching global vaccination access? What are the obstacles?

@devisridhar During 2021 the supply of vaccines was limited and they mostly went to wealthy countries. Now we have a lot of supply overall and the problems are logistics and demand. The health systems in developing countries are a limiting factor.

@devisridhar mRna vaccines still can't meet all the demand so figuring out who gets what is complicated.#

@BillGates There's been a lot of discussion on responsibility of pharma companies like Pfizer/Moderna for access. What is the role of these companies in ensuring pricing and availability esp in low and middle income contexts?

@devisridhar When we have adequate supply then tiered pricing is used where the rich countries pay a lot more than middle income and low income pay the least which is funded by @gavi. When supply is limited rich countries have to not outbid the others so governments are key to this. #

@BillGates @gavi Looking back on 2020/21 (and given you warned of a respiratory pandemic for years before), what do you think is the biggest mistake most countries (with resources) made in responding?

@devisridhar @gavi A few countries like Australia moved fast to diagnose cases at scale and isolate people who were infected. They were able to limit deaths dramatically. Once the numbers get large in a country it is too late. So the first few months made a lot of difference.

@devisridhar @gavi Also some countries did a better job of reducing mobility, using masks and protecting the elderly. We weren't prepared - no practice in advance.#

@devisridhar @gavi Do you think the world will come together to get ready for the next one? I hope so but I am not sure.#

@BillGates @gavi I'm optimistic about the '100 day challenge'- the idea of sequencing a new genome to developing diagnostics, therapeutics and effective vaccines- and getting them out to people. But requires leadership, planning & foresight. Now is the window to prepare.#

@BillGates @gavi One major problem has been online misinformation on Facebook & other platforms around vaccines, masks and other interventions- how do we deal with this challenge? When expertise is neglected and conspiracy theories are spread as if they are truth?

@devisridhar @gavi Trusted authorities like @WHO and @CDCgov need more resources to see the pandemic early (surveillance) and to communicate better. Social media got behind on trying to get factual information out - there will be a lot of debate about how to do better on that...

@devisridhar @gavi @WHO @CDCgov People like you and I and Tony Fauci have been subject to a lot of misinformation. I didn't expect that. Some of it like me putting chips in arms doesn't make sense to me - why would I want to do that?#