A presentation on my life in public health and vaccinations- from measles in the West Midlands of England, 1983-2014 to COVID-19 in Europe, 2020-now, implications for the public health community and vaccines manufactures including the vaccine TRIPS waiver. Presentation to a Spanish public health and vaccines forum, October 18th 2021 211018 middleton spanish vaccines and industry presentation 1 version recorded

1. Vaccinations: saving lives in millions
Professor John Middleton
President, the Association of Schools of Public Health in the
European Region

2. Vaccinations: saving lives in millions
Buenos días compañeros, señoras y
señores en este importante foro
español de vacunas y salud pública

3. Vaccinations: saving lives in millions
How should the public health community work with vaccine
manufacturers?

4. How should the public health community work with vaccine
manufacturers?
As partners committed to improving health and saving lives
With complete honesty, we must understand where there are differences and diffulties in delivering
what we each want
Complete transparency in data sharing and science
Being completely unafraid to be critical, in both directions, when either partner is wrong
We should have our disagreements in private and present a united front in public, but there can be
no suggestion of collusion, no thread for conspiracy theories to be founded
This meeting is a space for dialogue, a chance to come together and get our views on the table.
Vaccinations: saving lives in millions

5. Vaccinations: saving lives in millions
In 2007, British Medical Journal
readers voted Vaccination the
fourth most important medical
milestone since 1840
After sanitation, antibiotics and
anaesthesia
https://www.bmj.com/content/334/7585/111.2.full

6. Vaccinations: saving lives in millions
An extraordinary story of success:
Eradication of smallpox
The near eradication of polio
The high levels of protection against childhood
infections
The potential or theoretical eradication of measles,
hepatitis B
The extraordinary, unprecedented, global effort on
COVID-19 vaccines

7. Vaccinations: saving lives in millions

8. Vaccinations: saving lives in millions
In 2014, the US Centers for Disease Control and Prevention
estimated that the vaccines given to American infants and
children over the past 20 years will prevent 322 million
illnesses, 21 million hospitalizations and 732,000 deaths
over the course of those lifetimes.

9. Vaccinations: saving lives in millions
In my time in service public health in Coventry
and Sandwell in the West Midlands between
1982-2014, there have been a staggering 26
innovations in immunization and vaccination
programmes . I oversaw implementation of
Measles mumps and rubella vaccine, new
schedules for childhood vaccines, Human
papilloma virus, meningococcal vaccines,
shingles vaccine, pneumococcal vaccine, flu
vaccines for adults and children and more…

10. Vaccinations: saving lives in millions
94
95
96 96
93 93
92
94
95 95
94
80
82
83
89 89 89
88
90
91 91 91
70
75
80
85
90
95
100
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
DTP3 MCV2
Percentage of children (%) vaccinated against measles (MCV2), diphtheria,
tetanus and pertussis (DTP3) in the WHO European Region in 2010- 2020
Source:
WHO/UNICE
F Estimates
of National
Immunizatio
n Coverage

11. Vaccinations: saving lives in millions
Vaccine Min coverage% Max coverage% No of countries with less
than 90% vaccination
coverage
DTP3 73 99 6 (of 53)
MCV2 76 99 13 (of 52)
PCV3 60 99 16 (of 40)
HPV 4 99 28 (of 31)
Immunization coverage in WHO European Region countries in 2019
Source: WHO/UNICEF Estimates of National Immunization Coverage

16. Vaccinations: saving lives in millions

17. Vaccinations: saving lives in millions

18. Vaccinations: saving lives in millions

22. Vaccinations: saving lives in millions

23. Vaccinations: saving lives in millions
Proportion of the population who would refuse COVIOD_19 vaccine if offered it now. Institute of Health
Metrics and Evaluation, March 2021

24. Vaccinations: saving lives in millions
https://www.sorryantivaxxer.com

27. Vaccinations: saving lives in millions

28. Vaccinations: saving lives in millions
Planning for an outbreak of health

29. Renew the mandate of the UN and
WHO in global health governance
The new Treaty for pandemic
preparedness
Governance
Transparency and information
sharing
Resources and capacity
New continental/WHO regional
structures with response capacity
Ceded authority to supranational
structures

30. Revised mandate of
ECDC and EMA
Crisis preparedness
and response
New regulation for
pharmaceutical
industry
Europe’s Beating
Cancer plan

31. We can’t afford to ‘wait and see’ : we must invest more in public health protection.
We must not regret tomorrow, not doing what we know we can do today.
Prof Jose M. Martin-Moreno

33. Vaccinations: saving lives in millions

34. Vaccinations: saving lives in millions

35. Vaccine
Waiver
needed
now

36. Vaccinations: saving lives in millions

37. https://www.forbes.co
m/sites/niallmccarthy/2
021/05/06/which-
companies-received-
the-most-covid-19-
vaccine-rd-funding-
infographic/?sh=eef64e
a4333d

38. Vaccinations: saving lives in millions
There is no place for intellectual property protection
during a humanitarian crisis
But there must be fair assessment of how industry
should be properly paid for their work and their
products and to protect and ensure investment for
future new life-saving products

39. Vaccinations: saving lives in millions
Science knows no
country, because
knowledge belongs to
humanity, and is the
torch which
illuminates the world.
Louis Pasteur

40. Thank you
John Middleton,
President
Association of Schools of Public Health
In the European Region
John.middleton@aspher.org