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.
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.)
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.
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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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.
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.
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…
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/…
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."