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Okay. Could you just start by saying your name? I'm John Bell. And I'm Regis, professor of medicine in Oxford.

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Okay, so start can you just tell me a little bit about yourself if you can get into about three sentences

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how you got from your earliest interest in science and medical issues to where you want it?

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Yeah. So I'm, I'm I'm a clinician scientist.

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I've been in Oxford for more than 30 years.

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I came here originally as a Rhodes Scholar, trained in medicine here, went to London, came back, worked in David Weatherall,

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and then spent most of the 1980s in Stanford at the height of the molecular biology revolution,

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and then came back here in 1988, ran a program in immunology and genetics, became Nuffield Chair of Medicine,

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following then quite a role in 92 and then ten years later became Regis professor of medicine.

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And and sort of broadening. Responsible for a number of the strategic things that have happened in Oxford Medicine over the past 20 years.

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And if there was one big question that gets you back to bed in the morning, what would you say it was?

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Yeah, I'm. I'm, I'm.

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All my professional career, I've been extremely interested in getting a much more precise understanding of the mechanisms of different diseases.

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It's these days, people call it precision medicine, but the ability to move from clinical patterns of disease to a real understanding

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of what's going on at a molecular level is that that's the thing that's kept my

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research going and and kept me interested in the field so we could talk for ages about

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your interest in the genetics of common diseases like diabetes mellitus and so on.

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But I think the strategic side, which you mentioned, is really what we want to focus on.

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So you've and you've been involved in those strategic questions both within Oxford and beyond.

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So let's just start with Oxford for the time being. How would you describe the state of research in medical sciences when you either

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when you first got here in 87 or when you first became a Nuffield professor?

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Well, I mean, I experienced it a bit when I was a student here because I came as a Rhodes Scholar and and

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did the on a school course in physiological sciences and then went to the clinical school.

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And, and it was very, very small scale.

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There were some extremely able people in medical school and of course it had a distinguished record,

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even though it was small, but it had limited it had limited horizons.

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It didn't really feel like it had huge scope and it was going to take a long as it had done for 500 years.

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And that was all fine. And it was really over my time as a medical school that that it began to step up to say, no, we can do more than this.

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Biomedical science is likely to be the big scientific operation for the next 30 years.

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So let's make a move. But the the the university then was pretty complacent about where it sat in the global world of academic excellence.

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I mean, I think it thought because it was Oxford, it was the best university in the world and it clearly wasn't by some margin.

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Clearly it wasn't.

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And there was a view, I think, that we could be good at everything when in fact we probably couldn't and we certainly couldn't compete.

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And of course, you know, in the sort of 1970s, the funding for science was pretty limited nationally.

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So it was really hard to compete at any different level.

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So, you know, I'd had that glimpse of Oxford as a declining organisation over that period, a great place to be loved, to be here as a student.

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It was all fabulous. But really, you know, it had it had, I think, a view of itself, which was unrealistic.

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By the time I came back from Stanford in the late eighties, things had started to move in medical school,

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largely driven by Peter Moores and David Weatherall to build it up.

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There was a very strong global health programme long before anybody else David had built the Wellcome Trust.

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I built the Weatherall Institute, now called the Weatherall Institute,

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which was a real successful venture in molecular medicine, which is the reason I came back.

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And then when I took the chair of Medicine in 92, I could pick up on where he left off and started to build this campus,

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which is the old road campus where we've now got eight or ten institutes, you know, 2500 to 3000 people.

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It's one of the biggest biomedical research campuses in Europe.

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And to build excellence in a whole variety of domains where the university had never really played cancer, for example,

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where the excellent programme which expanded the genetics of common disease, we've really built on our strengths in immunology and infection.

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We built out the data themes that data analytics, big data institute and and drug discovery has become a central part of it.

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So yeah, I mean this has been a huge expansion over 20 years. And how is that funded?

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I mean, are all kinds of different ways? Yeah, I think, you know, the the funding of these things require quite a bit of kind of entrepreneurial flair

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because there isn't any single pot of money that you can get all the money from.

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So you get a bit of money from here and a bit of money from there.

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And I think the crucial bit of the the vision, which the total vision was never pitched to anybody,

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but the individual component parts of the of the puzzle were pitched one at a time as being exciting.

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What we need to do now, this is the next step in building global excellence.

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And those then get pitched. They get a donor, you build a building, you recruit people, you expand it and so on and so forth.

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So. So that's basically how they. How the campus has evolved and that, you know,

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I spent most of my last 20 years building out this campus and building the excellence that's kind of underpinned it.

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So that's been hugely interesting and exciting.

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And if that hadn't happened, we probably wouldn't have had a vaccine program.

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They'll probably not be. There will be no stuff.

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Stuff don't know. A lot of that wouldn't have happened. So.

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So I think the underpinning of the Excellence in Oxford Biomedicine has really come from the

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dramatic expansion in people and infrastructure that's occurred over the past 30 years,

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probably in broad terms, and that that's been hugely impactful.

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So before you go, before we get back to Kobe in Oxford, I'd also like to address your role in in national bodies.

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So I've just got down to a couple of things here. So for 26,

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you were both the third president of the Academy of Medical Sciences and the first

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chair of something called the Office for Strategic Coordination of Health Research.

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What were your goals in those positions? So so it actually goes back a bit before that because the one of the things I,

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I picked up when I was in Stanford was the huge opportunities that came with the growth of life sciences and biotechnology.

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So by this means in the commercial sector? In the commercial sector.

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Yeah. So by the time I became Regent Professor, which was 2002, I'd been involved in the creation of a couple of biotech companies.

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We, we built one of them up with another one ultimately fell over.

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But I was very actively engaged in that space. And in 2002, on the back of that experience, I was approached by Roche,

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which is the big Swiss pharmaceutical company, who asked me to join their main board in Switzerland.

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So I joined the board in 2002 and I, I, that was a huge opportunity for me,

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one that I didn't even know when I signed up how big the opportunities going to be because understanding

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how a large life sciences company actually works at board level is a fascinating experience.

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So first of all, you understand big companies, which is an issue in its own right,

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but also how do you generate innovation inside the context of a large entity?

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And that is really hard to do. And Roche went from in the time I've spent 20 years in there board, in the time that I was there,

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we went from having almost no products in late stage development to having a

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profile of of products which was better than almost anybody in the industry,

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and that was by driving the R&D agenda. So I had a lot to do with that when I was at Roche was very heavily involved.

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I spent a year on sabbatical in Basel working with the team at Rosso.

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I that was a that was a dimension to my experience which most people in academia don't have.

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And I think that that really created opportunities for me in the last 20 years to do stuff that most academics never get a chance to do.

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And one of the things that emerged from that was that when the presidency of the Academy came up,

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they called me up and said, look, you should do this. And, you know, not really other things, do you?

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And with a bit of arm twisting, I decided to do it.

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And that turned out to be a really good thing to do because the Academy was just about to take off, which is quite new.

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You won't be the third. I was only the third. Yeah, Peter Lockman was the first. Keith Peters was the second and I was the third.

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But at that stage we had no permanent home.

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So, you know, over my time there, we took the facility and Portland Place took a 40 year lease on that, raised the money to redevelop it.

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The old it was the old Ciba building for the symposia.

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So we got it on a firm footing, but we also pushed really hard to get it recognised by policymakers in Whitehall as the place to go.

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If you want advice on medicine, don't go to the Royal Society, go to the academy.

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And so I spent a lot of time working with people like David Willetts and the likes who were there at the time and indeed over that period of time.

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I also worked with Gordon Brown and Tony Blair and all that team and that they went they got to the point that they would come to us for advice.

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David, you, of course, was very active over that period trying to again, from his commercial background, trying to build up life sciences in the UK.

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And he did. What was his role? He was an adviser to government.

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He was an ex venture capitalist. He's head up advent in the UK,

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very impressive character and he was very close to Treasury because he chaired a variety of the big Treasury committees and he was

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incredibly supportive of the idea that we tried to make the life sciences and gender publicly funded agenda much more coherent.

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So he wanted that all brought together under a single board,

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which was the Office for Strategic Coordination Health Research, which managed the flow of money to MRC,

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to the new National Institute of Health Research, which is how it aims to show and anything else that the Government wanted to fund in that space.

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So, so I, I was asked to be the first chair that Gordon Brown was the Chancellor.

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They upped the amount of money for life sciences and the MRC and the NIH are

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by a very substantial amount after about a year that we had Oscar in place,

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and that was the beginning, I think,

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of a really good run for life sciences because of course we were still also skating on welcome funding, which was growing year on year.

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So it was a really good time to be doing biomedicine in the UK and it was dramatically better than any other scientific subject

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who didn't have the ear of government and didn't have the support that we have from the big charities for biomedicine.

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So that all that was good. So I of course, when I've been doing that for a while, people said, well, look, I talked to JB.

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He knows lots about industry, he knows a lot about biotech, he knows much about academia.

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He's the person to go to if you want information about how we make this all work, because the government,

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successive governments were very interested in the economic growth agenda because they

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finally realised that we couldn't keep getting coal out of the ground and making steel.

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We had to do stuff which is in the tech sector. So I was brought in, I actually, I think originally in the Gordon Brown era, which was, as you know,

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short lived and then by David Cameron and I was nominated the life sciences champion for the UK

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and that basically that meant the guy you talk to want to talk about building up life sciences.

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And that didn't that didn't involve you in having a big secretariat behind you?

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No, no. I mean, my secretariat, which I used pretty effectively initially, was the Oscar group, and we had four or five people were based in Treasury.

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And I was very I think there's a good story here because the it turns out that yeah, yeah,

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it turns out that one of the most effective ways of getting things done in Whitehall is to be friends with people in Treasury because they were all.

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So it's good if you know the Prime Minister and very good you know the Prime Minister, but almost as important, you know the Treasurer guys.

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So the Office for Strategic Coordination, this is Cox's idea was in Treasury.

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So I had an office in Treasury. I knew all the officials in Treasury we would meet all the time.

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And so I developed a whole set of personal connections that other departments couldn't get at

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because of course the other departments were desperate to talk to the guys from Treasury. But I had an office in Treasury.

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So it, I mean, it's interesting how these things just happen to occur.

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So, so I had this great network and then when David Cameron came to power, he was extremely interested in building up life sciences.

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And he wanted me and I and a chap from AstraZeneca called Chris brings me to have help advise him as

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to how we could use the strengths of the health system in the NHS to help build a commercial entity.

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And the point I made to him, which I think he accepted,

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is that it's very hard to imagine how a country could spend 30% of its public sector spending on something

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like the health service and not expect to get any economic growth out of that because at the moment,

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you know, at that stage there was no relationship in the NHS and the commercial sector.

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So I promise to help build that in a in a systematic way over a period of time.

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And we did and David was fantastic.

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Was he very interesting.

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Didn't he was a very affable sort of prime minister is very keen if you went to see him, he always wanted to wrote things down.

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And so I went to see him with Chris and we would give a report card on how people would perform.

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It said this is what they should do. And then we would go and say, Well, that was definitely beta minus and that was alpha higher up, all the rest.

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And he paid a lot of attention. And of course,

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David had this personal issue with one of his children who had a terrible developmental disorder and after he'd been very tough for them.

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So, you know, on one occasion he said, look, you know, you know a lot about genetics.

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Can you come and talk to me about genetics?

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And of course, I knew even more than most people about genetics because Roche is the world's biggest in vitro diagnostics company.

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And it was at that stage they were looking at what a company like that could do in the whole world of clinical genetics.

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So they had explored all the companies to do genetics and had discovered that actually

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the price of DNA sequencing was about to fall off a cliff and become very cheap.

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So I went in one day and with a couple of others, Mark Walport and Sally DAVIES and others,

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we, we, we gave David Cameron a tutorial on modern day genomics, which he loved.

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And he said, Oh God. He said, This is terrific. We really need to do something in this space.

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So I pitched the idea of a 100,000 genomes project to the Genomics England project, which he loved.

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And he said, Right, well, I'm just going to do that. So off we go. And how is that project set up?

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Well, it was set up by the prime minister, wasn't set up by peer review or by the MRC, which is set up by the Prime Minister.

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He has funded. Funded straight from the Department of Health, right.

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Yeah. Yeah. So it, it, it was another example and I've been involved in three or four of these over the years.

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That if you want to do really big and ambitious projects that are high risk,

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don't go through the conventional funding system because you'll never get there because they shoot at you until you drop dead.

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So we did that with UK Biobank. We did that with Genomics England.

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We're doing it now with our future health so that the object with genomics England is to produce eventually a commercial product.

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And the object was to see whether you could turn genetics in a health care system into something which was much more ambitious,

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capable of delivering a much better result for patients and ultimately generating genetic data which industry and

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other people and academics could get great benefit out of so that there were lots you would have to pay for.

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Which industry, in my view at the time,

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was that we wouldn't necessarily want industry to pay for it and we would want them to be

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interested in coming to the UK to do their work that would actually allow them to get to X,

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Y and Z. So it's a it was it wasn't that it wasn't a transactional thing.

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I'll pay this to get you that. What it was, was, look, we've got this great resource.

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Why don't you come see if it's helpful in drug discovery or diagnostics and see where we get to so that that was the ambition of that.

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So they so David was really good because it shows you how powerful it is to have the Prime Minister on board because when it stalled,

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which he did, he would pick up the phone and say, what the heck is going on, get going.

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And and as a result, it took about 18 months to get it going after he decided to do it.

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But then, you know, they were off to the races. And it all turned out to be true because the price of sequencing fell by a factor

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of about three or four and it became affordable and they set up Genomics England,

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which ran about and I've been on the board of that since. It's, you know, it's been a quite a successful enterprise.

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And it was way out there before anybody else had ever thought of thinking.

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So at a national level that was, you know,

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those sort of things actually have had quite a big impact on the UK's position in the global biomedical space.

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So UK Biobank, which I was also involved in setting up, which is run by Rory Collins, is, you know, Genomics England.

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These are the kind of things they're big projects. They use the NHS capacity to do things at scale.

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They're the sort of things that academics all over the world want to see be able to use effectively.

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And industry's obviously extremely interested as well. So so I show that in my role as Life Sciences Champion, I did a lot of those things.

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Then of course we had the Brexit debate. David stepped down and Theresa may took on the job.

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She reappointing these life sciences champion. I worked with her and Greg Clarke because they had they decided that he was the science minister.

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You know, he was the baize secretary of state for Bass. Yeah. So science was underneath him.

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Yes, he was that but but but he wanted us to do industrial strategy,

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not in the classic Harold Wilson sense of the word, but in terms of are there tech sectors that we need to build up?

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Are there areas of high value jobs, high value growth opportunities?

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Do we want to build out? And the first one that he chose was Life Sciences, and it was me.

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He has to lead it again because I was known pretty well in Whitehall.

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So we wrote a report which we published and then we have been busy rolling that out.

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Up to 2019 brought in about three and a half billion pounds of inward investment, invested about 600 million UK government capital.

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But it created a huge opportunity for the life sciences and the industry.

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I think widely views the UK now as being one of the best places in the world to come do research and build a building industry from so that,

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so, so that that kind of gets us to 2019.

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But by the time 1219 came, everybody knew me because I was the advisor on life sciences.

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I knew all the ministers, I knew the secretaries of state. I had a team of people called the Office of Life Sciences, which I worked with closely,

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who are responsible for building up life sciences between bays and Department of Health.

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And, you know, I was a regular visitor with Jeremy Heywood, obviously in number ten, but also with Jeremy Hunt and David Prior was then in health.

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James O'Shaughnessy So I know all the ministers knew me and I was that was sort of where I got to and Oxford,

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although obviously in my role in Whitehall, I couldn't preferentially support Oxford anything we did for Life Sciences nationally.

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Oxford Boat was going to float as fast as anybody's.

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And you know, that has driven a lot of really exciting things in the Oxford environment, digital pathology,

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a lot of stuff around sequencing of UK Biobank, all that stuff has fed back to you and that's all come out of the licence strategy.

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It's been quite a symbiotic relationship between building up things here, but also building up things nationally.

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That's really, really good background. Excellent. So let's get to COVID itself.

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So can you remember I'm asking everybody this when you first became aware that this was not just a little thing happening?

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Yeah, no, I. I can remember. I think I suspect most people can remember, actually, but I was skiing at Christmas with my family in Switzerland.

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Because when I was at Roche I bought a chalet in the mountains in Switzerland, so I was standing on the deck at Christmas.

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It must have been late afternoon. And I got a phone call from Jeremy Farah, who is director the Wellcome Trust, that used to run our unit in Vietnam.

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And I was a close friend of Jeremy's and a very good guy. And he called me up.

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He said, I don't know whether you're paying attention, JP, but there's been trouble in China.

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And, you know, in Wuhan there's an outbreak of a pretty severe respiratory illnesses.

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Looks a bit like SARS, but it could be something else. They're busy sequencing it.

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We're trying to work out what's going on. But this, I suspect, will be the next pandemic.

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So. Oh, okay. Right. Okay. So that's that was a bit of a date.

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And so I thought, okay, well, this is pretty good.

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And then, of course, the head of China CDC is a guy named George GAO, who was a postdoc in my lab for five years.

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SIMON George. So, so anyway, I got in touch with George account.

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I can't remember a phone number.

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Anyway, the truth is, George Bush was up to his eyeballs in this thing and he said, Oh, this is bad, this is definitely bad.

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We'll have the sequence by the beginning of January. I hope we'll be able to tell you what it was.

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So that was when I knew there was likely to be trouble brewing.

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The sequence, of course, appeared about the seventh or 8th of January, and it turned out to be a SaaS like virus.

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And so you knew that there would be potential trouble.

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Now, the previous two sars-cov-1 epidemics had burned themselves out relatively quickly high mortality, 35% mortality, but they burned themselves out.

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So there was a view that it'll all be okay because it'll burn itself out.

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Nobody knew why the patients burn themselves out, which is a bad place to be.

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But anyway, that was but the, the, the downside scenario was it wasn't remember how far it was going to move around pretty quickly.

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So I then of course had I kept doing what I was doing, but I was pretty attuned to what was happening in China.

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I went to a board meeting at Roche in late January and I still remember we started the board meeting with them.

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I have a chairman session with the like the board and the chief executive and I said, What are you guys doing about the pandemic in China?

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And they all and what part of China? And I said, Well, let me tell you, mate, you guys are a global company.

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You've got a big problem. And by the way, you're going to be called upon because you have all the diagnostics,

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you've got all the therapeutics, and you better sort yourselves out. So anyway, no one in the room had really clocked it at that stage.

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And I was very striking because we had the head of National who was in the room and the head of Shell was in the room.

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And, you know, these are greedy top end people and no one had gone, Oh Jesus, this is not good.

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These guys are not paying attention. This is a really serious and by this stage, they were shutting down large bits of China.

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Lots of big cities on the East Coast were being shut down. It was I mean, it was starting to get to real crisis proportions.

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So that was a that was a central moment for me because I thought, actually,

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not only are we going to have a pandemic, but we're going to be caught completely unprepared.

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So I came back. I came back. First of all, they said, okay, thanks for that.

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We better get moving, which they did to their credit, not fast enough as it happened.

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But anyway, they did get moving. But when I came back here I started poking the NHS to say, You guys ready for this?

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And I got them a whole barrage of rather complacent responses saying It'll all be fine.

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I said, Well, how do you know it all? Well, it'll all be fine. These things, they burn themselves out over the Indian Ocean.

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They don't pretty go very far. Don't worry, we got some guy working on preparedness in the NHS.

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I can't remember his name, but he's doing something, you know, it was one of those Oh God, this is out of right.

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Pressure waiting to happen. So that now about the time I went to that Roche meeting, I also went to a meeting which was summoned by Richard Corner,

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which you will have heard about, which was the first assembly of everybody.

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There were about 35 or 40 people in the room and and it was him just to fill in for people who are listening.

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This was kind of all the top medical researchers getting together to say this is crisis we need.

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Yeah, that's right. And all the ones who felt they could contribute something. So everybody's out in Townsend was there.

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Sarah was there, Adrian was there, Andy Pollard was there.

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You know, everybody was there. It was really good. Dave Stewart was there because of course, he's a spectacular viral structural biologist.

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Gavin Street is a viral immunologist.

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We had an amazing array of people and I kind of put I looked around the room, I thought, boy, this is a really impressive show.

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And, you know, at that stage there were lots of statements.

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Sarah was really confident she would have a vaccine because she'd been working on Boris Allen.

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They had another strategy for building on vaccine, which was a perfectly good one, and there were lots of interest.

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What the virology was likely to look out. There were good relationships with Porton Down, so we were talking about how we did stuff in that space.

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Dave Stewart was already created the structural proteins of Spike so that he could study them using crystallography.

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Did some of the early studies with the Chinese happens so.

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And then there was this massive global network and Peter Horby of course was linked into the

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global network and he was saying we got to get this right because in the flu pandemic in 2010,

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we completely screwed up clinical trials. It was a complete mess so that I went away from that meeting thinking, Boy,

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that's really impressive and I'd be really surprised if anybody can compete with that.

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So on one hand we had total complacency in Whitehall and with the NHS and yet in Oxford there

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was massive activation with people who didn't have any money but were doing their best.

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The university was great about allowing us to spread our money a bit wider to get on with some of this stuff.

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And then in February the first cases started to appear in the UK.

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There was a couple in York who were Chinese visitors in Brighton and that and then just after half term, which was just about now in February,

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the second or third week of February, everybody came back from half term and they brought COVID with them.

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So they had the Brighton outbreak, they had a number of other isolated cases.

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It was clear that the disease was onshore and it was also pretty clear from the Lombardy experience in Italy, which had started about a month before,

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that this thing was going to go the curve, the law breakers were terrifying and our curve was right on the left of the Lombardy,

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but it followed exactly the same trajectory. So I remember sharing thoughts with Jeremy where we looked at the data with it, right?

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This looked just like Italy, where the thing's going to crash. And then of course, in Italy, all the health care systems had fallen over.

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There were people in the isles and lots of people dying and nobody really knew how to look after the disease.

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So that that was a that was obviously a national catastrophe going to come.

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And at the very beginning of March, I got summoned to a meeting and I can't remember who summoned me to this meeting,

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but I think it was Will Warr, who is the health SpAd in number ten, who's an old student, but she's an existing student.

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I still a student to finish it by default. But anyway,

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he's very good guy and he had worked with us in all this and then had moved across from Boris with Boris came into that job and was doing a great job,

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I have to say. And, and he said, look, we've got to we've got to get a grip to the testing.

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So there were about eight or 10 minutes in the room and.

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We'd also had a meeting with the industry guys who were not very good actually,

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because the industry has where they were all promoting their own products. It was all about hope.

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So Jeremy and I and Will and then a couple of guys from Public Health, England.

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Alex sink a [INAUDIBLE] and one of this deputy CMO's.

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And anyway there's a mixture of people. And I brought in because I was the government adviser on life sciences.

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So, you know, they said, well, what do we do next? And. And I said, well, you know, the obvious approach to diagnostic testing is PCR.

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So we should we should get some PCR from how many PCR tests did we do yesterday?

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And they said, well, in the whole of the NHS, in the whole public health England, we did about 4000 PCR tests and I think you've got to be joking.

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And they said, Yeah, we've run out of supplies,

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we don't need nucleotides because of course the whole of the NHS was built on a sort

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of and it's what they call a home brew model and that is you make up the test,

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you buy the supplies, you get three nice ladies on level seven to do four tests a day, and that's done, but it goes home.

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Well, that I can tell you that was not going to work in a pandemic. And there was no there had been no planning to fix this.

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The original PCR test developed by Public Health England was the wrong tests.

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One very helpful. The W.H.O. was clumsy and slow.

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They got the wrong primers. The whole thing was a complete dog's breakfast.

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So I said, Look, you're going to have to get test from the commercial sector because that's, you know, you can't do this on a home made job.

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You've got to do this at scale so they patchy that I then got a call from somebody White House and answer okay we've done a deal with Roche to

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provide us with stuff and I had nothing to do with that deal because of course at that stage I was just stepping off the board at that stage.

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So I said, Look, I can't even do this, but you need to know Roche cannot produce very many tests because they're not used to doing that.

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So if you're lucky, you'll get about 5000 tests a day from Roche,

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which basically doubles the number of tests you got, which is miles below what you're going to need.

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So I said you've chosen the wrong supplier.

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And and then over the course of the next week, I had a nice call from Claire Wallace at Thermo Fisher, who's another big American diagnostics company.

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And of course, I knew all these people from my Lifesciences job. So she said, Gee, I can't get anybody to answer the bloody phone in Whitehall.

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And I said, Well, what do you want to talk to about it? She said, Well we can, we can provide you with tests.

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And I said, How many can provide? And she said, Well, we can do 100,000 a day if you want us to.

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We've got lots of supplies, you've got a really good test, but I can't get anybody to answer the phone.

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So I then went in through my contacts, head Office of Life Sciences, and I said to the lady who ran off.

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So I said, You're gonna have to take this on because no one else is competent to do it.

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So we had another quick meeting. Jeremy Will. Christy MacLeod.

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Somebody from Public Health, England has said, look, you will not get this done through the NHS.

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They haven't got a clue. So you've got to set up labs which only test big, huge labs, automation, robots, blah, blah, blah.

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And they said, Well, why not have a distributed model?

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And I said, Well, because you won't be able to manage it because you'll have machines breaking down.

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The quality control will always be different. You won't want to have it have three big labs.

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One, two, three. So they said, okay, what are you going to do?

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And so I knew, I knew about the resourcing, not the Queen's, because it was a grant to Oxford that it funded the virus or something.

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Keynes and I also knew that they had a staff of about 30 people and they were underemployed.

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So I called up the guy who ran that and the chairman of their board, and I said,

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You guys have to become a site for doing large scale, large scale PCR testing or this after.

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Because I remember when I spoke to Derek, he talked about how you called him up and said, we need somebody to validate.

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I know that was that that was the next step. That was. No, that.

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So it was a PCR thing, which is the first thing. And then I also knew the guy who ran the there was had a centre in Manchester and all the

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other PA that again was called this Medicines Discovery Catapult and Chris Malloy ran.

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That is an old friend of mine. So I called him up. I said, Chris, we need a site in the Midlands or in the north west.

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Can you set this up? So he said, J.B., I'm up for it.

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Let's go. And then I said, Well, let's let the Scots fight amongst themselves as to where it's going to be in Glasgow or in other sites.

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And just somebody tell the Scots to sort it out, but they need one up there as well.

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So we created, you know, literally in a week, three major centres, Thermo said.

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We know everybody who owns one of our machines and actually so we sent the army out to pick the machines up from the universities,

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took them all to these sites. They set it all up, they've got them hardware and we're literally day to day because the numbers of tests and

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started at about 4000 had fallen back in the NHS to 3500 because they couldn't scale it.

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And so now we started to try and build a story to get 200,000 tests a day, which was the target that Matt Hancock set.

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It's probably not a smart idea because he had no idea whether we get to him,

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but he made the number up and he asked and called me up, said, you know, can we do that?

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I should think you'd be bloody lucky, but we can try.

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So anyway, and that was by the end of April, so we had the tail end of March in the whole of April to get to that number.

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And in fact, in the end we did get to that number, but that was so that was step number one.

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And then I got James Bethell, who is the secretary and was the junior minister for life sciences.

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Lord Bethell, who I got to know pretty well, called me in and said, look, I think what we need is we need a vaccine,

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passports, we need serological testing so that people can prove themselves.

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If they've had the infection, it's all fine. So I said, well, that's that's a hard page.

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So I called Derek and said, Look, Derek, I need some help on this because you got to do this.

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And he said, okay, there's just this antibody test, this animal doing this and this.

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It all fell flat because the tests were no good,

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but it also fell flat because we realised we didn't know whether the antibodies actually protected you from another infection.

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So, so actually that, that had a about a month where we were trying to build it all up.

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Meanwhile, in Oxford, Dave Stewart and Richard Cornell in the team had built this really terrific lab based antibody testing thing,

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which was hugely accurate. In fact,

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we showed it was the most accurate of all the platforms that were available and was a really

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terrific asset for monitoring the surveillance of who'd been infected globally and nationally.

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So that. So all that stuff, the antibody thing was going around like this.

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PCR was on its way. I think I got two calls a week about PCR and I just said, keep going.

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You know, Kristen, call me up. That data thing was hard because the NHS can't do data.

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But anyway, there were your various groups.

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They set up these big, you know, drive up testing sites that still exist and you know, they, they built out that three lighthouse labs.

370
00:37:26,560 --> 00:37:33,040
So testing was looking pretty good. The the lateral flow tests for antibodies didn't work.

371
00:37:33,040 --> 00:37:36,970
The allies of the lab based Eliza did incredibly well.

372
00:37:37,510 --> 00:37:41,690
And then. So they had four pillars for testing.

373
00:37:41,720 --> 00:37:45,850
The first was PCR testing. So I've been very involved in that.

374
00:37:45,860 --> 00:37:48,200
The beginning stepped back once it got going.

375
00:37:48,890 --> 00:37:59,720
The second pillar was antibody testing, which was either lateral flow, antibody testing or a lot of programs.

376
00:38:00,470 --> 00:38:04,670
The third pillar was surveillance.

377
00:38:04,910 --> 00:38:06,020
I think that was the fourth pillar.

378
00:38:06,020 --> 00:38:12,140
Anyway, there were four pillars and so the surveillance thing was critical because we had to get some readable was going on.

379
00:38:12,560 --> 00:38:21,200
So I one of my close contacts in Treasurer was Governor Mike when he was the economic advisor to the Chancellor.

380
00:38:22,040 --> 00:38:29,080
And Mike called me up and said, Look, you know, you've got to keep us briefed as what's going on.

381
00:38:29,090 --> 00:38:34,999
So I was having a conversation with Treasury with some regular somebody else, and he said, I said,

382
00:38:35,000 --> 00:38:39,830
Surveillance, Mike, we've got to understand what the [INAUDIBLE] is going on here because we have no idea.

383
00:38:40,280 --> 00:38:45,919
And for God sake, don't trust the NHS because the NHS has been given a huge amount of money to run

384
00:38:45,920 --> 00:38:49,790
their own little allies of programmes to work out how many people were infected.

385
00:38:50,300 --> 00:38:56,080
So they did it. And then there was radio silence because they couldn't hook the data, so they couldn't assemble all the data.

386
00:38:56,080 --> 00:39:00,350
So nobody knew they after all that they couldn't do that. So I said, just forget all that.

387
00:39:00,800 --> 00:39:06,830
We need to set up studies. So Mike said, you should call the Office of National Statistics has a great idea.

388
00:39:07,070 --> 00:39:14,810
So I called the Endowment. I was working very closely with a woman called Tamsin Barry, who is still working about doing a lot of stuff with me.

389
00:39:15,290 --> 00:39:18,709
And she was she is she she's one of the best civil servants I worked with.

390
00:39:18,710 --> 00:39:25,550
She was really outstanding. And she had been given responsibility for helping with the surveillance and the antibody testing.

391
00:39:26,390 --> 00:39:30,590
And I said, Tamsin, look, you know, Ian's up for this, so why don't we get going?

392
00:39:31,010 --> 00:39:34,820
So it was on the back of that that we got together with Ian. He said, Let's make a plan.

393
00:39:35,870 --> 00:39:39,199
We need to fund API as a more of a person for that as Sarah Walker.

394
00:39:39,200 --> 00:39:42,889
She's terrific. And so, you know, obviously she is terrific.

395
00:39:42,890 --> 00:39:45,350
And and and she ran with that.

396
00:39:45,350 --> 00:39:55,819
And that's, again, been a flagship of the whole programme, led by her and supported by audience and just massively impressive by every standard.

397
00:39:55,820 --> 00:39:59,990
So so that that's how honest got started. That was Tamsin, really.

398
00:39:59,990 --> 00:40:03,370
But I made the original contact and Jeremy was very involved in that as well.

399
00:40:03,380 --> 00:40:10,790
That's why you see our names link with the thing as it goes on. And, and so that was all fine.

400
00:40:10,790 --> 00:40:16,970
And then in the background, of course, there the famous vaccine was rumbling along.

401
00:40:17,180 --> 00:40:24,560
So Gavin coming up to look JBL worried about vaccine because first of all, I have no idea what the bloody thing's going to work on,

402
00:40:26,420 --> 00:40:33,860
but if it did, we're going to be in massive trouble because of course, we there's just a million things that we can't do as a university.

403
00:40:34,650 --> 00:40:35,840
I said, Yeah, tell me about it.

404
00:40:35,850 --> 00:40:44,720
I mean, it's just they're so far gone in terms of scaling this thing up that I said, I don't think they really know what they don't know.

405
00:40:45,950 --> 00:40:52,370
And there's a complexity because both Sarah and Adrian are big shareholders.

406
00:40:52,370 --> 00:41:00,579
In fact, SciTech. And that has us sort of it's got an angle on the IP, even though they've done nothing to contribute to making the vaccine.

407
00:41:00,580 --> 00:41:07,360
That was all, Sarah. They've got an angle on the IP that is going to be complicated and we can't go blindly into that.

408
00:41:07,660 --> 00:41:11,110
And thirdly, we've got to make sure the bloody thing is safe before it goes anywhere.

409
00:41:11,680 --> 00:41:17,080
And at this stage, there was a an outcry from some Oxford academics saying, oh my God,

410
00:41:17,560 --> 00:41:21,880
because there's this concept of enhancement where you give a vaccine and the disease you get is worse.

411
00:41:22,390 --> 00:42:08,000
So they said, Oh, there's going to be enhancement. But we also all agreed that we needed a partner and and there a commercial, a commercial partner.

412
00:42:08,300 --> 00:42:14,570
So all the things that we don't do, global regulation, you know, it's now approved in hundred and 70 countries.

413
00:42:14,570 --> 00:42:18,510
How are we going to do that? We've got 20 manufacturing sites all over the world.

414
00:42:18,530 --> 00:42:24,080
We produced and deployed 3.30 2.8 billion doses of the bloody thing.

415
00:42:24,620 --> 00:42:25,520
Wish we were going to do that.

416
00:42:26,210 --> 00:42:34,070
So this is where it got quite complicated because of course there were people in Oxford saying, well, we can do that bloody joke.

417
00:42:34,730 --> 00:42:39,290
That's just, you know, it was great. And even vaccine tech said, Well, why don't you use us?

418
00:42:39,300 --> 00:42:44,840
Well, you know, VAX tech was a, you know, a tiny little biotech, no experience in any of this stuff.

419
00:42:45,500 --> 00:42:50,989
And I'd had a conversation with Roger Perlmutter, who was the head of R&D at Merck.

420
00:42:50,990 --> 00:42:56,630
Again, I knew he was a great friend, and he called me up in January to say, what do you know about the Oxford vaccine?

421
00:42:57,080 --> 00:43:00,350
Think it's pretty interesting. I said, it's not a vaccine yet, but it could be a vaccine.

422
00:43:00,350 --> 00:43:03,230
And so he said, well, tell me if you're interested in pursuing it.

423
00:43:04,580 --> 00:43:08,270
And I think Adrian at that stage said, no, no, we don't want to pursue it with anybody.

424
00:43:08,270 --> 00:43:12,140
But then at this stage, I said, look, we better call Roger up and see what he's going to do.

425
00:43:13,130 --> 00:43:16,430
10 minutes. Yeah, got it. We're running out of time. Okay. Rapidly.

426
00:43:19,850 --> 00:43:24,770
So Roger called me up and. And I said, Look, Roger, I think we should have this conversation.

427
00:43:24,830 --> 00:43:28,069
He said, Are you sure Adrian and Sarah want to talk to me?

428
00:43:28,070 --> 00:43:31,700
And I said, Well, I think so. So I spoke to Adrian, Sarah, and they said, Yeah, let's have a conversation.

429
00:43:32,690 --> 00:43:36,349
So they sent the BD team over from while she was on Zoom.

430
00:43:36,350 --> 00:43:41,389
But we talked to the BD team. We did a draft about what it would look like.

431
00:43:41,390 --> 00:43:48,650
I said you guys would be a great partner. There are a couple of problems, though, and one is it's going to be really important.

432
00:43:48,650 --> 00:43:58,190
We make this stuff onshore and they said, well, we make it in Ireland as it does we make in the U.S. that's no problem.

433
00:43:59,720 --> 00:44:03,620
So we went back and forth, all very friendly, have to say there was no hostility.

434
00:44:03,620 --> 00:44:12,229
And and then Sarah Nagin got cold feet and said, no, because Roger's I he's a tough guy.

435
00:44:12,230 --> 00:44:16,730
And he said no. He said, if we take this on, we take it on. But just to be clear, we're driving the bus.

436
00:44:16,730 --> 00:44:25,280
You're not driving the bus. So they got very twitchy about that and had the issue of cost for developing countries.

437
00:44:25,820 --> 00:44:29,090
Yeah. So so that we and so there were two red lines.

438
00:44:29,090 --> 00:44:35,600
One was at cost for the world, actually, and the second one was global production.

439
00:44:36,020 --> 00:44:40,159
So that Merck were pretty comfortable with all production because they couldn't do that and they've done it before.

440
00:44:40,160 --> 00:44:44,750
So that I think the problem and you know, they're one of the big vaccine players,

441
00:44:44,750 --> 00:44:51,230
so they know what they're doing and they we never got to the end of the conversation of that cost.

442
00:44:52,040 --> 00:44:56,449
And I think where we were going was at cost for developing countries,

443
00:44:56,450 --> 00:45:03,290
but not at cost for the U.S. They were going to make money in the U.S. and and I think the vice chancellor and

444
00:45:03,290 --> 00:45:11,000
Gavin and I had all thought that given the scale of what was going to be a huge global health care crisis,

445
00:45:11,480 --> 00:45:18,770
it was going to be hard for us to be making money off the back of that and that we would prefer that it was a cost everywhere.

446
00:45:19,610 --> 00:45:24,349
And I was talking quite a lot to Trevor Mundell because I chair the Gates Global

447
00:45:24,350 --> 00:45:28,489
Health Committee and Trevor is the president of Global Health Gates and they,

448
00:45:28,490 --> 00:45:35,299
they know vaccines inside out. So I said, that's it, Trevor help we get we need help with our vaccine because we can't do it ourselves.

449
00:45:35,300 --> 00:45:40,070
And he said, Boy and boy, do you need help. So he put a lot of his team on thinking about what we would do.

450
00:45:40,760 --> 00:45:46,610
And it was at that time that I think Richard Girling, who is at Centre View, who is a great friend of Oxford,

451
00:45:46,970 --> 00:45:53,030
had contacted Adrian or Sarah and said You should talk to Pascal at AstraZeneca, which they did.

452
00:45:53,030 --> 00:45:56,179
And I remember because they went to see they had it well, I'm not sure they went to see him.

453
00:45:56,180 --> 00:46:01,339
They probably did it on Zoom and they were going to see my can't remember but they they had a long conversation many in

454
00:46:01,340 --> 00:46:08,659
Pascal and Pascal he decided he was going to do this while Pascal had been the head of pharma Roche when I was on the board,

455
00:46:08,660 --> 00:46:11,989
so I knew it well. So he called me up. He said, J.B., I talked to you.

456
00:46:11,990 --> 00:46:14,240
So I said, okay, that's all we got to do.

457
00:46:14,270 --> 00:46:22,610
So I remember a long conversation on a Saturday afternoon with Pascal with several hours talking about what we do,

458
00:46:22,610 --> 00:46:26,930
what they thought about the vaccine, what they thought the prospects were, could they do it, could not do it.

459
00:46:27,860 --> 00:46:32,989
And we got to the two big issues, not for profit and global manufacturing.

460
00:46:32,990 --> 00:46:36,080
And he said, no, no, wait, we're up for that. That's what we will do.

461
00:46:37,160 --> 00:46:42,469
We do need to make money out of this thing over time, but certainly from the first period of time for, you know,

462
00:46:42,470 --> 00:46:50,120
for the first year or whatever, while it's a crisis, we we will do our best to get it at a cost based vaccine.

463
00:46:51,530 --> 00:46:55,620
So I then called Trevor and I said, Trevor, can they do it? Because I said, We can't do this deal.

464
00:46:56,660 --> 00:47:00,830
They said, I'll talk to Amelio. Who's their talk? Actually got to Trevor.

465
00:47:00,830 --> 00:47:04,840
Come back. Yeah. He's had to be pushed, but he thinks they can probably do it.

466
00:47:04,850 --> 00:47:08,390
They're really good at biologics. It's a great company. They should be okay.

467
00:47:09,110 --> 00:47:14,210
And most importantly, they're philosophically aligned with you. So you're not going to fight with them starting on day one.

468
00:47:15,260 --> 00:47:22,310
So so we then talk to the principals, the scientists, and they all said, looks okay to us.

469
00:47:23,150 --> 00:47:26,180
And I said, okay, AlphaGo.

470
00:47:26,180 --> 00:47:29,180
So we then got the university legal team in play.

471
00:47:29,990 --> 00:47:33,320
AstraZeneca legal team got a term sheet out within four or five days.

472
00:47:33,890 --> 00:47:37,129
No discussion, no arguments, no trouble is all fine.

473
00:47:37,130 --> 00:47:41,120
Settled on a royalty rate which was pretty acceptable for us milestones.

474
00:47:41,120 --> 00:47:46,339
They were very generous about milestones. There was no problem with the commercials and the principles were all in there.

475
00:47:46,340 --> 00:47:50,899
So that was all good. And then we so during the course of all these, of course,

476
00:47:50,900 --> 00:47:56,840
having had continual input from Whitehall saying you need to keep us involved because it's very important to us.

477
00:47:56,840 --> 00:48:06,440
So I was talking to Matt Turton, who was the senior civil servant now on the vaccine task force, and Matt Hancock and James baffled.

478
00:48:07,400 --> 00:48:11,510
And we were working our way through the story bit by bit.

479
00:48:11,510 --> 00:48:16,399
And Matt Hancock said, You can't do a deal with Merck because they won't be able to do it onshore.

480
00:48:16,400 --> 00:48:23,330
So that's a no no, you just can't do it. So I realised that the Merck line was dead and I called Roger and said, What?

481
00:48:23,330 --> 00:48:27,170
We can do it, Roger. And he said, Look, it's fine. He said, Don't worry, there's no hard feelings of you.

482
00:48:27,170 --> 00:48:30,500
Go and good luck to you. He said, It's going to be hard but good.

483
00:48:30,870 --> 00:48:36,170
So that so that that was that was sort of how we got to the signing of the deal.

484
00:48:36,590 --> 00:48:41,150
The Plan for the future. AstraZeneca agreed to run a big trial in America.

485
00:48:41,660 --> 00:48:45,980
They rapidly extended their manufacturing footprint to.

486
00:48:47,370 --> 00:48:49,320
20 different sites all over the world.

487
00:48:50,100 --> 00:48:58,520
They got organised with seed stocks, got people organised to start to make product, which incidentally was much more complicated than they thought.

488
00:48:58,590 --> 00:49:05,309
We thought it was a turn out to be a delay because remember this was by now we signed a deal in April.

489
00:49:05,310 --> 00:49:08,970
I think by June they were busy trying to manufacture.

490
00:49:09,000 --> 00:49:13,050
We didn't really get large scale manufacture going until the end of December.

491
00:49:13,350 --> 00:49:21,810
So, you know, this was quite a hard piece of work. So anyway, that that sort of gets you to the end of phase one.

492
00:49:21,930 --> 00:49:25,690
Yeah, we probably better stop that, which is less than 5 minutes.

493
00:49:25,690 --> 00:49:30,420
Yeah. But I've got two pages questions thought to us, well you better come back next time I come back.

494
00:49:30,510 --> 00:49:33,000
Come back for another hour. Yeah, great. Because I can.