Okay. Could you just start by saying your name? I'm John Bell. And I'm Regis, professor of medicine in Oxford.
Okay, so start can you just tell me a little bit about yourself if you can get into about three sentences
how you got from your earliest interest in science and medical issues to where you want it?
Yeah. So I'm, I'm I'm a clinician scientist.
I've been in Oxford for more than 30 years.
I came here originally as a Rhodes Scholar, trained in medicine here, went to London, came back, worked in David Weatherall,
and then spent most of the 1980s in Stanford at the height of the molecular biology revolution,
and then came back here in 1988, ran a program in immunology and genetics, became Nuffield Chair of Medicine,
following then quite a role in 92 and then ten years later became Regis professor of medicine.
And and sort of broadening. Responsible for a number of the strategic things that have happened in Oxford Medicine over the past 20 years.
And if there was one big question that gets you back to bed in the morning, what would you say it was?
Yeah, I'm. I'm, I'm.
All my professional career, I've been extremely interested in getting a much more precise understanding of the mechanisms of different diseases.
It's these days, people call it precision medicine, but the ability to move from clinical patterns of disease to a real understanding
of what's going on at a molecular level is that that's the thing that's kept my
research going and and kept me interested in the field so we could talk for ages about
your interest in the genetics of common diseases like diabetes mellitus and so on.
But I think the strategic side, which you mentioned, is really what we want to focus on.
So you've and you've been involved in those strategic questions both within Oxford and beyond.
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
when you first got here in 87 or when you first became a Nuffield professor?
Well, I mean, I experienced it a bit when I was a student here because I came as a Rhodes Scholar and and
did the on a school course in physiological sciences and then went to the clinical school.
And, and it was very, very small scale.
There were some extremely able people in medical school and of course it had a distinguished record,
even though it was small, but it had limited it had limited horizons.
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.
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.
Biomedical science is likely to be the big scientific operation for the next 30 years.
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.
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.
Clearly it wasn't.
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.
And of course, you know, in the sort of 1970s, the funding for science was pretty limited nationally.
So it was really hard to compete at any different level.
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.
It was all fabulous. But really, you know, it had it had, I think, a view of itself, which was unrealistic.
By the time I came back from Stanford in the late eighties, things had started to move in medical school,
largely driven by Peter Moores and David Weatherall to build it up.
There was a very strong global health programme long before anybody else David had built the Wellcome Trust.
I built the Weatherall Institute, now called the Weatherall Institute,
which was a real successful venture in molecular medicine, which is the reason I came back.
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,
which is the old road campus where we've now got eight or ten institutes, you know, 2500 to 3000 people.
It's one of the biggest biomedical research campuses in Europe.
And to build excellence in a whole variety of domains where the university had never really played cancer, for example,
where the excellent programme which expanded the genetics of common disease, we've really built on our strengths in immunology and infection.
We built out the data themes that data analytics, big data institute and and drug discovery has become a central part of it.
So yeah, I mean this has been a huge expansion over 20 years. And how is that funded?
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
because there isn't any single pot of money that you can get all the money from.
So you get a bit of money from here and a bit of money from there.
And I think the crucial bit of the the vision, which the total vision was never pitched to anybody,
but the individual component parts of the of the puzzle were pitched one at a time as being exciting.
What we need to do now, this is the next step in building global excellence.
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.
So. So that's basically how they. How the campus has evolved and that, you know,
I spent most of my last 20 years building out this campus and building the excellence that's kind of underpinned it.
So that's been hugely interesting and exciting.
And if that hadn't happened, we probably wouldn't have had a vaccine program.
They'll probably not be. There will be no stuff.
Stuff don't know. A lot of that wouldn't have happened. So.
So I think the underpinning of the Excellence in Oxford Biomedicine has really come from the
dramatic expansion in people and infrastructure that's occurred over the past 30 years,
probably in broad terms, and that that's been hugely impactful.
So before you go, before we get back to Kobe in Oxford, I'd also like to address your role in in national bodies.
So I've just got down to a couple of things here. So for 26,
you were both the third president of the Academy of Medical Sciences and the first
chair of something called the Office for Strategic Coordination of Health Research.
What were your goals in those positions? So so it actually goes back a bit before that because the one of the things I,
I picked up when I was in Stanford was the huge opportunities that came with the growth of life sciences and biotechnology.
So by this means in the commercial sector? In the commercial sector.
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.
We, we built one of them up with another one ultimately fell over.
But I was very actively engaged in that space. And in 2002, on the back of that experience, I was approached by Roche,
which is the big Swiss pharmaceutical company, who asked me to join their main board in Switzerland.
So I joined the board in 2002 and I, I, that was a huge opportunity for me,
one that I didn't even know when I signed up how big the opportunities going to be because understanding
how a large life sciences company actually works at board level is a fascinating experience.
So first of all, you understand big companies, which is an issue in its own right,
but also how do you generate innovation inside the context of a large entity?
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,
we went from having almost no products in late stage development to having a
profile of of products which was better than almost anybody in the industry,
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.
I spent a year on sabbatical in Basel working with the team at Rosso.
I that was a that was a dimension to my experience which most people in academia don't have.
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.
And one of the things that emerged from that was that when the presidency of the Academy came up,
they called me up and said, look, you should do this. And, you know, not really other things, do you?
And with a bit of arm twisting, I decided to do it.
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.
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.
But at that stage we had no permanent home.
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.
The old it was the old Ciba building for the symposia.
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.
If you want advice on medicine, don't go to the Royal Society, go to the academy.
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.
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.
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.
And he did. What was his role? He was an adviser to government.
He was an ex venture capitalist. He's head up advent in the UK,
very impressive character and he was very close to Treasury because he chaired a variety of the big Treasury committees and he was
incredibly supportive of the idea that we tried to make the life sciences and gender publicly funded agenda much more coherent.
So he wanted that all brought together under a single board,
which was the Office for Strategic Coordination Health Research, which managed the flow of money to MRC,
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.
So, so I, I was asked to be the first chair that Gordon Brown was the Chancellor.
They upped the amount of money for life sciences and the MRC and the NIH are
by a very substantial amount after about a year that we had Oscar in place,
and that was the beginning, I think,
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.
So it was a really good time to be doing biomedicine in the UK and it was dramatically better than any other scientific subject
who didn't have the ear of government and didn't have the support that we have from the big charities for biomedicine.
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.
He knows lots about industry, he knows a lot about biotech, he knows much about academia.
He's the person to go to if you want information about how we make this all work, because the government,
successive governments were very interested in the economic growth agenda because they
finally realised that we couldn't keep getting coal out of the ground and making steel.
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,
short lived and then by David Cameron and I was nominated the life sciences champion for the UK
and that basically that meant the guy you talk to want to talk about building up life sciences.
And that didn't that didn't involve you in having a big secretariat behind you?
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.
And I was very I think there's a good story here because the it turns out that yeah, yeah,
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.
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.
So the Office for Strategic Coordination, this is Cox's idea was in Treasury.
So I had an office in Treasury. I knew all the officials in Treasury we would meet all the time.
And so I developed a whole set of personal connections that other departments couldn't get at
because of course the other departments were desperate to talk to the guys from Treasury. But I had an office in Treasury.
So it, I mean, it's interesting how these things just happen to occur.
So, so I had this great network and then when David Cameron came to power, he was extremely interested in building up life sciences.
And he wanted me and I and a chap from AstraZeneca called Chris brings me to have help advise him as
to how we could use the strengths of the health system in the NHS to help build a commercial entity.
And the point I made to him, which I think he accepted,
is that it's very hard to imagine how a country could spend 30% of its public sector spending on something
like the health service and not expect to get any economic growth out of that because at the moment,
you know, at that stage there was no relationship in the NHS and the commercial sector.
So I promise to help build that in a in a systematic way over a period of time.
And we did and David was fantastic.
Was he very interesting.
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.
And so I went to see him with Chris and we would give a report card on how people would perform.
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.
And he paid a lot of attention. And of course,
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.
So, you know, on one occasion he said, look, you know, you know a lot about genetics.
Can you come and talk to me about genetics?
And of course, I knew even more than most people about genetics because Roche is the world's biggest in vitro diagnostics company.
And it was at that stage they were looking at what a company like that could do in the whole world of clinical genetics.
So they had explored all the companies to do genetics and had discovered that actually
the price of DNA sequencing was about to fall off a cliff and become very cheap.
So I went in one day and with a couple of others, Mark Walport and Sally DAVIES and others,
we, we, we gave David Cameron a tutorial on modern day genomics, which he loved.
And he said, Oh God. He said, This is terrific. We really need to do something in this space.
So I pitched the idea of a 100,000 genomes project to the Genomics England project, which he loved.
And he said, Right, well, I'm just going to do that. So off we go. And how is that project set up?
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.
He has funded. Funded straight from the Department of Health, right.
Yeah. Yeah. So it, it, it was another example and I've been involved in three or four of these over the years.
That if you want to do really big and ambitious projects that are high risk,
don't go through the conventional funding system because you'll never get there because they shoot at you until you drop dead.
So we did that with UK Biobank. We did that with Genomics England.
We're doing it now with our future health so that the object with genomics England is to produce eventually a commercial product.
And the object was to see whether you could turn genetics in a health care system into something which was much more ambitious,
capable of delivering a much better result for patients and ultimately generating genetic data which industry and
other people and academics could get great benefit out of so that there were lots you would have to pay for.
Which industry, in my view at the time,
was that we wouldn't necessarily want industry to pay for it and we would want them to be
interested in coming to the UK to do their work that would actually allow them to get to X,
Y and Z. So it's a it was it wasn't that it wasn't a transactional thing.
I'll pay this to get you that. What it was, was, look, we've got this great resource.
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.
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,
which he did, he would pick up the phone and say, what the heck is going on, get going.
And and as a result, it took about 18 months to get it going after he decided to do it.
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
of about three or four and it became affordable and they set up Genomics England,
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.
And it was way out there before anybody else had ever thought of thinking.
So at a national level that was, you know,
those sort of things actually have had quite a big impact on the UK's position in the global biomedical space.
So UK Biobank, which I was also involved in setting up, which is run by Rory Collins, is, you know, Genomics England.
These are the kind of things they're big projects. They use the NHS capacity to do things at scale.
They're the sort of things that academics all over the world want to see be able to use effectively.
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.
Then of course we had the Brexit debate. David stepped down and Theresa may took on the job.
She reappointing these life sciences champion. I worked with her and Greg Clarke because they had they decided that he was the science minister.
You know, he was the baize secretary of state for Bass. Yeah. So science was underneath him.
Yes, he was that but but but he wanted us to do industrial strategy,
not in the classic Harold Wilson sense of the word, but in terms of are there tech sectors that we need to build up?
Are there areas of high value jobs, high value growth opportunities?
Do we want to build out? And the first one that he chose was Life Sciences, and it was me.
He has to lead it again because I was known pretty well in Whitehall.
So we wrote a report which we published and then we have been busy rolling that out.
Up to 2019 brought in about three and a half billion pounds of inward investment, invested about 600 million UK government capital.
But it created a huge opportunity for the life sciences and the industry.
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,
so, so that that kind of gets us to 2019.
But by the time 1219 came, everybody knew me because I was the advisor on life sciences.
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,
who are responsible for building up life sciences between bays and Department of Health.
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.
James O'Shaughnessy So I know all the ministers knew me and I was that was sort of where I got to and Oxford,
although obviously in my role in Whitehall, I couldn't preferentially support Oxford anything we did for Life Sciences nationally.
Oxford Boat was going to float as fast as anybody's.
And you know, that has driven a lot of really exciting things in the Oxford environment, digital pathology,
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.
It's been quite a symbiotic relationship between building up things here, but also building up things nationally.
That's really, really good background. Excellent. So let's get to COVID itself.
So can you remember I'm asking everybody this when you first became aware that this was not just a little thing happening?
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.
Because when I was at Roche I bought a chalet in the mountains in Switzerland, so I was standing on the deck at Christmas.
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.
And I was a close friend of Jeremy's and a very good guy. And he called me up.
He said, I don't know whether you're paying attention, JP, but there's been trouble in China.
And, you know, in Wuhan there's an outbreak of a pretty severe respiratory illnesses.
Looks a bit like SARS, but it could be something else. They're busy sequencing it.
We're trying to work out what's going on. But this, I suspect, will be the next pandemic.
So. Oh, okay. Right. Okay. So that's that was a bit of a date.
And so I thought, okay, well, this is pretty good.
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.
SIMON George. So, so anyway, I got in touch with George account.
I can't remember a phone number.
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.
We'll have the sequence by the beginning of January. I hope we'll be able to tell you what it was.
So that was when I knew there was likely to be trouble brewing.
The sequence, of course, appeared about the seventh or 8th of January, and it turned out to be a SaaS like virus.
And so you knew that there would be potential trouble.
Now, the previous two sars-cov-1 epidemics had burned themselves out relatively quickly high mortality, 35% mortality, but they burned themselves out.
So there was a view that it'll all be okay because it'll burn itself out.
Nobody knew why the patients burn themselves out, which is a bad place to be.
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.
So I then of course had I kept doing what I was doing, but I was pretty attuned to what was happening in China.
I went to a board meeting at Roche in late January and I still remember we started the board meeting with them.
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?
And they all and what part of China? And I said, Well, let me tell you, mate, you guys are a global company.
You've got a big problem. And by the way, you're going to be called upon because you have all the diagnostics,
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.
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.
And, you know, these are greedy top end people and no one had gone, Oh Jesus, this is not good.
These guys are not paying attention. This is a really serious and by this stage, they were shutting down large bits of China.
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.
So that was a that was a central moment for me because I thought, actually,
not only are we going to have a pandemic, but we're going to be caught completely unprepared.
So I came back. I came back. First of all, they said, okay, thanks for that.
We better get moving, which they did to their credit, not fast enough as it happened.
But anyway, they did get moving. But when I came back here I started poking the NHS to say, You guys ready for this?
And I got them a whole barrage of rather complacent responses saying It'll all be fine.
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.
They don't pretty go very far. Don't worry, we got some guy working on preparedness in the NHS.
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.
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,
which you will have heard about, which was the first assembly of everybody.
There were about 35 or 40 people in the room and and it was him just to fill in for people who are listening.
This was kind of all the top medical researchers getting together to say this is crisis we need.
Yeah, that's right. And all the ones who felt they could contribute something. So everybody's out in Townsend was there.
Sarah was there, Adrian was there, Andy Pollard was there.
You know, everybody was there. It was really good. Dave Stewart was there because of course, he's a spectacular viral structural biologist.
Gavin Street is a viral immunologist.
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.
And, you know, at that stage there were lots of statements.
Sarah was really confident she would have a vaccine because she'd been working on Boris Allen.
They had another strategy for building on vaccine, which was a perfectly good one, and there were lots of interest.
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.
Dave Stewart was already created the structural proteins of Spike so that he could study them using crystallography.
Did some of the early studies with the Chinese happens so.
And then there was this massive global network and Peter Horby of course was linked into the
global network and he was saying we got to get this right because in the flu pandemic in 2010,
we completely screwed up clinical trials. It was a complete mess so that I went away from that meeting thinking, Boy,
that's really impressive and I'd be really surprised if anybody can compete with that.
So on one hand we had total complacency in Whitehall and with the NHS and yet in Oxford there
was massive activation with people who didn't have any money but were doing their best.
The university was great about allowing us to spread our money a bit wider to get on with some of this stuff.
And then in February the first cases started to appear in the UK.
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,
the second or third week of February, everybody came back from half term and they brought COVID with them.
So they had the Brighton outbreak, they had a number of other isolated cases.
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,
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,
but it followed exactly the same trajectory. So I remember sharing thoughts with Jeremy where we looked at the data with it, right?
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.
There were people in the isles and lots of people dying and nobody really knew how to look after the disease.
So that that was a that was obviously a national catastrophe going to come.
And at the very beginning of March, I got summoned to a meeting and I can't remember who summoned me to this meeting,
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.
I still a student to finish it by default. But anyway,
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,
I have to say. And, and he said, look, we've got to we've got to get a grip to the testing.
So there were about eight or 10 minutes in the room and.
We'd also had a meeting with the industry guys who were not very good actually,
because the industry has where they were all promoting their own products. It was all about hope.
So Jeremy and I and Will and then a couple of guys from Public Health, England.
Alex sink a [INAUDIBLE] and one of this deputy CMO's.
And anyway there's a mixture of people. And I brought in because I was the government adviser on life sciences.
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.
So we should we should get some PCR from how many PCR tests did we do yesterday?
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.
And they said, Yeah, we've run out of supplies,
we don't need nucleotides because of course the whole of the NHS was built on a sort
of and it's what they call a home brew model and that is you make up the test,
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.
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.
The original PCR test developed by Public Health England was the wrong tests.
One very helpful. The W.H.O. was clumsy and slow.
They got the wrong primers. The whole thing was a complete dog's breakfast.
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.
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
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.
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.
So if you're lucky, you'll get about 5000 tests a day from Roche,
which basically doubles the number of tests you got, which is miles below what you're going to need.
So I said you've chosen the wrong supplier.
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.
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.
And I said, Well, what do you want to talk to about it? She said, Well we can, we can provide you with tests.
And I said, How many can provide? And she said, Well, we can do 100,000 a day if you want us to.
We've got lots of supplies, you've got a really good test, but I can't get anybody to answer the phone.
So I then went in through my contacts, head Office of Life Sciences, and I said to the lady who ran off.
So I said, You're gonna have to take this on because no one else is competent to do it.
So we had another quick meeting. Jeremy Will. Christy MacLeod.
Somebody from Public Health, England has said, look, you will not get this done through the NHS.
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.
And they said, Well, why not have a distributed model?
And I said, Well, because you won't be able to manage it because you'll have machines breaking down.
The quality control will always be different. You won't want to have it have three big labs.
One, two, three. So they said, okay, what are you going to do?
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.
Keynes and I also knew that they had a staff of about 30 people and they were underemployed.
So I called up the guy who ran that and the chairman of their board, and I said,
You guys have to become a site for doing large scale, large scale PCR testing or this after.
Because I remember when I spoke to Derek, he talked about how you called him up and said, we need somebody to validate.
I know that was that that was the next step. That was. No, that.
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
other PA that again was called this Medicines Discovery Catapult and Chris Malloy ran.
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.
Can you set this up? So he said, J.B., I'm up for it.
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.
And just somebody tell the Scots to sort it out, but they need one up there as well.
So we created, you know, literally in a week, three major centres, Thermo said.
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,
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
started at about 4000 had fallen back in the NHS to 3500 because they couldn't scale it.
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.
It's probably not a smart idea because he had no idea whether we get to him,
but he made the number up and he asked and called me up, said, you know, can we do that?
I should think you'd be bloody lucky, but we can try.
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.
And in fact, in the end we did get to that number, but that was so that was step number one.
And then I got James Bethell, who is the secretary and was the junior minister for life sciences.
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,
passports, we need serological testing so that people can prove themselves.
If they've had the infection, it's all fine. So I said, well, that's that's a hard page.
So I called Derek and said, Look, Derek, I need some help on this because you got to do this.
And he said, okay, there's just this antibody test, this animal doing this and this.
It all fell flat because the tests were no good,
but it also fell flat because we realised we didn't know whether the antibodies actually protected you from another infection.
So, so actually that, that had a about a month where we were trying to build it all up.
Meanwhile, in Oxford, Dave Stewart and Richard Cornell in the team had built this really terrific lab based antibody testing thing,
which was hugely accurate. In fact,
we showed it was the most accurate of all the platforms that were available and was a really
terrific asset for monitoring the surveillance of who'd been infected globally and nationally.
So that. So all that stuff, the antibody thing was going around like this.
PCR was on its way. I think I got two calls a week about PCR and I just said, keep going.
You know, Kristen, call me up. That data thing was hard because the NHS can't do data.
But anyway, there were your various groups.
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.
So testing was looking pretty good. The the lateral flow tests for antibodies didn't work.
The allies of the lab based Eliza did incredibly well.
And then. So they had four pillars for testing.
The first was PCR testing. So I've been very involved in that.
The beginning stepped back once it got going.
The second pillar was antibody testing, which was either lateral flow, antibody testing or a lot of programs.
The third pillar was surveillance.
I think that was the fourth pillar.
Anyway, there were four pillars and so the surveillance thing was critical because we had to get some readable was going on.
So I one of my close contacts in Treasurer was Governor Mike when he was the economic advisor to the Chancellor.
And Mike called me up and said, Look, you know, you've got to keep us briefed as what's going on.
So I was having a conversation with Treasury with some regular somebody else, and he said, I said,
Surveillance, Mike, we've got to understand what the [INAUDIBLE] is going on here because we have no idea.
And for God sake, don't trust the NHS because the NHS has been given a huge amount of money to run
their own little allies of programmes to work out how many people were infected.
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.
So nobody knew they after all that they couldn't do that. So I said, just forget all that.
We need to set up studies. So Mike said, you should call the Office of National Statistics has a great idea.
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.
And she was she is she she's one of the best civil servants I worked with.
She was really outstanding. And she had been given responsibility for helping with the surveillance and the antibody testing.
And I said, Tamsin, look, you know, Ian's up for this, so why don't we get going?
So it was on the back of that that we got together with Ian. He said, Let's make a plan.
We need to fund API as a more of a person for that as Sarah Walker.
She's terrific. And so, you know, obviously she is terrific.
And and and she ran with that.
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.
So so that that's how honest got started. That was Tamsin, really.
But I made the original contact and Jeremy was very involved in that as well.
That's why you see our names link with the thing as it goes on. And, and so that was all fine.
And then in the background, of course, there the famous vaccine was rumbling along.
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,
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.
I said, Yeah, tell me about it.
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.
And there's a complexity because both Sarah and Adrian are big shareholders.
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.
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.
And thirdly, we've got to make sure the bloody thing is safe before it goes anywhere.
And at this stage, there was a an outcry from some Oxford academics saying, oh my God,
because there's this concept of enhancement where you give a vaccine and the disease you get is worse.
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.
So all the things that we don't do, global regulation, you know, it's now approved in hundred and 70 countries.
How are we going to do that? We've got 20 manufacturing sites all over the world.
We produced and deployed 3.30 2.8 billion doses of the bloody thing.
Wish we were going to do that.
So this is where it got quite complicated because of course there were people in Oxford saying, well, we can do that bloody joke.
That's just, you know, it was great. And even vaccine tech said, Well, why don't you use us?
Well, you know, VAX tech was a, you know, a tiny little biotech, no experience in any of this stuff.
And I'd had a conversation with Roger Perlmutter, who was the head of R&D at Merck.
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?
Think it's pretty interesting. I said, it's not a vaccine yet, but it could be a vaccine.
And so he said, well, tell me if you're interested in pursuing it.
And I think Adrian at that stage said, no, no, we don't want to pursue it with anybody.
But then at this stage, I said, look, we better call Roger up and see what he's going to do.
10 minutes. Yeah, got it. We're running out of time. Okay. Rapidly.
So Roger called me up and. And I said, Look, Roger, I think we should have this conversation.
He said, Are you sure Adrian and Sarah want to talk to me?
And I said, Well, I think so. So I spoke to Adrian, Sarah, and they said, Yeah, let's have a conversation.
So they sent the BD team over from while she was on Zoom.
But we talked to the BD team. We did a draft about what it would look like.
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.
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.
So we went back and forth, all very friendly, have to say there was no hostility.
And and then Sarah Nagin got cold feet and said, no, because Roger's I he's a tough guy.
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.
You're not driving the bus. So they got very twitchy about that and had the issue of cost for developing countries.
Yeah. So so that we and so there were two red lines.
One was at cost for the world, actually, and the second one was global production.
So that Merck were pretty comfortable with all production because they couldn't do that and they've done it before.
So that I think the problem and you know, they're one of the big vaccine players,
so they know what they're doing and they we never got to the end of the conversation of that cost.
And I think where we were going was at cost for developing countries,
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
Gavin and I had all thought that given the scale of what was going to be a huge global health care crisis,
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.
And I was talking quite a lot to Trevor Mundell because I chair the Gates Global
Health Committee and Trevor is the president of Global Health Gates and they,
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.
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.
And it was at that time that I think Richard Girling, who is at Centre View, who is a great friend of Oxford,
had contacted Adrian or Sarah and said You should talk to Pascal at AstraZeneca, which they did.
And I remember because they went to see they had it well, I'm not sure they went to see him.
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
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,
so I knew it well. So he called me up. He said, J.B., I talked to you.
So I said, okay, that's all we got to do.
So I remember a long conversation on a Saturday afternoon with Pascal with several hours talking about what we do,
what they thought about the vaccine, what they thought the prospects were, could they do it, could not do it.
And we got to the two big issues, not for profit and global manufacturing.
And he said, no, no, wait, we're up for that. That's what we will do.
We do need to make money out of this thing over time, but certainly from the first period of time for, you know,
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.
So I then called Trevor and I said, Trevor, can they do it? Because I said, We can't do this deal.
They said, I'll talk to Amelio. Who's their talk? Actually got to Trevor.
Come back. Yeah. He's had to be pushed, but he thinks they can probably do it.
They're really good at biologics. It's a great company. They should be okay.
And most importantly, they're philosophically aligned with you. So you're not going to fight with them starting on day one.
So so we then talk to the principals, the scientists, and they all said, looks okay to us.
And I said, okay, AlphaGo.
So we then got the university legal team in play.
AstraZeneca legal team got a term sheet out within four or five days.
No discussion, no arguments, no trouble is all fine.
Settled on a royalty rate which was pretty acceptable for us milestones.
They were very generous about milestones. There was no problem with the commercials and the principles were all in there.
So that was all good. And then we so during the course of all these, of course,
having had continual input from Whitehall saying you need to keep us involved because it's very important to us.
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.
And we were working our way through the story bit by bit.
And Matt Hancock said, You can't do a deal with Merck because they won't be able to do it onshore.
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?
We can do it, Roger. And he said, Look, it's fine. He said, Don't worry, there's no hard feelings of you.
Go and good luck to you. He said, It's going to be hard but good.
So that so that that was that was sort of how we got to the signing of the deal.
The Plan for the future. AstraZeneca agreed to run a big trial in America.
They rapidly extended their manufacturing footprint to.
20 different sites all over the world.
They got organised with seed stocks, got people organised to start to make product, which incidentally was much more complicated than they thought.
We thought it was a turn out to be a delay because remember this was by now we signed a deal in April.
I think by June they were busy trying to manufacture.
We didn't really get large scale manufacture going until the end of December.
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.
Yeah, we probably better stop that, which is less than 5 minutes.
Yeah. But I've got two pages questions thought to us, well you better come back next time I come back.
Come back for another hour. Yeah, great. Because I can.