THREAD
1/
As a @harvardmed doctor, I will be one of the first people to get a vaccine. My family in Zimbabwe, however, will be some of the last, if they get vaccines at all.
In global health, vaccination coverage has been an issue since vaccines were a thing…
1/
As a @harvardmed doctor, I will be one of the first people to get a vaccine. My family in Zimbabwe, however, will be some of the last, if they get vaccines at all.
In global health, vaccination coverage has been an issue since vaccines were a thing…
2/
For example, in the 1990s, the oral cholera vaccine was added to the WHO essential drug list (a compendium of “must have” resources for all countries). The lifesaving vaccine costs under US$1, yet the global stockpile is tiny and saved for emergencies.
But…
For example, in the 1990s, the oral cholera vaccine was added to the WHO essential drug list (a compendium of “must have” resources for all countries). The lifesaving vaccine costs under US$1, yet the global stockpile is tiny and saved for emergencies.
But…
3/
Because Western countries have adequate water infrastructure, they rarely experience cholera, and therefore it is not a global resource priority.
Because Western countries have adequate water infrastructure, they rarely experience cholera, and therefore it is not a global resource priority.
4/
This is reinforced by an idea called global health security, whereby the health of people in poor countries only matters if it could impact those in rich countries, like HIV/AIDS.
This is reinforced by an idea called global health security, whereby the health of people in poor countries only matters if it could impact those in rich countries, like HIV/AIDS.
5/
In 2008, a cholera epidemic in Zimbabwe infected 100,000 people, 4,000 of whom died.
In 2008, a cholera epidemic in Zimbabwe infected 100,000 people, 4,000 of whom died.
6/
President Mugabe blamed the outbreak on the West and restricted aid and sanitation in opposition stronghold areas. Cholera became highly politicized, just like masks in the COVID-19 pandemic.
hhrjournal.org/2017/07/the-ch…
President Mugabe blamed the outbreak on the West and restricted aid and sanitation in opposition stronghold areas. Cholera became highly politicized, just like masks in the COVID-19 pandemic.
hhrjournal.org/2017/07/the-ch…
7/
There have been multiple cholera outbreaks since then. Only in 2018 was there a mass drive to vaccinate 1.4 million people. This study shows how effective the vaccines were:
sciencedirect.com/science/articl…
There have been multiple cholera outbreaks since then. Only in 2018 was there a mass drive to vaccinate 1.4 million people. This study shows how effective the vaccines were:
sciencedirect.com/science/articl…
8/
While the COVID-19 vaccine may reach my family, the history of global health shows just how little rich countries care about poor ones.
While the COVID-19 vaccine may reach my family, the history of global health shows just how little rich countries care about poor ones.
9/
VACCINE NATIONALISM is a case in point.
Rich countries have spent billions of dollars to pre-purchase large quantities of the vaccine for preferential use among their citizens.
nytimes.com/2020/12/03/wor…
VACCINE NATIONALISM is a case in point.
Rich countries have spent billions of dollars to pre-purchase large quantities of the vaccine for preferential use among their citizens.
nytimes.com/2020/12/03/wor…
10/
Countries like Zimbabwe will rely on a limited number of vaccines via COVAX, the global vaccine alliance to get vaccines to poor countries. COVAX has only $700mil so far compared to the billions spent by countries like the US.
gavi.org/vaccineswork/c…
Countries like Zimbabwe will rely on a limited number of vaccines via COVAX, the global vaccine alliance to get vaccines to poor countries. COVAX has only $700mil so far compared to the billions spent by countries like the US.
gavi.org/vaccineswork/c…
11/
Although COVAX will pay for some, they will not pay for all vaccines in LMICs. At first, they will have just enough first for 5% and then 20% of the population.
Although COVAX will pay for some, they will not pay for all vaccines in LMICs. At first, they will have just enough first for 5% and then 20% of the population.
12/
And if my family *does* get a vaccine, there are a myriad of barriers that will cause delay.
-Refrigeration and supply chain
-Coordination
-Corruption
And if my family *does* get a vaccine, there are a myriad of barriers that will cause delay.
-Refrigeration and supply chain
-Coordination
-Corruption
13/
So, getting a vaccine for me is bittersweet. It will protect me in my job. But that shot (or two) will be a powerful reminder of how unequal this world is, and how we can never stop trying to change that.
So, getting a vaccine for me is bittersweet. It will protect me in my job. But that shot (or two) will be a powerful reminder of how unequal this world is, and how we can never stop trying to change that.
#globalhealth
@rajpanjabi @michellemorse @DrwilfredoM @reganhmarsh @drlouiseivers @AaronLBerkowitz @paimadhu @GlobalHealthMGH @Craig_A_Spencer
@DrMaryTBassett @RobertBonacci @KrutikaKuppalli
@BogochIsaac @ProfMattFox @megan_b_murray
@JeremyFarrar @IlonaKickbusch
@rajpanjabi @michellemorse @DrwilfredoM @reganhmarsh @drlouiseivers @AaronLBerkowitz @paimadhu @GlobalHealthMGH @Craig_A_Spencer
@DrMaryTBassett @RobertBonacci @KrutikaKuppalli
@BogochIsaac @ProfMattFox @megan_b_murray
@JeremyFarrar @IlonaKickbusch
#medtwitter
@brighamchiefs @pedsmd2b @tony_breu @colleenmfarrell @gradydoctor @COREIMpodcast @ETSshow @arghavan_salles @aoglasser @AmyOxentenkoMD @cpsolvers @ChaseTMAnderson @drjessigold @jack_turban @RyanMarino @DGlaucomflecken @LashNolen @DrOniBee
@brighamchiefs @pedsmd2b @tony_breu @colleenmfarrell @gradydoctor @COREIMpodcast @ETSshow @arghavan_salles @aoglasser @AmyOxentenkoMD @cpsolvers @ChaseTMAnderson @drjessigold @jack_turban @RyanMarino @DGlaucomflecken @LashNolen @DrOniBee
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