Dr. Enrique Chacon-Cruz:
Welcome everybody, and happy to start with these globally crucial and relevant topics.
Climate change is reshaping disease ecology in livestock and agricultural systems, increasing zoonotic spillover risks, threatening food safety, and driving greater antimicrobial use in animal production. This accelerates antimicrobial resistance and raises risks for human health through foodborne pathogens, environmental transmission, and emerging infectious diseases. Today, four top scientists, Dr. Peter Hotez, Dr. Rino Rappuoli, Dr. Monserrat Arroyo, and Dr. Clarisse Ingabire and I will be hosting a conversation here.
How can international finance and global institutions strengthen vaccine R&D, and where are the greatest opportunities to improve equitable access across diverse policy and regulatory environments?
Dr. Clarisee Ingabire:
Thank you, Enrique, and thank you all for having us. It’s a pleasure to be here this afternoon. My name is Clarisse Ingabire, and I am a livestock specialist at the World Bank in Washington, D.C.
International financing institutions such as the World Bank and IFAD have an important role to play in vaccine R&D, even though we do not traditionally fund research directly. Our contribution is largely catalytic: we help de-risk investments through the financing we provide to governments—typically Ministries of Finance, Agriculture, and Livestock—to support priority areas such as environmental management, agricultural development, and livestock systems. Within these investments, there are always opportunities to influence and strengthen research and vaccine development.
We also have market-shaping power through our convening role. By bringing countries together around shared goals, we can help create predictable demand. For example, in the Sahel, our support to regional pest-eradication efforts enabled governments to pool financing and create a viable market for vaccines, allowing them to purchase directly from manufacturers.
In addition, we help strengthen the enabling environment. Although the funding is often modest, it acts as seed capital for reference laboratories, epidemiological surveillance, and intelligence systems. These investments generate the data needed for researchers and manufacturers to better understand diseases and produce effective vaccines that governments can subsequently procure.
Finally, we do not work alone. Because we sit at the table with governments, we can mobilize key partners—including WOAH, The Pan African Veterinary Vaccine Centre of the African Union (AU-PANVAC) Africa CDC, and others—to support regulatory harmonization, strengthen animal health systems, and build national capacity. This helps countries better articulate their needs and participate meaningfully in shaping vaccine research and procurement.
I’ll pause here.
Dr. Enrique Chacon-Cruz:
Well, that’s a great answer. Thank you, Dr. Ingabire. Now let me turn to Dr. Monserrat Arroyo..
The World Organization for Animal Health (WOAH) has identified priority diseases where improved vaccines could reduce antimicrobial use. How can these priorities guide investment and policy globally?
Dr. Montserrat Arroyo:
Thank you for that question and I’m really happy to be here today. I’m the World Organization for Animal Health Deputy Director General for International Standards and Implementation and since early in the year 2000, we have done a lot of work to bring recognition of the AMR impact. We need to nvest in the reduction of AMR and we have identifyomg the gaps, the different challenges and so that investments are targeted and efficient.
Last year, as we do every year during our General Assembly in may, we had a forum on Vaccines and vaccination, where we identified challenges throughout the implementation of vaccination for Animal Health, and through which challenges were identified as well as very pragmatic steps to address these challenges. So, what can we do to reduce the use of antimicrobials?Use vaccines? Where role do vaccines play in regards to AMR? We are at the right moment to act,we have a convergence of scientific, political and epidemiological factors that create this moment for action to reduce AMR. In 2024, member states through the United Nations Resolution made a commitment to invest for the reduction of antimicrobial resistance making specific commitments towards this reduction, being one of them the implementation of vaccination.
So how can we create the enabling environment so countries can actually implelement programs where vaccines can actually support the reduction of antimicrobial resistance? We all know that 70% of human diseases come from animals, so we need to focus on how we can avoid some of these spillovers. We need to make investment on animal health.
And in order to make investment for animal health, we need to be targeted and efficient because we all have competing priorities. So how can we prioritize? Well, WOAH decided, let’s make a list of diseases,prioritized by species that will effectively reduce antimicrobial use. And we have made these lists where priority diseases by species have been prioritized and which now allow us to produce target product profiles of vaccines where research and development can actually target vaccines for these diseases.
And we’ve targeted the three main species that actually have an extreme variation on antimicrobial use. Just by an example, there are countries that are using four milligrams per kilogram of antibiotics while others are using 300 milligrams per kilogram. This is a great area of opportunity to help countries reduce the use of antimicrobials, this is a big area where investments need to be made.
So the three main target species are pigs, chickens, and fish because if we invest in these species, for example, pigs, they are projected to account for 45% of global antimicrobial use. So if we can use vaccines for the main diseases that affect them, then these 45% of antimicrobial use can be efficiently reduced. In chickens, there have been advances in commercial systems that have reduced their AM use, but in low, middle, and income countries, small farmers lack affordable vaccines and therefore can be more prone to use antimicrobials
Because even if there are some vaccines, being able to make them accessible, usable, and affordable to low and middle income countries is still a long way ahead. And then finally, when we’re talking about fish, aquaculture is considered to increase production in the next few years, by 17.4% by 2032. Therefore with this estimated increase in production, it’s highly probable that And at the same time, when you have this increase, the disease pressure will increase too, and the need for effective response to disease increases too
so we need to reduce the need for antimicrobials infisheries. For example, Norway implemented a vaccine program which has allowed them to reduce 90% overall antimicrobial use in salmon So there are case studies that really show that by using vaccines, you can reduce antimicrobial use.
And by that, through that, you reduce antimicrobial resistance.
Dr. Enrique Chacon-Cruz:
Thank you. That’s a great response, and I remember when Prof. Rino Rappuoli’s lectured us about the salmon, because not only it decreased antimicrobial resistance to humans, but also increased production of salmon in that study.
It was good. It was cost effective intervention.
Okay, now the next question is for Dr. Peter Hotez.
What is the role of climate change in shaping vaccine policy, and how do we support the new vaccines required for the diseases that will surely emerge as a consequence of climate change? Yeah, well, thanks so much, and thanks for having me on the panel.
Dr. Peter Hotez:
It’s great to see you, even though we both live in Houston. I had to come to Washington to see you.
I think when you think about vaccines for climate change, it’s first imperative to talk about the diseases that are emerging because of climate change. Now, going on the cable news channels all the time in the last few years, it turns out one of the most common questions I’m asked is, hey, doc, what the heck is going on? That’s actually the question. Hey, doc, what the heck is going on? You’re like, okay, well, what do you really mean by that? What they’re really getting at is why in the last couple of decades are we now seeing this kind of regular cadence, if you will, regular sequence of catastrophic pandemics? I’ll benchmark it with severe deep respiratory syndrome.
The original SARS of COVID-19, of course, was caused by SARS-2, but SARS-1 emerged in 2002 out of southern China and infected Toronto, Canada. Then this regular onslaught came. You had Middle Eastern respiratory syndrome, another coronavirus in 2012.
You had H1N1 in 2009. Then you had Ebola in West Africa that came to Dallas, Texas in 2014. Then Ebola again in 2019.
Then we had Zika not only in Brazil and the Caribbean, but South Texas and South Florida. We’ve had the return of malaria transmission in South Texas, South Florida. You had, and then of course the biggest of them all, COVID-19.
Now we’ve got a problem with H5N1. Those are the better known ones. What’s also happening that’s kind of flying below the radar screen, unless you’re living down in the Gulf Coast, is we’ve seen the return of dengue, chikungunya.
You’re now seeing the expansion of yellow fever beyond the Amazon into more populated areas of southeastern Brazil that we hadn’t seen before, and Colombia, which really concerns me because Brazil is the opposite of Las Vegas. What goes on in Las Vegas stays in Las Vegas. What goes on in Brazil never stays in Brazil.
It comes up to the Caribbean, Colombia, and eventually the Gulf Coast. What the heck is going on? I think climate change is clearly a factor, and that would help explain the mosquito-borne diseases. I take a walk in the morning in my neighborhood Houston, and mosquito season, I can assure you, has already started.
In fact, it started a few weeks ago, and now it’s going to go to the end of December. Mosquitoes, like the warming temperatures, particularly in the 80s, chip died mosquito that we have on the Gulf Coast. Viruses are developing faster, and also the culex mosquitoes that transmit my style, and the same way as encephalitis, but the tick-borne diseases are not really accelerating in Texas like we’ve never seen before.
That one’s a little more straightforward. You might say, well, what does that have to do? By the way, the same thing that’s happening in the Gulf Coast and Texas, we’re seeing a parallel phenomenon in Southern Europe. Just like we’ve seen the return of malaria to South Texas and South Florida, we’ve had to return malaria to Greece and Italy.
I don’t want to ruin anyone’s plans for summer travel to Southern Europe this summer, but that’s going on as well in dengue in Paris. That one’s a little more straightforward with climate. You might say, well, why would climate change affect something like a coronavirus, like SARS or COVID-19, or Ebola? The answer is most likely bats as a mammalian definitive host.
So, coronaviruses, filoviruses like Ebola are natural viruses of bats. Now, with the altered climate patterns, you see bats have new habitats, and they’re coming closer to human populations, but that’s not the only thing happening. So, climate change is clearly helping to drive these illnesses, but it’s not just the bats coming closer to the people.
It’s the people coming closer to the bats because we’ve seen this big expansion of urban populations. So now, for the first time, more people on our planet, this happened about 10 years ago, more people on our planet live in urban areas than rural areas, and the urban expansion is not symmetric. It’s happening in these kind of ginormous clusters that we call megacities, and for someone I was a kid, three big megacities were always Tokyo, New York, and London.
Now, all the megacities are emerging in low- and middle-income countries. So, by one estimate, Lagos and Kinshasa in Nigeria and Congo, respectively, will have 40% of the world’s people living in poverty by 2050. So, now the megacities are in places like Dar es Salaam and Kinshasa and Lagos, but also now in Bogota and Lima, Mexico City, Sao Paulo, and then also in the Middle East, and of course in Asia, particularly in India.
So, the kind of the apocalyptic version of the world is that you’re seeing this whole new generation of hot and sweltering megacities, and that’s where the next battle is, I believe. And so, when we think about vaccines, what vaccines are we going to need, think about those big hot and sweltering urban clusters, which are outstripping urban infrastructure for clean water, sanitation, for food security, for housing. So, you know, here in where I’m at, we are in Texas, which is kind of the tip of the sphere, the hot and sweltering megacities in Houston and Dallas, Fort Worth and San Antonio and Austin.
You go into the low-income neighborhoods, there’s no window screens, lack of air conditioning, if you can believe it, but also there are places of people are dumping their cars and truck tires in the low-income neighborhoods of the megacities of Texas. And, of course, those tires that are being dumped are this Ritz-Carlton Hotel for Aedes aegypti mosquito. So, this is why we’re seeing this big round tonight.
And so, I think we’re not ready. We’re clearly not ready in the U.S. where we halted pandemic preparedness, but I think when you think about, okay, what are the vaccines that we’re really going to need, clearly it’s going to be for arbovirus infections, mosquito transmitted infections, tick-borne illnesses, but also anything that’s coming from bats, like coronaviruses, like filoviruses. These are what we’re going to need, and I don’t think we’ve really put together a plan, certainly not in the United States, for how are we going to manage those and what are the vaccines we’re going to have at hand.
And, in some cases, it may not even be new vaccines. I mean, for instance, in the U.S., we have no yellow fever vaccine stockpiled. So, when people ask me, hey, Doc, what scares you the most? People are often surprised when I say, actually, yellow fever, because historically, when yellow fever has struck the Gulf Coast cities and really going up the Mississippi, there’s nothing that struck here like yellow fever and caused the abandonment of our towns and cities, and now that we’re seeing the expansion of yellow fever, we’re not ready.
So, these, and of course, if you think the anti-vaccine activists make up stories about COVID-19 vaccines, wait until you see what they’re going to do with something like yellow fever vaccine, which actually has real side effects that are quite concerning, and that’s going to block its uptake. So, we are in a very precarious position right now, and my view is the two big 21st century drivers on this are climate change together with the warming temperatures, ultra-rainfall patterns, but it’s not climate change in isolation, it’s climate change.
Dr. Enrique Chacon-Cruz:
So, just to finalize the question with you, do you think the anti-vaccine era is moving the world forwards or backwards in what is now the Anthropocene era?
Dr. Peter Hotez:
Well, I guess we first have to define what Anthropocene is, because it’s not a household term, and it’s somewhat controversial also.
I like it. I like it as a metaphor. Some people don’t like it, and it kind of says, if you think of the big geological epic, you know, the Pilocene, the Pleistocene, and then the Holocene starting at the end of the Ice Age, there’s some who would argue that humans have so profoundly altered our environment that we wound up buying ourselves our own geological epic, which is called the Anthropocene, and there are different people with different views on when the Anthropocene started.
Some would liken it to the start of the Industrial Revolution, and the chemical signature there was increased lead in the atmosphere, and then of course all the greenhouse gases. Others will benchmark it at the end of World War II, when for the first time we had radionuclides in the ground, and that was the chemical signature. But it goes hand in hand, that buying ourselves our own geological epic, those two big activities are going to be climate change and urbanization, and we have to really think about what are the vaccines for the Anthropocene network.
Dr. Enrique Chacon-Cruz.
Thank you, Dr. Hotez. Now, Dr. Rino Rappuoli, why new antibiotics alone are not sufficient to solve the problem of antimicrobial resistance?
Dr. Rino Rappuoli:
Well, thank you. It’s a good question, a good follow-up, Peter, because I think for sure one thing that really marks the Anthropocene, if we use the term, is antimicrobial resistance.
That was a problem that we didn’t have before the discovery of antibiotics. Obviously antibiotics are a fundamental tool of medicine, but the antibiotics solved one problem and created another one, which is probably as big as the problem we had before the discovery of antibiotics. So the problem with antibiotics is that they are essential and we absoluley need them when people are sick, however since all the antibiotics that we’ve been using derive from natural products, during the evolution bacteria have been working for billions of years to find ways to survive in their presence.
So anytime you have a microorganism that produces an antibiotic, somewhere else there is another microorganism that knows how to neutralize that antibiotic, and becomes resistant. So the consequence of that is that as soon as the first antibiotic was developed and started to be used, immediately resistant bacteria were identified. Initially, this was not a real problem. If we could not use this antibiotic anymore, we had a new one, and if resistance occurred als to this,we could move to a new one, and so on. We did that over time, 1950s, 1960s, 1970s, 1980s, and then 1980s, that’s when we got to the point where we had no new antibiotics, I mean, no new classes of antibiotics, and now we are in trouble because we don’t have new antibiotics to solve the problem.
Fortunately, we have vaccines, and there is no resistance to most of the vaccines. Indeed with vaccines, we already erradicated smallpox, we conquered tetanus, diphtheria, measles, mumps, rubella, and we did not encounter resistance to those vaccines. There are some variants of viruses, and some non vaccine capsular types that can escape immunity, but the resistance, the way we have for antibiotics, doesn’t exist in the case of vaccines.
When I look at the way we dealt with antimicrobial resistance, so far, from 1940s, when we started to use antibiotics to today, we had the assumption that antibiotics will solve everything. And that has been a very wrong assumption, because today we know that trying to solve the problem of antibiotics, only with antibiotics, is not going to work. We lost the battle, we lost the war.
In conclusion, if we really want to solve the problem of antimicrobial resistance, we need to use all the tools that we have, not just one product. So, we need to use vaccines, in humans, and I’m very glad to hear of the movement to use more and more vaccines in the animals. But maybe vaccines and antibiotics are not going to be enough.
We need other tools such as monoclonal antibodies, CRISPR-Cas solutions, pahges, good diagnosticsand any new technology that can be useful.
The problem of antimicrobial resistance is so important today, that we do need to use all the tools that we have and this that modern sciencecan provide. So, it’s a long way to say that if we continue to believe that by using only antibiotics we will solve the problem, we’ll make the problem bigger.
But my view is not pessimistic. I think we can address antimicrobial resistance, but we need to use all the most advanced science that we have today, to develop new tools, and to use the tools we already have. Vaccines, monoclonals, phages, whatever we can think of.
Dr. Peter Hotez:
Do you mind if I ask, you know, a question, a follow-on question?
Dr. Rino Rappuoli:
Sure.
Dr. Peter Hotez:
So, you know, as you know better than anyone, the 1920s and 1930s, the Russians were really pushing hard on bacteriophage, and I think they still have programs going, and at Baylor College of Medicine, in our microbiology department, we have an investigator named Anthony Maresso who’s doing some exciting work. I’m curious your thoughts about therapeutic bacteriophages, as I guess you’d call them, halfway between an antibiotic and halfway between a vaccine.
Dr. Rino Rappuoli:
Good question, there’s a lot of good history in the Eastern European countries and Russia. They had collections of hundreds of phages, and they were abloe to select the phages thatwould kill a given bacterium . There’s never been a placebo-controlled trial, so it’s impossible to say whether actually they really work, but I believe that they worked, because they had the science and the tools to select the phages. Now, in the Western world, I’ve never been able, although many startups and biotechs have been trying, to do a real clinical trial to confirm whether they work .
Now, if you ask me personally what I think, I think they can work, and in cases where, there’s no more alyternatives and you dealk with bactyreia that are resistant to everything, maybe it’s a good thing to try therm. But I see them more as a last resource, if nothing else works. And the reason I say that is because, although I’ve not been working with phages now for 40 years, I started working with phages in microbiology, and anytime I made a plaque, in the center of the plaque I could always see some bacteria growing, and those were the bacteria resistant to the phage.
So, resistance to phage is very easy. So, I don’t think you will solve the problems of the system. But the phages can be good to use once, especially in desperate cases, but I don’t think they’re widespread solutions, because they are also very immunogenic.
Dr. Enrique Chacon-Cruz:
Dr. Rappuoli, also, you know, your technology, reverse vaccinalology 2.0, you can actually treat diseases in patients infected with AMR bacteriae, which is a really novel concept. Okay, going with this same flow, I’m going to ask Dr. Clarisse Ingabire, is vaccination a solution to anti-microbial resistance, or just one piece of a much larger strategy? Or puzzle, let’s say.
Dr. Clarisse Ingabire:
Thank you again for the excellent question. Vaccines are highly effective and widely used in the animal health sector, often through mass campaigns or targeted programs. However, structural challenges—such as limited access, cold chain constraints, and the difficulty of reaching remote smallholder farmers—mean that vaccination cannot be the only solution.
Because many smallholders lack information and accessible animal health services, they often rely heavily on antibiotics to manage illnesses such as mastitis, tick-borne diseases, fevers, and other morbidities. This reliance is compounded by the availability of substandard drugs. Strengthening vaccine R&D is therefore crucial, but so is improving farmers’ understanding of diseases and appropriate treatments.
We also emphasize farm- and market-level biosecurity as essential preventive measures. Most of the diseases we deal with are of a transboundary nature, and animals frequently mix at grazing areas, water points, vaccination sites, and markets. In pastoral systems, constant animal movement further increases transmission risks. Changing on-farm practices and farmer behaviors is critical to reducing—or even breaking—these transmission cycles.
Surveillance is another key area. Given limited government financing and competing priorities such as education and health care, animal health surveillance must often focus on high-risk areas. Lessons from diseases like Highly Pathogenic Avian Influenza and foot-and-mouth disease, Rift Valley fever have taught us how pathogens and vectors move, how animals and people interact, and how to conduct better risk assessments. This allows us to identify hotspots where targeted vaccination or compartmentalization strategies are most effective.
Overall, vaccination must be part of a broader, integrated approach to disease prevention and preparedness—including biosecurity, surveillance, and farmer education. And once again, increased investment in the animal health sector is essential. Despite its significant contribution to national economies and GDPs, it continues to be underfunded.
Dr. Enrique Chacon-Cruz:
That’s great. So, following your answer, I remember you gave us the example of Rift Valley Fever. How would you target that, using that example, to make it simpler to understand? Thank you.
Dr. Clarisse Ingabire:
Well, Rift Valley Fever is a prime example of a disease strongly influenced by climate change. Its occurrence is linked to rainfall anomalies, vegetation patterns, and other environmental factors. Thanks to decades of research, scientists now monitor these indicators and issue early alert messages. These alerts help professionals—such as those in slaughterhouses—adjust their practices, use protective equipment, and reduce transmission from animals to humans.
Surveillance strategies also include monitoring unvaccinated “sentinel” herds in pastoral areas to detect outbreaks early. Vaccination is a critical tool, but it must be targeted and combined with risk assessment, alert systems, and strong government policies. Because these vaccines are not universally used by farmers, governments often subsidize vaccination in high-risk areas, ensuring the most vulnerable herds are protected.
Rift Valley Fever has become a priority in national zoonotic disease planning—alongside rabies, brucellosis, and tuberculosis. Through One Health collaboration, integrating human, animal, and environmental health sectors, countries can share information and make informed, coordinated decisions to prevent outbreaks and protect both animal and human populations.
Dr. Montserrat Arroyo:
Thank you. Clarisse made a very important point when she said, “when we have the vaccines.” I want to emphasize this because vaccines are often seen as a simple or “magic” solution, when in reality, their effective use depends on many enabling conditions.
First and foremost, vaccination requires investment in veterinary services. Countries must have enough trained veterinarians and animal health professionals who can actually deliver vaccines in the field. For example, in Ghana, the number of veterinarians is about ten times lower than in many other countries, including some very lowincome countries. This means there is insufficient capacity to carry out not only vaccination, but the full range of essential veterinary activities.
This brings us to the broader question of capacity. Investing in capacity means having:
Surveillance systems that can identify priority diseases
Laboratory capacity to confirm diagnoses
Basic infrastructure to store, distribute, and administer vaccines safely
Only when these elements are in place can a country make informed decisions about vaccination.
Even then, additional questions arise. When a decision to vaccinate is taken, does the vaccine exist in the country? Is it authorized by national regulatory frameworks? If a vaccine exists, is it effective against the specific strain circulating? Is it commercially available, affordable, and supplied through a reliable and sustainable production and distribution system?
All of these factors must be carefully considered. Vaccination is not simply a policy decision; it is an operational reality that depends on strong systems and longterm investment.
Finally, when we speak about a One Health approach, this is where the challenge often lies. Too often, we remain reactive—responding once a crisis is already underway. To make One Health effective, we must become proactive, anticipating risks and addressing them early, instead of constantly running behind emerging problems.
Too often, our approach is reactive rather than preventive. We already apply forwardlooking thinking to issues such as climate change: we assess impacts, anticipate risks, and act in advance. The same logic should apply to animal and zoonotic diseases. We have early warnings, alerts, and scientific evidence that tell us which diseases are likely to emerge or spread. The question should be: which risks should we start preventing now, before they become crises?
Prevention can take many forms. Vaccination is a key tool, but it is not the only one—biosecurity, surveillance, and strong veterinary services are equally essential. However, prevention requires dialogue, political will, and sustained investment.
Crucially, this investment must be viewed beyond a narrow agricultural lens. Animal health is not “just agriculture”; it is fundamentally about food security, public health, and economic stability. Underinvestment in vaccines or animal production systems directly affects the availability and affordability of food.
The impact is already visible. In 2021, widespread outbreaks of avian influenza severely reduced poultry production in many countries, leading to shortages of lowcost protein such as eggs and chicken. This contributed to a documented increase in global hunger—by around 5%—demonstrating how animal disease shocks can rapidly translate into food insecurity.
For this reason, investment in prevention must be multisectoral. It cannot rest solely with ministries of agriculture. Ministries of finance must recognize the broader economic implications, and the human health sector must also engage. Preventing spillover events, protecting food supplies, and reducing zoonotic risks all require strong and wellresourced veterinary services.
Antimicrobial resistance (AMR) provides another stark example. While 171 countries now have national AMR action plans, fewer than ten have allocated funding specifically for animal health activities. Economic analyses show the consequences of inaction are profound: if AMR in animals is not addressed, food security for up to two billion people could be compromised by 2050, due to reduced productivity and resilience in livestock systems.
These examples underline a central message: we cannot afford to wait and respond after crises occur. Shifting from reaction to prevention—through sustained, coordinated, and crosssectoral investment—is essential to protect animal health, human health, and global food security.
Dr. Peter Hotez:
Oh, so can I do a follow-on? Because I think you’ve made, you know, maybe one of the most important points of this afternoon, and that is our, you know, the phrase a little differently, our technical ability to make a vaccine is outpaced our political, social, financial instruments that we have to ensure it gets developed and used. I mean, we have now an N=2, in part because of people at this conference, right? We saw with human vaccines, with Ebola in 2019, you throw enough technology at it, you’ll make a vaccine.
In this case with Ebola, it was the vesicular stomatitis virus (VSV) and the adenovirus, multiple other technologies, and we wound up making a vaccine that stabilized the Democratic Republic of Congo in 2019. With COVID-19, we threw mRNA and DNA vaccines and particle technology and simple recombinant protein technology, and we wound up making a huge difference. And I like to believe that for most pathogens now, you know, if we take that approach, a parallel approach of using multiple technologies, we can make that vaccine.
But I think we’re starting to realize that that’s the easy part, because now, not even anti-vaccine activism aside, you know, countries still think this is something that we should do on the cheap, right? That there still is, even with COVID-19 and Ebola, there’s not this understanding that the public health impact of an epidemic or a pandemic is just the tip of the iceberg. It’s, you know, how damaging it is to the economy, how damaging it is to the security. And the G20 countries particularly have not positioned themselves to be willing to scale it up and pay for it.
You know, CEPI is a small start, but it’s a very small start. We, you know, clearly, we have to recognize that these are security issues as important as, you know, invading a country militarily. And that’s still not in the mindset yet.
Dr. Enrique Chacon-Cruz:
And there we have to really push harder on the policy in Africa’s society. Maybe one thing that just adds to the problem, there is no predictability. In the case of animal health, we have a lot of companies that want to produce vaccines, but there is no predictability of the demand, because countries are not able to say, okay, you know, we’re going to be vaccinating at this level, this amount.
So, it makes it very hard to actually be able to get certain vaccines to the correct market, because this predictability is not there.
Dr. Rino Rappuoli:
I would just like to make a comment on this, because the, as Peter said, toady we could make most of the vaccines that we need . We have the technologies to do it.
It’s just a question of investing and doing it. The problem is that, we all believe that the AMR is a very important problem that we need to tackle it. But none of the vaccines have AMR claims in their label. No label say that vaccines kill also bacteria resiatnt to anotbiotics.
Now, if it’s not in the label, AMR it’s not going to be the included in cost effectiveness calculations. So the today vaccines have no recognition for being able to address AMR. This is a problem we need to address.
We need to address many problems, starting from the regulatory pathway, because I feel that most of the vaccines for bacteria resistant to antibiotics are not developed, because there’s no value for them. There’s no market. And therefore while work on the technologies , but also we need to work on the policy to make sure that vaccines for AMR are developed. These are wonderful tools that can solve the problems, but we are not developing them because we have not been able to provide the value that they really have.
Dr. Peter Hotez:
oHotez:Just one other point. So there’s a really interesting book written by someone who’s been watching, interested in nuclear weapons, and it’s called, the book is called The Gift of Time, and it’s by Jonathan Schell. And he makes kind of a similar observation about nuclear weapons and technology.
It’s not very hard to build a catastrophic hydrogen bomb, but the hardest part is the regulatory policy framework to keep it under wraps. And again, this concept of technology outpacing our political, social, and financial institutions. It’s not only about vaccines, it’s, it applies to other technologically, formerly technologically complicated innovation.
Dr. Enrique Chacon-Cruz:
This is flowing great, thank you. So this is a general question. How can we better communicate the animal-human environment link to climate and health policy makers? You notice that we can have livestock vaccines, but also human vaccines. And how can we identify the investments in the safety of climate mitigation? I’m trying to interconnect all of this.
Agricultural, you know, animal health, climate change, and human vaccines. So how can we better communicate this issue of animals, humans, in the climate-shared environment?
Dr. Montserrat Arroyo:
It is a difficult question, but one way forward is to anchor our messaging to commitments that already exist. For example, we can build on the UN resolution on antimicrobial resistance. The issue is no longer whether AMR is a problem—we already know that it is. We have strong scientific evidence and robust data demonstrating its scale and impact.
The real challenge is how we communicate this more effectively, particularly to decisionmakers outside the animal health community. Too often, we ask ministries of finance to engage with animal health arguments, rather than speaking in the economic terms that matter most to them. Instead, we need to clearly demonstrate the financial cost of AMR—how it contributes to GDP losses across countries—and this is already well documented.
We also have concrete examples that show the return on investment of prevention. In the United Kingdom, for instance, the introduction of E. coli vaccination in poultry led to an 80% reduction in antimicrobial use overall, not only for E. coli but for other diseases as well. This intervention achieved an estimated threetoone return on investment. These are the types of arguments that resonate across sectors.
This is where we need to “meet in the middle.” While political will is often cited as the barrier, decisionmaking also takes place in a context of competing priorities. In a world of multiple crises, the question becomes: what is the cost of inaction? On AMR, we have clear evidence of widespread and longterm damage. It is a global problem that does not respect borders, and it is not confined to one sector—it affects human health, animal health, agriculture, the environment, and economic development.
We are already seeing the consequences. AMR is contributing to increased complications and mortality in human health, including rising pediatric deaths. While low and middleincome countries are disproportionately affected, highincome countries are also experiencing growing impacts, supported by strong epidemiological data.
This underscores the need to communicate better and act more proactively, but also to ensure accountability. If countries commit to preventive measures such as vaccination, then vaccination coverage should be reflected as a concrete indicator within AMR national action plans. Financing also needs to be addressed more strategically. Currently, official development assistance and philanthropic funding often classify livestock vaccines narrowly as AMR prevention or food security interventions, rather than recognizing them as longterm investments in resilience.
Ultimately, we need a shift at all levels toward using economic evidence, addressing known system gaps, and strengthening both veterinary and human health services. Incentives must align with policy objectives, and persistent challenges—such as supply chains and coldchain capacity—must be resolved. Having a vaccine is not enough; without the systems to deliver and sustain it, the opportunity for prevention is lost.
Dr. Enrique Chacon-Cruz:
Thank you.
Dr. Rino Rappuoli:
Yeah, I think Dr. Montserrat has said a lot in this space. We have done a lot of progress in One Health, and we have made AMR as a common goal. Right now, most governments are aware that AMR is one of the big health issues or humans and for anomals
And now, many countries, have One Health Coordination Committee, and there is collaboration. They talk about broad collaboration, in some instances, it’s still a concept, but it’s something that we have already achieved, a first step, I would say. The issue comes again when it comes to funding, and prioritization.
Yesterday, in the AMR workshop, they said that when we communicate about the deaths coming from the AMR pandemic, policymakers might not necessarily be impressed, because people die every day, and there are so many other issues to deal with. Perhaps we need to communicate about the cost to the economy, about the economic cost and burden of doing nothing, and compare it to the benefits of investing. What is that right investment? And what is the return on that investment? We need to be able to convince the policymakers that are our interlocutors, to take action.
If I tell to invest on AMR using ethical issues, it doesn’t really bring a benefit. If it’s presented in a way that by investing you increase the efficiency at the production level and increases biosecurity, by reducing disease transmission by vaccination, then you may have a good argument.
Dr. Clarisse Ingabire:
Policymakers and regulation play a critical role because individual farmers may not change practices on their own. For example, if laws prohibit the use of certain antibiotics as growth promoters and are backed by effective inspection and surveillance, meaningful progress can be made. Similarly, national campaigns to raise awareness about biosecurity, disease prevention, and surveillance can help reduce antibiotic use at the farm level.
Collaboration with partners is also essential. By providing evidence, scientific insights, and data, we can help convince both policymakers and producers, creating the conditions to make real progress in addressing antimicrobial resistance (AMR).
Dr. Enrique Chacon-Cruz:
Thank you so much. Unfortunately, we’re right on the time.
So, I think this was the hottest topic for today’s congress, but if you can give us one minute, last words regarding these crucial topics. This has been a great panel.
Dr. Peter Hotez:
Thank you. Thank you for organizing it. And thank you to my colleagues.
We have to remember in this century alone, in this new century, over the last 25 years, we’ve had six major, at least six major epidemics or pandemics because of zoonotic spillover, right? We’ve had three coronavirus pandemics, SARS-1, SARS-2, and MERS. We’ve had two Ebola, serious massive Ebola epidemics, 2014, 2019, and now H5N1 in the U.S., all from zoonotic spillover. And so, the point is Mother Nature is not being coy with us.
She’s telling us exactly what she has in mind, right? She’s going to be hurling more and more zoonotic spillover events in the coming years. This is just the beginning because they’re accelerating because of climate change and urbanization, of course, is what I’m telling you. And yet, we still have the very sad fact that most Americans actually believe that COVID-19 occurred because of a lab leak or because of gain-of-function research.
Nobody in the United States, except the people up here and the people out there, know what zoonotic spillover is. And we have to flip that around. Yet, this is one of the greatest threats to humanity that we’re not aware of, and it continues to accelerate extend.
Yet, this is one of the greatest threats to humanity that we’re not aware of, and it continues to accelerate extend.
Dr. Enrique Chacon-Cruz:
Thanks, Peter.
Clarisse, short, but not subtle final words.
Dr. Clarisse Ingabire:
Collaboration and partnership are essential to translating scientific evidence into effective solutions. As emphasized today, getting the right information from academia and research is critical to developing the right vaccines and tools.
At the same time, we cannot lose sight of equity and access. Many smallholder producers in the regions where we work lack funding and access to vaccines. We must explore innovative approaches that ensure these tools reach the people who need them most.
Climate change adds urgency. Its impacts are real and ongoing, and we must improve our ability to predict outbreaks, change behaviors, and intervene before a crisis occurs. This means strengthening pre-event surveillance to detect risks early and break transmission cycles before they escalate.
We now have unprecedented amounts of data and powerful tools, including AI, to analyze it and guide where attention and resources should be focused. To be effective, we must also engage policymakers—helping them understand the drivers of their decisions and empowering them to act decisively. By combining science, technology, equity, and strategic policy engagement, we can create a proactive, resilient approach to animal health and vaccine access.
Dr. Enrique Chacon-Cruz:
Great. Thank you, Clarisse. Monserrat, again, short but not subtle.
Dr. Montserrat Arroyo:
We need to go from reactive to preventive. And if we want to prevent, and we say that 70 percent of diseases come from animals, we do need to invest where the money will give better returns on investment. So we do need to invest in animal health.
Dr. Enrique Chacon-Cruz:
Thank you. Rino, please.
Dr. Rino Rappuoli:
Well, first of all, thank you for setting up this panel. I think, frankly, it’s the first time in more than 40 years of my career doing vaccines that I’m sitting in the same panel as someone who is doing vaccines and talking about vaccines for animals. Now, what do we need? Well, I think we need two or three things which are essential.
One, we need to stop thinking that antibiotics alone will solve the problem. And a lot of the policies worldwide still believe that’s the case. That’s the first step.
The second thing, we need to have more of these meetings. We need to be open. We need to be… If people do vaccines for humans, they do vaccines for animals.
People do regulatory things. We need innovative financial mechanisms. The innovation should not be just scientific.
We need innovation in the financial mechanisms because we are facing a problem for which we don’t have… I mean, the only solutions we may have are technical, but we don’t have 100%. We don’t have the policy solutions. We don’t have the financial solutions.
We don’t have the regulatory solutions. So I think we need to have more conversation on this side, and we need to convince that it’s only by collaboration. We should acknowledge the different instruments and different things that we solve the problems that are facing.
Dr. Enrique Chacon-Cruz:
Thank you so much. I’m really honored for having you here, and I’m pretty sure we will have this discussion again. Thank you for attending this great, great panel.
