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Tom Bollyky Profile picture
Tom Bollyky
@TomBollyky
Director of Global Health; Economics & Development @CFR_org. Founder @ThinkGlobalHlth. Law Prof sometimes. Dad (3x); book author (1x) @tbollyky@med-mastodon.com
Oct 29, 2021 • 23 tweets • 10 min read
Developing safe & effective vaccine faster in a pandemic?

Helps but benefits only nations that can manufacture

Ensuring every region can make + administer vaccines as fast as rich nations?

Priceless.

Here's how via @JHSPH_CHS @JenniferNuzzo & me et al
bit.ly/3EwEA5n The COVID-19 pandemic has highlighted some strengths and some significant gaps and weaknesses in this global pandemic R&D and response ecosystem 2/

centerforhealthsecurity.org/our-work/publi…
Sep 24, 2021 • 11 tweets • 6 min read
Countries have pledged to donate 1.9B COVID vaccines but delivered 1.1B

@samckiernan @serena_tohme combed govt websites, COVAX docs & media reports to identify the 61 nations that have pledged, where doses are going & which nations have yet to deliver 1/
thinkglobalhealth.org/article/billio… The US has most outstanding, but that is misleading as President Biden just this week added 500m to US total pledged donation by 1.1B COVID vaccine doses

Team Europe on the other hand...
2/
thinkglobalhealth.org/article/billio…
Jun 9, 2021 • 9 tweets • 6 min read
Maximizing potential benefit of vaccine donations depends on doses going where they can do the"most good" but there's no consensus on where that would be

Murray @IHME_UW @RCReinerJr & I propose an approach that prioritizes epidemiology over geopolitics 1/
thelancet.com/journals/lance… This week's summit in Cornwall, UK should be the time when G7 leaders finally act on their promises to send surplus COVID-19 vaccine supplies to the many other countries where they remain scarce #G7UK

But how will those vaccine donations be allocated? 2/
bloomberg.com/news/articles/…
Mar 27, 2021 • 8 tweets • 5 min read
Recent US pledge of 2.5 M vaccine doses to Mexico is notable:

-It's the largest single bilateral pledge of doses so far in this crisis

- It's going to a nation in great need

- It came from a democracy

Here's me in @TheAtlantic on why that matters 1/
theatlantic.com/ideas/archive/… So far, 14 countries have donated a total of 22.5 million doses to 97 nations

Most donations outside of Asia-Pacific have been too small (150k doses or less) to meet local or global demands

2/
 thinkglobalhealth.org/article/politi…
Jan 20, 2021 • 10 tweets • 6 min read
President-elect Biden has set a goal of vaccinating 100 million Americans (30% of the population) in 100 days.

It is an ambitious, achievable goal.

Here is what that will require, via @JenniferNuzzo, Sid Baccam @IEMNews, and me in the @nytimes 1/
nytimes.com/2021/01/20/opi… Primary constraint on vaccinating more Americans so far has not been supply

Despite production shortfalls, US still distributed close to enough doses to vaccinate average of 1M people daily

Bigger hurdles have been administration & demand 2/
covid.cdc.gov/covid-data-tra…
Dec 30, 2020 • 4 tweets • 2 min read
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…
Dec 29, 2020 • 7 tweets • 3 min read
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…
Nov 14, 2020 • 16 tweets • 7 min read
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/
Oct 23, 2020 • 15 tweets • 7 min read
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…
Oct 23, 2020 • 6 tweets • 5 min read
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-…
Oct 1, 2020 • 13 tweets • 6 min read
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…
Sep 17, 2020 • 7 tweets • 4 min read
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
Sep 15, 2020 • 5 tweets • 5 min read
#COVID19 has overwhelmed health systems & economies worldwide

But *if* remains at its current pace, it's unlikely to overtake cardiovascular disease, cancers, & other major NCDs as leading causes of death globally

New analysis @ThinkGlobalHlth @IHME_UW
thinkglobalhealth.org/article/just-h… Image The case is closer in high-income countries where #COVID19 is the *6th* leading cause of death 2/

thinkglobalhealth.org/article/just-h… Image
Jul 27, 2020 • 20 tweets • 9 min read
US officials compare #COVID19 vaccine allocation to oxygen masks dropping on depressurizing plane:

Put yours on first, then help others

Major difference, of course, is the oxygen masks do not drop only in 1st class but that's likely scenario on Covid vaccines

Unless we act 1/ Vaccine nationalism, or a “my country first” approach to COVID19, will have profound & far-reaching health, economic & political consequences

This thread is based on @ForeignAffairs article from @ChadBown & me on those consequences & how to avoid them 2/
foreignaffairs.com/articles/unite…
Jul 21, 2020 • 8 tweets • 3 min read
I am sorry you feel that way. I quoted you to try to give a fair representation of your piece. The original title and message of your piece as posted yesterday was this 1/
Image You made an unacknowledged change to that title today to include public health, which I am glad you did. I think it improves the piece 2/ Image
Jul 20, 2020 • 15 tweets • 7 min read
I am a fan of @MaxCRoser & @OurWorldInData, but this thread is misleading (at best)

Most of decline in mortality against infectious diseases in now wealthy nations occurred before widespread availability of antibiotics & development of most vaccines 1/
Our history does not show that we lost terribly to infectious diseases before most vaccines were developed

More importantly, we don't need to lose terribly to #COVID19 unless & until science delivers us a vaccine

It's important policymakers & public understand that 2/
Jul 1, 2020 • 18 tweets • 12 min read
6 months into #COVID19, our best measures of pandemic preparedness have not been correlated w/fewer deaths

In fact, nations w/higher JEE, GHSI, and #UHC scores have had *higher* death rates, even accounting for age structure & timing of 1st case

why? 1/ #COVID19 has revealed that we don't yet understand how best to measure countries' capacity to respond effectively to severe pandemic threats

this admittedly wonky thread is based on new @ThinkGlobalHlth post looking at JEE, GHSI & #UHC in this pandemic 2/
thinkglobalhealth.org/article/all-be…
May 19, 2020 • 15 tweets • 9 min read
There is not a lot new in the President's latest letter on @WHO handling of the #COVID19 pandemic, sent ahead of second day of #WHA73

But there are few items worth noting, and I will conclude with what I see as major takeaways 1/
Notably, letter doesn't rely on any of the theories about the virus's origins (lab safety accident, bioweapon etc) that Trump administration officials have pushed in recent months

If there was "enormous evidence" you'd expect to see it referenced here 2/
theguardian.com/world/2020/may…
May 18, 2020 • 6 tweets • 4 min read
A few important excerpts from the conference paper filed by EU & over 100 countries at #WHA73 1/

apps.who.int/gb/ebwha/pdf_f… As reported, includes call for independent review "at the earliest appropriate moment"

Focused on performance of IHR & WHO, rather than country actions (either China as original epicenter or role of individual country responses to #COVID19 incl. US) /2 apps.who.int/gb/ebwha/pdf_f… Image
May 16, 2020 • 14 tweets • 8 min read
Ahead of #WHA73, @ThinkGlobalHlth interviewed Taiwan Foreign Minister Wu on his country's success against #COVID19 & confrontation with @WHO.

It was a long, candid interview and worth reading in its entirety, but this thread is about WHO-specific bits 1/ thinkglobalhealth.org/article/corona… For context, Taiwanese officials in March indicated they had warned WHO about evidence of human to human transmission. Here is how a press report characterized that claim 2/
ft.com/content/2a70a0…
May 16, 2020 • 4 tweets • 1 min read
these are wonderful