Revolutions often go full circle, recreating circumstances that led to initial upheaval

For 2d time in 20 yrs world faces a treatment access crisis

1st crisis transformed #globalhealth but laid seeds for latest crisis over vaccines

My latest w/@ChadBown
foreignaffairs.com/articles/world…
20 yrs ago, crisis over AIDS drugs brought deep & lasting changes, pumping $$ into R&D of new meds & creating new institutions to deliver them

But it also shifted focus of #globalhealth 2/

foreignaffairs.com/articles/world…
Global health became less a/b cooperation among nations on common threats and more a/b aid-driven initiatives and public-private partnerships to solve the problems of *other* people—mostly in low-income countries 3/
Aid-driven institutions & partnerships have done enormous good delivering food, cash & AIDS drugs to world’s poor

But they have struggled against many of collective action problems that constitute world’s biggest health threats:

pandemic preparedness, climate change, NCDs 4/
Vaccine nationalism is another collective action problem that aid dollars and public-private partnerships cannot on their own resolve

If competition continues to trump cooperation on vaccines, a 20-year “age of miracles” in #globalhealth will have come full circle 5/
In this article, @ChadBown & I explore how incoming Biden administration can work with likeminded governments to resolve a key bottleneck in equitable global distribution of COVID-19 vaccines: scaling out vaccine manufacturing 6/

foreignaffairs.com/articles/world…
Only international cooperation on the basis of shared interests can mobilize the global manufacturing, trade, and delivery response that will end this public health crisis and help build a more resilient system for the future 7/7

foreignaffairs.com/articles/world…

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More from @TomBollyky

30 Dec
Good news! Vaccine is relatively cheap, easy to produce & store, well tolerated. 3B doses projected in 2021

Haven't seen submission or decision, but MHRA reportedly approved 2 dose regimen (62% effective) & is encouraging a 1-dose regimen to speed access
Results published in Lancet indicate say this a/b 1 dose regimen

It will be interesting to see public response and distribution strategy for regimen w/lower efficacy than Pfizer/Moderna options & uncertainty about duration of protection
thelancet.com/journals/lance… Image
Apparently, Oxford/AstraZeneca has not even filed a submission package with EMA yet. FDA decision isn't coming soon either.

This is such an important vaccine for global access and so much is strange about how its sponsors have pursued it
reuters.com/article/us-hea…
Read 4 tweets
14 Nov
Interim results on Pfizer vaccine are promising

But getting safe doses to those who would benefit most depends on reversing a trend that has defined this pandemic:

to quote Isaac Asimov, “science gathers knowledge faster than society gathers wisdom” 1/
theatlantic.com/ideas/archive/…
US #COVID19 hospitalizations & deaths are surging, and projections are ~200,000 more Americans will lose their lives to the virus before March

A safe vaccine could help shift that trajectory but only if we learn from past US failures distributing vaccines to adults 2/
According to recent analysis, 75% Americans would need to receive a vaccine that prevents at least 80% of infections for that vaccine to end #COVID19 pandemic on its own

(h/t @PeterHotez) 3/
ajpmonline.org/article/S0749-…
Read 16 tweets
23 Oct
Countries without government trust have performed badly in #COVID19, even when you account for differences in population age and size, and the timing of the pandemic

New analysis in @ForeignAffairs via @samckiernan, Sawyer Crosby @IHME_UW, and me 1/
foreignaffairs.com/articles/unite…
“Government exists to protect us from each other,” Reagan once said, but goes “beyond its limits . . . in deciding to protect us from ourselves”

When applied to pandemics, Reagan was wrong & so are policymakers, in esp. in US, who have adopted this view
foreignaffairs.com/articles/unite…
Confronted w/novel contagious virus, for which there's no effective treatment & no preexisting immunity, the only way to protect citizens from one another is by convincing them to protect themselves

Esp. in free societies that depends on trust between government and its people
Read 15 tweets
23 Oct
The most important lessons from #COVID19 are less about virus itself but what it has revealed about the political systems that have responded to it

@IlonaKickbusch & I were thrilled to guest edit a @bmj_latest series on preparing democracies for pandemics
bmj.com/democracy-and-…
The @bmj_latest series examines the mechanisms that might explain underperformance of democracies in #COVID19 crisis and proposes ideas to better “pandemic proof” this political system

The articles in series includes: 2/8
bmj.com/democracy-and-…
A commentary from @IlonaKickbusch & me on preparing democracies for pandemics 3/8:

bmj.com/content/371/bm…
Read 6 tweets
1 Oct
The U.S. 'early' travel ban wasn't early, it wasn't a ban, and it wasn't effective

Worse still, the widespread use of travel bans by US & others have made us less safe.

New in @washingtonpost on from @JenniferNuzzo & me 1/

washingtonpost.com/outlook/2020/1…
1. The US wasn't early

45 other countries implemented travel restrictions against China before US did on Feb. 2

At that point, US & 20+ other countries had already reported #COVID19 cases. Several were even reporting local transmission of cases 2/

thinkglobalhealth.org/article/travel…
Between the first official report of outbreak in China & announcement of U.S. travel restrictions, 40,000+ travelers from China are estimated to have entered United States 3/

nytimes.com/2020/04/04/us/…
Read 13 tweets
17 Sep
The WH decision to nix this USPS initiative to distribute 600m masks to at-risk states will be hard to defend

That especially true given the late March timing & what President now acknowledges he knew at that point regarding how deadly the #COVID19 is 1/

Introducing a WH-supported initiative to deliver 600M masks to at risk states could have meaningfully helped to reduce community transmission in late March

That was still before reported cases really took off nationally 2/ Image
And in #Louisiana, which this USPS mask initiative was meant to prioritize first 3/ Image
Read 7 tweets

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