Amy Maxmen, PhD Profile picture
Jul 13 12 tweets 9 min read
🚨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

May 10
Woo! Glad to see 40 yrs of evidence making its way into Senate hearing on abortion. 🧵

@SecYellen says research has shown that Roe had a favorable impact on the well-being of women & children & that denying access can deepen poverty. reuters.com/legal/litigati…
In October, I wrote about this body of evidence on abortion access, presented by >800 economists & researchers studying reproductive health & @PublicHealth.

They filed several briefs to the Court in advance of this case from Mississippi👇🏽 #RoeVWade nature.com/articles/d4158… ImageImage
Frighteningly, Justice Roberts disregarded evidence showing that abortion access has been important to women's lives & in the leaked draft decision, Justice Alito wrongly suggested that studies were inconclusive. nature.com/articles/d4158… ImageImage
Read 4 tweets
Mar 10
I read Paul Farmer's excellent work while writing his obit @Nature. Here's a 🧵 of some of lines I highlighted from his papers & books.

Feel free to add.

1. “What happens to poor people is never divorced from the actions of the powerful.”

nature.com/articles/d4158…
2. "Relying on the moral compass of companies that answer to shareholders to voluntarily license their technologies will have limited effect on vaccine equity. Their market is driven by profit margins, not public health."
3. “Given the 20th century’s market tendency toward increasing economic inequity in the face of economic growth, the future holds plenty of false charity...The charity & development models, though useful at times, are found wanting in rigorous and soul-searching examination..."
Read 11 tweets
Feb 24
🧵Why is Africa CDC asking for a pause in vaccine donations? It's not because of a lack of demand or because supplies are adequate.

1. Distribution requires $$$$ and humans. US vaccines didn't magically appear in pharmacies, stadiums & churches across the US.
2. Distribution requires massive logistics & planning. So, dumping millions of doses in random batches of donations, rather than a reliable supply, overwhelms the system. endpts.com/africa-cdc-to-… Image
3. Distribution requires communication. People are mistrustful around the world. The US government has supported a ton of outreach work. It's insufficient, but at least 65% of us are vaccinated.
Read 6 tweets
Dec 14, 2021
Vaccinated people w/breakthroughs probably transmit far less disease.
🧵Studies cited in a paper by @mlipsitch @florian_krammer et al.
-Lower viral loads in vax vs unvax
-Less household transmission from vax to unvax
-Contact tracing finds vax less likely to infect contacts
...
-Even when viral levels ARE similar in vax & unvax (per Ct), some studies suggest most virus shed by vax is non-viable & so less infectious.
-Boosters lower Delta virus levels in vaxxed breakthrough infectious.
-No strong word on Omicron YET
...
ref nature.com/articles/s4157…
Will I get a breakthrough infection? That's influenced by strength of immune response at moment of exposure, which is influenced by age etc, time since vaccine & type of exposure (eg mask, duration etc). Great graph nature.com/articles/s4157…:
Read 5 tweets
Dec 5, 2021
The Supreme Court is poised to ignore data presented by 1000+ scientists on the negative affects of abortion bans.

Chief Justice Roberts: "Well, putting the data aside"
I covered these studies by researchers, filed to the Court, on the importance of abortion access to people's lives, education, careers & economic stability.

Legal decisions aren't typically based on philosophical questions about when life begins...nature.com/articles/d4158…
But this Court features something new: 3 conservative justices appointed by Trump, after he & Pence vowed to overturn Roe.

Undermining this precedent will likely result in 22+ states banning abortion. nature.com/articles/d4158…
Read 10 tweets
Dec 2, 2021
Today the Supreme Court hears a case to overturn 50 yrs of Roe v Wade, which could result in 22 states banning abortion.

Mississippi argues women don't need abortion & it may harm them. These claims are not supported by data.

My piece:
nature.com/articles/d4158…
If the Supreme Court reverses 50yrs of Roe, economist @Caitlin_K_Myers estimates that 100,000 women in 22 states will be unable to get the abortions they seek each year because they cannot afford the time & cost of travel to the nearest clinic.
nature.com/articles/d4158…
Mississippi’s court filing claims that abortion access is unrelated to women's progress, isn’t necessary & may be harmful.

A filing in support says abortion led to the ‘feminization of poverty’ & ‘declining levels levels of happiness’.

Peer-reviewed data doesn't agree.
Read 7 tweets

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