United Nations General Assembly: This is like the Super Bowl for global health advocates like me

And, some weekend reading for you

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The past few weeks (and this week) has been like the Super Bowl in the global health world (well, maybe just for me!) with the UN General Assembly. (Hence, this is the reason why I’ve only posted once this week.) I usually have the proceedings on a lot (my kids are now used to hearing people from all over the world talk about climate change, vaccines, global security, etc). In the era of the never-ending global pandemic, this year’s UNGA is doubly interesting.

This post is full of links to read this weekend on the complex issue of global vaccines. Happy reading! Ok, here we go.

In President Biden’s first address at the UN, he committed upping the number of vaccines by a whopping 500 million doses and urge other high-income countries to do the same. (Picture source)

President Biden stressed the fight to end the pandemic will require "a collective act of science and political will." (Check out the masks in the pictures above. Well done, countries! Well, most of them. Ugh.)

President Biden also hosted a virtual summit on COVID-19 during the UNGA week that pulled together country leaders, private sector groups, healthcare workers, and civil servants in LOTS of countries to talk about vaccine equity and what the world collectively can do. You can read his full statement here. But, I wanted to highlight some of the main points.

  1. “And as we [the globe] do so [work together to donate vaccines and combat the pandemic], we should unite around the world on a few principles: that we commit to donating, not selling — donating, not selling, doses to low- and lower-income countries, and that the donations come with no political strings attached; and that we support COVAX as the main distributor for sharing WHO-approved vaccines; and that we fight vaccine disinformation and exercise transparency to build vital public trust in these lifesaving tools….“Today, the United States is also announcing that we’re providing an additional $370 million to support administering these shots and delivery globally.  And we will be providing more than $380 million to assist in the Global Vaccine Alliance — GAVI — to further facilitate vaccine distribution in regions in the greatest — with the greatest need.”

    This is a big deal and comes after President Biden announced the additional half billion doses going to low-income countries in need. The big deal is they are going through COVAX. If you’ve followed me for any amount of time, you’ve heard me mention COVAX and several of you have signed the vaccine equity letters through COVAX and the WHO. The organization is co-led by major global health entities with a proven track record of global equity work including CEPIGavi and WHO, alongside key delivery partner UNICEF. In other words, COVAX is the powerhouse of vaccine equity distribution that has been incredibly underfunded in 2020. Thankfully, this is changing and they are getting some of the support and funding that’s needed.

  2. “We’re working with partner nations, pharmaceutical companies, and other manufacturers to increase their own capacity and capability to produce and manufacture safe and highly effective vaccines in their own countries.  For example, our Quad partnership with India, Japan, and Australia is on track to help produce at least 1 billion vaccine doses in India to boost the global supply by the end of 2022.”

    Let’s hear it for empowering and equipping countries for their own capacity! I asked my daughter how she would spend 1 million dollars at the UN (this is dinner-time table talk for the Smith fam - along with the latest episode of Lego Masters). And, part of her answer was equipping distribution and manufacturing of vaccines within countries. She also included transportation because she’s heard the stories about vaccines being transported painstakingly by boats on the Amazon and by foot in rural places in Africa. These healthworkers are heroes! But, we can do better in providing better transportation to remote areas of the world. Something as simple as transportation is an equity issue, isn’t it?

    And, President Biden agrees about the local production of vaccines. =) That is happening in several countries already with the goal of boosting production in other continents - including a large center in South Africa. This will also shift the power structure away from paternalistic, colonial views in global health that are deeply rooted - but, are slowly being turned over. In fact, more and more global leaders are working towards that shift and you can read about one of the leaders, Dr. Madhu Pai (one of my epidemiology heroes) here. He wrote a provocative and fantastic article on shifting away from individualistic/paternalistic global work (i.e., think colonialism) towards a collective identity.

    I want to end with Dr. Pai’s thoughts on the vaccine summit. In another great article, he wrote “charity and good intentions will not end the COVID-19 pandemic…vaccine charity is not vaccine justice…the problem with this charity-based approach is that rich nations have not delivered on what they already pledged. G7 countries have delivered only 14% of the total vaccine doses they had promised, according to the chief economist of the International Monetary Fund.

    Vaccination numbers reveal the real story. Although 6 billion vaccine doses have been administered globally, only 2% of people in low-income countries have received at least one dose. Several rich nations are offering third (booster) doses to their citizens, even as 3.5 billion people are waiting for their first dose. This will make it even harder for low- and middle-income countries (LMICs) to access vaccines.”

    When we look at the distribution of vaccines, we still have a long way to go. “Yesterday's summit was an important moment to galvanize and reset the global Covid-19 response,” said Elisha Dunn-Georgiou, President & CEO, Global Health Council. “That said, the necessary and immediate approach of donating vaccines will not be enough to end the pandemic. Charity alone is not sustainable and doesn’t help to achieve equity- not only in vaccine access, but in improved health systems and quality health care,” she emphasized.

    I would encourage you to read the links I provided - especially the ones from Dr. Pai on vaccine equity. We have to shift towards vaccine justice - not charity. This will take a worldview mindshift for many of us in high-income countries that have simply been ingrained with the individualistic ways of capitalism (y’all, don’t DM me and call me socialist. I know there’s good to capitalism. But, there’s also some not-so-good parts that are years of colonialism “us vs them” mentality which breeds inequity and continues to churn individualistic mindsets - rather than collective solidarity. Both here in the US and globally.)

    Isn’t this loving our global neighbors? Think back to the Good Samaritan story and who walked by the person in need. And, those who didn’t. That’s an equity story.

    Ok, I’m going back to watching the live UN proceedings. If you want to join, you can go here. You can also follow Samatha Powers - the current director of USAID and former UN ambassador (if I could be anyone in the world when I grow up, it would be her.)

    And, if you want to read about my journey to the UN (and why we still need more women at the table there), go here.

    -FNE

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