IHME has produced some excellent work (I count its staff members among my collaborators and friends), but also a variety of challenging conflicts of interest. The 2018 MOU with WHO is particularly so 1/
The WHO reliance on IHME for burden of disease metrics creates a too-big-to-fail problem that also disincentivizes investment in in-country capacity. LMIC researchers will struggle to convince WHO that their efforts stand up to the IHME juggernaut 2/
I’ve been thinking about vaccination cards in the US a lot and am struggling to figure out what side to fall on. Cards are a huge part of monitoring and communication in LICs. Without them we’re really in a fog about vaccination coverage 1/
We haven’t got recent experience in the US, so this would be a new strategy and could go awry, leading to stigma and adverse consequences 2/
We also will need to document coverage, and in the absence of a centralized health delivery system in the US (e.g. MCA), a simple, low-tech solution like cards could make follow-up and monitoring of coverage much simpler to implement than trying to work with many providers 3/
Hey PSU folks — It’s come to my attention that there is a rumor circulating that I have tested positive for SARS-CoV-2 and am ill. Both are false. It is heartwarming to receive the well-wishes but I am fine 1/
It is also a moment to reflect on the fact that testing positive for a communicable infectious disease is not a condemnation of the individual. If anything, it reflects a failure of the public health infrastructure to prevent that outcome 2/
Now, as we stand at the edge of the COVID-19 vaccine era, this is more even more important to consider. We have always had (blunt) tools (w/ significant off-target consequences) to prevent people from getting sick. We will soon have better tools in the form of a vaccine 3/
A thing won't save us, systems will - a thread co-sponsored by @nitanother : A collective 2.5 decades of studying measles in LMICs has shown us that individual things (vaccines/tests/drones) are not sufficient to eradicate a virus nor provide for the health of populations 1/
Measles has had a highly effective vaccine for over 50 years; has had effective serological tests (with a meaningful correlate of immunity) for decades, but that has not been enough to eliminate a virus that kills 100s of children a day worldwide 2/
Individual things (technological solutions) are exciting and provide hope. We anxiously await their discovery, praise the discoverers. But things alone, without plans for scale-up, equitable distribution, and sustainability are operationally useless 3/