Amy Maxmen, PhD Profile picture
Jul 13, 2022 12 tweets 9 min read Read on X
🚨My latest: An in-depth feature tackling global vaccine inequality🧵

1/ This is bigger than Covid. It’s about unsafe policies & practices ensuring that profit & power stays in the Global North.

It’s about what needs to change.

#longreads #CovidVaccine nature.com/immersive/d415…
2/ COVID demonstrated the folly of relying on goodwill & the West.

Nearly 80% of people in rich countries have been vaccinated & fewer than 20% in poor countries. This is cruel AND dumb. Economies are connected. Variants spread. nature.com/immersive/d415…
3/ Covid vaccine inequality is unjust but not surprising.

Years passed before HIV drugs were available in lower income countries. Decades passed before vaccines against pneumonia were available. Cancer treatments, monoclonal antibodies...people die in these delays.
4/ “Reliance on a few companies to supply global public goods is limiting & dangerous” said @Tedros as he launched an mRNA tech transfer hub w/ nodes in 15 nations.

My feature is about this collaborative solution, seeking to upend dependency. nature.com/immersive/d415…
5/ I visited the heart of the Hub in S. Africa #Afrigen, where researchers have developed a vaccine like Moderna’s & are teaching other companies in the global south how to do it.

But making mRNA vaccines turns out to be the easier part of this project…nature.com/immersive/d415…
6/ The truly hard part is overcoming IP barriers & a market tilted in favor of Big Pharma.

It’s not a coincidence that most of these companies are based in the same countries that pushed to expand global IP rules in the 90s. nature.com/immersive/d415…
7/ A hurdle that low&mid-income countries must overcome are IP rules #TRIPS, which S. Africa & India unsuccessfully tried to waive.

@JosephEStiglitz says that TRIPS serves corporate interests at the expense of the poor. Others call it a project in "maintaining global power".
8/ Broad, tightly-held IP may deter the Hub’s 15 companies in the global south.

(Moderna’s vaccine has already earned billions for the company & produced 3 billionaires, even though its development was largely paid for by the public.)

nature.com/immersive/d415…
@_HassanF says...
9/ Emerging companies in the global south will need governments & @gavi to buy their vaccines. It's worth a premium.

As the great @larrybrilliant told me: “Equity is often thought of as a burden, but it is a strategic need in the battle against pandemics”
nature.com/articles/d4158…
10/ An emerging narrative is that there's a surplus of vaccine, that countries don't use em & thus a push for global south manufacturing is moot.

Reader: It is not. For the real story, pls read my #longread, an investigation into global vaccine inequity.
nature.com/immersive/d415…
11/Thanks to ~70 (!) people I spoke with for this investigation; insightful editing & graphics @nature @bmaher @creditdesign; Travel 🙏🏽 to @PulitzerCenter, SA pics @samreinders; Malawi pics by wonderful @thokochikondi; Malawi translation by Prophet Duada (Prophet & Thoko ❤️👇🏽)
PS Thanks for this paper @__emh. I highlighted the crap out of it.

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More from @amymaxmen

Mar 18
🧵On this anniversary of the pandemic's start, I revisited horrors of early 2020. My hope is fading bc I don't see *any* big changes to protect us.

My latest piece on the CDC suggests the next pandemic will be worse. @KFFHealthNews / @NBCNews

nbcnews.com/health/health-…
Flashbacks to 2020. Remember nurses in garbage bags? Hospital & nursing home leadership told staff to forego N95s, pointing to CDC advice that they weren't warranted. >3,600 health workers died of Covid in 2020. Image
Flashback to 2020. Remember horrific outbreaks in nursing homes & prisons?

A lack of testing -- despite our enormous capacity for it -- meant outbreaks exploded. A lack of strong advice & regulation led to testimonials like this one, from a veterans' home. Image
Read 10 tweets
Sep 15, 2023
🧵My latest: Inequality becomes entrenched with each new booster rollout. Gone are the days of intensive vaccine campaigns.

“Urging people to get boosters has really only worked for Democrats, college graduates, and people making over $90,000 a year,” says @gregggonsalves
<55% of nursing home residents in several states got the last booster, no reason to expect rates to be different this time around.

<11% of incarcerated people in Minnesota go the last booster.

And gaping disparities between Black & white people are back. kffhealthnews.org/news/article/n…
In 2021, outreach included mobile vaccine sites & education. It worked. But ended.

Now the vaccines cost 4x more. @Maybarduk asks, “If these vaccines had been kept at the same price, what decisions would be made to expand the response?” kffhealthnews.org/news/article/n…
Read 4 tweets
May 10, 2023
🚨I've talked with dozens of experts & officials who worked on the pandemic response.

Here are 7 transformations that must happen if the US doesn't -- once again -- get utterly destroyed by a virus.

Not simple. This is real talk. 🧵
Mine @washingtonpost
washingtonpost.com/opinions/2023/…
1. Testing centers should remain everywhere, for HIV, for flu, etc. washingtonpost.com/opinions/2023/…
2.Set nurse-to-patient ratios in hospitals. The nurses we briefly cheered for are facing violence & burnout & leaving the profession, and we need them. washingtonpost.com/opinions/2023/…
Read 11 tweets
May 8, 2023
80% of women in US jails are mothers & nearly 60% of women in prisons. Many are the primary caretaker.

1.3 million people in the US have been separated from their mothers before age 18 due to their mothers’ imprisonment

So let's write about incarcerated moms but this is not it. Image
Ref to the NYT Holmes piece and prisonpolicy.org/blog/2022/05/0…
Biance Clayborne vs Elizabeth Holmes. "Devoted mothers" waiting for trial. ImageImage
Read 4 tweets
Mar 25, 2023
My 2c on the latest in Covid origins @PostOpinions

Genetic sequences from the Wuhan market can reveal so much, curbing baseless debates & accusations.

Ideally, China shares the data soon. But if not, I think the scientists on this week's report should. washingtonpost.com/opinions/2023/…
This week's analysis from @acritschristoph et al was exciting. It showed the potential of genetic data in this investigation. zenodo.org/record/7754299…

But their work needs to be verified by other scientists analyzing the raw data. And there's much more to be seen. eg 👇
It's not cool to suggest that one group of scientists should publish another scientists' data. But I am because of the import.

This morass highlights how badly the world needs to overhaul its system for sharing genetic data in a fast-moving pandemic.

washingtonpost.com/opinions/2023/…
Read 6 tweets
Mar 25, 2023
⭐️Essential, new study analyzes the natural experiment of Covid in the US: State by state comparison.

🧵of important findings on inequality, mandates & more.

From @TomBollyky @CFR_org et al @TheLancet thelancet.com/journals/lance…
High rates of Covid infection & death linked to states with:
-higher poverty
-more income inequality
-fewer yrs of education
-more people who are Black & Hispanic
-less healthcare
-more people who voted for Trump in 2020
thelancet.com/journals/lance…
Pathetic that many of these same factors drove disparities seen in tuberculosis & typhus in the 1800s.

Conclusions have been a fairer distribution of resources & labor protection. Alas. Du Bois politely called this blindspot a "peculiar indifference."
Read 7 tweets

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