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Madhu Pai, MD, PhD

@paimadhu

12 Feb

On "clinical deserts" in global health:

Folks in global health often care about vaccinations, bed-nets, WASH & other public health measures.

This is important, but what communities first want is medical treatment for people who are sick.

Good projects address BOTH needs!

As Paul Farmer & other clinicians in global health point out:

"People, when they are sick, are not looking to be sprayed, controlled, counselled, told about bush meat... they are looking to survive, and when they see the quality of care is not good, they are going to flee"

Farmer uses Ebola in West Africa to illustrate how dominant this "control-over-care" paradigm is in the global health, and why it has its origins in colonial medicine. See my interview:

forbes.com/sites/madhukar…

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Madhu Pai, MD, PhD

@paimadhu

3 Jan

History lesson:

When anti-retrovirals were developed for HIV in the 90s, drug-makers had no interest in Africa ("not a lucrative market") & ART was unaffordable.

Zidovudine was marketed at a price of US$8000 per year!

We are seeing the same lack of pharma interest in providing affordable #COVID19 vaccines for Africa

bloomberg.com/news/articles/…

After a lot of global advocacy, widespread access to affordable ARVs became feasible after Cipla, a generics Indian manufacturer offered triple therapy for less than a dollar a day.

Full story here: …balizationandhealth.biomedcentral.com/articles/10.11…

Read 8 tweets

Madhu Pai, MD, PhD

@paimadhu

2 Dec 20

Just finished teaching my online global health course!

Some reflections & lessons

Because it was online, I invited speakers from around the world - a HUGE change from the past and the single most impactful change.

75% of course faculty were Black, Indigenous or POC

LMIC faculty lit up the course with their authenticity, credibility & lived experience!

Other changes that worked well:

- Began with colonialism lectures
- Sessions on privilege, anti-oppression, anti-racism and allyship
- Content on power asymmetry in global health & decolonizing GH

Read 10 tweets

Madhu Pai, MD, PhD

@paimadhu

13 Oct 20

In my global health course today, we will cover pandemics.

My summary of the major lessons from #COVID19 (so far):

1. Something like #COVID19 was expected, but countries were not prepared (despite all the post-Ebola commissions)

2. Global governance is fragmented and failing

3. WHO's response is under review & findings must be used to strengthen the agency

4. US is no longer a credible leader in global health

5. Nationalism & isolationism have become amplified during the pandemic

6. Countries suppress information & underplay the scale of the problem - not easy to hold them accountable

7. Science is under attack & infodemics are hard to fight

8. Political interference has greatly weakened public health agencies & experts

9. Bad leadership costs lives

Read 6 tweets

Madhu Pai, MD, PhD

@paimadhu

13 Sep 20

Thread on racism in #tuberculosis & global health.

I have been writing about power imbalance in global health.

Every aspect of global health is dominated by individuals, institutions and funders in HICs. Global health is neither global nor diverse.

forbes.com/sites/madhukar…

@apoorva_nyc

This NYT piece by @apoorva_nyc brought this discussion home to my own field of tuberculosis. It hits me hard because I know the people, and I served on the Board of @StopTB. I care about the agency & have given my time/expertise.

nytimes.com/2020/09/12/hea…

I respect the Board's independent investigation and look forward to the findings.

Whatever the outcome, it is critical to use this moment to reflect on the structural issues that make tuberculosis problematic. Otherwise, nothing will change.

Read 34 tweets

Madhu Pai, MD, PhD

@paimadhu

6 Aug 20

@GlobalHealthBMJ

Thread on 'global health degrees:

Ever wondered what a "Master's degree in Global Health" might cost you?

In our @GlobalHealthBMJ paper, by @svadzianita @av_Nathaly & @seyeabimbola, we identified 41 degree programs & estimated total tuition costs.

gh.bmj.com/content/bmjgh/…

Vast majority of such degree programs are in Europe & North America.

Across all 41 degree programs, the mean tuition fee was US $41,790 for international students and US $33,603 for domestic students.

This does NOT include living expenses, travel, healthcare or other costs.

Tuition was higher for international students, on-campus degrees, and in private schools. Even online degrees cost US $19353.

For US schools, the average tuition fee for all students was US $68,093. There was little difference between domestic and international student fees.

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