George F Gao | Global Health Must Go Global

On December 22, 2022, the Peking University Global Health and Development Forum 2022 was held with the main theme of Digital Transformation and Development Divides. Co-organized by the Beijing Forum, Asian Development Bank and PKU Institute for Global Health and Development, this Forum brought together world leading scholars, policy researchers and industry leaders from both China and international communities to share their insights and recommendations on the thematic topics, attracted over 10 thousands online viewers participated in the event. George F Gao, Director of CAS Key Laboratory of Pathogen Microbiology and Immunology, Institute of Microbiology and Dean of Savaid Medical School, University of Chinese Academy of Sciences, and Former Director-General of Chinese Center for Disease Control and Prevention delivered a keynote speech at the session of Global Health and Diplomacy.


I’m very pleased to be with you to discuss global health. I try to put my title as “Global Health Must Go Global.” Here we are talking something about global issues such as divides. For the time, we really need globalization. But we lack practice with it. We are having the COVID-19 pandemic with many challenges, such as data sharing and politicization in the world, which makes it difficult to do something at the global level, even though we are talking about globalization. We lack the common sense and the science to contribute our knowledge to control this pandemic.

First, where are we now with the COVID-19 worldwide and in China? In the world, the Omicron VOCs (variants of concern) dominate, and they change from time to time. As shown in this graph, it was Delta early this year, 2022, followed by Omicron and its VOCs. In terms of that, human beings can’t work together, but viruses are working together very well because they try to change their faces and change into so many different Omicron sub-variants. The death toll is down, but winter outbreak in the northern hemisphere. For instance, we have a problem with all these outbreaks in Beijing. In China, as shown on the left of this graph, it was the first wave in Wuhan. Then we had several waves but almost zero viruses using the “Zero-COVID” strategy. But starting from April 2022, this was the South outbreak and then later Beijing; now, the virus is everywhere. Though we are still using the so-called “Zero-COVID,” we are doing something for zero diseases instead of zero viruses.

Now that my voice is global, I want to remind everybody what lessons we have learned from the COVID-19 pandemic. How can we do something in terms of global? As you remember, from the very beginning in early 2020, Dr. Tedros Adhanom Ghebreyesus always, such as when I had a meeting together with him, emphasized “Solidarity, solidarity, solidarity!” and said three times the most important things. Now I’m calling for “Solidarity” again. For globalization, such as health issues and climate change, both areas are very much in need of cooperation between the US, China, and the rest of the world. In terms of global effort, science plays a very important role, and we call for science.

Meanwhile, we also want to call for data sharing. When you are talking something about global public health, data sharing is everything. We now have new techniques, technologies, and science there, but if we didn’t share data, the data would hide in your drawers, which wouldn’t help. Think about the flu pandemic in 1918, when we lost 25 to 50 million lives, compared to the COVID-19 pandemic, which has lost less than 7 million so far for the three years. It is very good statistics and means we have very good communication. For instance, I was involved in discovering the virus SARS-CoV-2 from the beginning. After 10 days, on 10th January 2020, China CDC released the genome sequence of SARS-CoV-2 in GISAID. Everybody in the world started to work on the vaccine development because you had this data available on the key site. Within one week, we got everything.

However, because we, the world, were not awake and didn’t realize the virus was so serious and clever. I use the word clever to compare with us human beings. We work so hard, but the viruses save themselves by changing their faces with so many variants, resulting that we still have the pandemic. Meanwhile, the whole world, scientists, and professionals were attacked. There were so many infodemics and rumors. People, the public thought the scientists created the virus, were delivered, disseminated by someone, and so on. We could not work together and do really good things. I do remember when I was appointed as the Director General of China CDC. The Lancet suggested me to write something from their perspectives and they said, “Geoge F Gao: Head of China CDC Signals a more global outlook,” which was the title of the paper published in the Lancet in 2018. At least under my leadership, we did a good job of data sharing. But again, we still have problems. Bill Gates claimed something about the prevention control for the next pandemic and what we can do together in his recent paper.

What has China done? What are we doing in China? We are especially criticized for this moment because we opened the door late. But for three years, we did a relatively brilliant job using the “Zero-COVID” strategy in China. Of course, now we are working very hard. First, China used the “Zero-COVID” strategy because it is a developing country with unbalanced development in different areas. So, we have to be careful. For the past three years, the “Zero-COVID” strategy had an outstanding achievement for life saving. China still has the least death toll compared to any other country. Second, we win the time for developing vaccines, drugs, and inhibitors. We should be even the first to know that the “Herd Immunity” could be a good choice because China has the Chinese Wisdom-“Da Yu Controlling Floods (大禹治水)” which was an implication for “Herd Immunity”. But from the very beginning, when we had this prototype virus isolated from Wuhan, it was so pathogenic that we could not do the “Herd Immunity” strategy then. So many countries like the UK implemented the “Herd Immunity” strategy. I know the UK very well because it was my second hometown, where I spent 10 years for my Ph.D. training and working at Oxford University as a lecturer. But we know “Herd Immunity” like the “Da Yu Controlling Floods” was not a good strategy to implement at that time in China. But now we know it’s high time to do this strategy or so-called “Herd Immunity”.

China’s contributions to modern public health

China has been doing this “Zero-COVID” strategy for the last three years, especially for 2020 and 2021, contributing something to modern public health. We always had zero viruses. The virus was imported into China from abroad from time to time. It is like the spring; we clean up the virus and the virus comes again. But in the rest of the world, you have the lake instead of the spring. When you have a tsunami, what China has are the waves. We could always identify the source of the virus because we have this spring. This is why we can do something for the modern public health. First, taking the origins of the COVID-19 pathogen as an example, we suspected it was from bats or pangolins from the very beginning; We tried so hard and confirmed that it was not from bats or pangolins. The virus carried by bats or pangolins is totally different from the COVID-19 virus or called SARS-CoV-2. Second, we found that the cold chain could bring the virus into China. Though it’s rare but it could. It might have some live pieces of the cells in the cold chains and then they can bring viruses.

Based on the above, I can put everything together for China’s contributions to modern public health. I call these “Three steps”. It’s very important for the health emergencies. The first step is science, I get answers from science after the virus determination of the parameters of the epidemiology. And then we also try to call the people to wear their masks, to make sure the public understands what you are doing. The public would like to be involved and comply with whatsoever, such as the strategy or the protocols you proposed. Then you have a very good decision-making system. So, this is very important. Science helps you seek the truth, and administration helps you to be more pragmatic, which is “科学求真,行政务实” in Chinese. This is very important because we have been running this “Zero-COVID” strategy. As a DG of China CDC, I put this into practice, which is very good.

I also wrote something for the Lancet public health. Community level capacity is critical. So, I’m calling for this globally. We, the developing countries, should pay more attention or spread our money on the community level capacity building. That will help you prevent and control the next pandemic. The paper “Science-based, public-involved, and swift administration strategy for future pandemic preparedness” has already been published in the Lancet. You could view the full text if you want to have a detailed description of what we have done in China or the China CDC.

Why do we have the COVID-19?

We were always attacked that the virus was created by humans and so on. Why do we have the COVID-19? How did we get here with the COVID-19 pandemic? A lot of rumors are there; the infodemic is always there. Is it Blake Swan or Grey Rhino? For the professionals like me, I’m a virologist and an immunologist though I’m doing some administration work. I was involved in the GPMB (Global Preparedness Monitoring Board). The GPMB 2019 annual report shows that flu and coronavirus might be the next positive for the pandemic. We knew it might happen. Also, I was involved in the “EVENT 201”.

We suspected we had a virus, a disease called CAPS (Coronavirus Associated Pneumonia Syndrome), that would be like COVID. I was there from the very beginning as a DG of China CDC. They said, “Oh, you guys and George F Gao did a bad job and you were sitting together with Avril Haines, a Director of the National Intelligence Security after the Biden administration. You guys are sitting together, communicating with each other, talking about something that the US will release the virus for China.” A lot of infodemics is there, like why you sit together with Dr. Haines, the conspiracy story. In fact, once we knew this, we published the data and shared the data in The Lancet entitled “A novel coronavirus outbreak of global health concern” with Dr. Chen Wang and Peter W Horby from Oxford and Frederick G Hayden from Virginia. We four knew something together on 24th January 2020, as written in the Lancet, that this coronavirus, a novel corona, could be a global health concern. We knew it was global. We couldn’t hide anything as professionals. We had to share the data. So, we put this as a global health concern.

Think about the Ebola and the influenza viruses. They always share. The viruses carried by migrating birds jumped to chickens, dogs, pigs, and human beings. This is an ecological cycle. Viruses belonging to the earth, not any country. Moreover, Ebola has the same ecological cycle. Thinking back, seven coronaviruses can infect human beings; two were newly discovered recently. The first one was HCoV-229E, found in 1965, and then you got so many. Currently, SARS-CoV-2 is expanding its territories. Their hosts range from humans into so many animals. So, it’s hard to eradicate this virus. The virus will stay with us.

Think about why we have so many viruses. Why is it global? That is due to human behavior change, climate change, and ecological changes. It’s a really big event but not just a local event. This is why we have to work together. In 2016, I was asked by a journal called Trends in Microbiology to write a review, there I claimed something about coronavirus- “it is likely not a matter of if, but when, the next recombinant CoV will emerge and cause another outbreak in the human population.” We knew it would happen. From the very beginning, we said vaccines are the international goods we should share. I wrote something in a China CDC journal called China CDC weekly as a cover story- “If we do not share the vaccines, the virus will share the world.” This is why we thank Gordon Liu for organizing this meeting on global health and divides.

We don’t want to have any divides or controversies. We want to share real things. Taking my own research group as a good example, in addition to my administration work, I have done a lot of work for the research. My group isolated the first human molecular bodies and shared them with Junshi (君实) and Eli Lilly. Given this one as a commercially available monoclonal antibody, it was already used in the USA and Europe and saved a lot of lives in early 2021. So, China and US can really work together. China isolated the virus and shared it with Eli Lilly, and it could put this one into the service for the human beings in the US and Europe. We need to work together to beat the next coronavirus or disease X.

While we are talking about this in the 21st century, we already have seven public health emergencies of international concern. The Recent one was Monkeypox. Now I want to call for it because we are doing something for the global health. Don’t forget the neo-pollutants such as masks. The disposal of masks could be a problem in the future. We must be cautious about it. We must do some work for the public through the study of science. I wrote a book called “Influenza Virus: An unavoidable enemy” published in 2018, indeed before the COVID-19 pandemic. The English version of the book will be available soon at the World Scientific in Singapore.

Furthermore, I did a lot of public communication of science work. I hope to work together with you in the future. Let’s make sure “Global health really goes global.” Thank you!