News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

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Restoring Broken Human Deal  by Juan Garay 

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Rich Nation Hypocrisy Accelerating Global Heating

Climate change: A driver of increasing vector-borne disease transmission in non-endemic areas

Quakes do not kill people, bad buildings do

 

 

 

 

 

 

IN A NUTSHELL
Editor's Note

How can the present ‘broken deal’ within humanity and with nature be restored? With this in mind, this far-reaching reflection piece takes into most account the global political and economic governance failure, increasingly evident during the first two decades of the 21st century, as the root, driven by greed, cause of global human injustice and nature destruction. And this occurs at a time when unempathetic (between humans and much lower with other forms of life), maniputaled and/or passive societies continue to play a negative role.

Against this backdrop, aside from implicitly advocating for decision makers worldwide to overturn the evidence that public interest almost regularly succumbs to the interest of the powerful, this analysis also suggests that a potential solution “lies in fostering a new societal paradigm rooted in empathetic local governance, ecosystem-friendly production and consumption of essential needs, and collaborative digital innovation to advance human knowledge and create global benefits”

By Juan Garay

Professor of Global Health Equity Ethics and Metrics in Spain (ENS), Mexico (UNAChiapas), and Cuba (ELAM, UCLV, and UNAH)

Co-founder of the Sustainable Health Equity movement

 Restoring Broken Human Deal

 

It appeared that the ending of the wars of the 20th century, referred to in China as “European” wars, led to a collective effort in establishing the United Nations, despite the devastating US nuclear bombing of Japan. However, one might argue that it was more of an arrangement among the victorious powers, centered around the Security Council’s authority, with the human rights charter serving as a superficial facade lacking enforceability. Historical evidence seems to support this perspective.

The post-war era saw a surge in global cooperation, centered on the US Marshall Plan and the interlinking of Western market economies. It also witnessed the formation of alliances among former adversaries in Europe and the emergence of independence movements in African nations, which were still under colonial subjugation. However, alongside these developments, the United States supported fascist regimes in the Americas and engaged in unsuccessful conflicts against communism in Asia and elsewhere. The Cold War intensified nuclear threats and polarized the world until the fall of the Berlin Wall. Meanwhile, China quietly pursued a strategy of combining global trade with communist single-party national development plans, resulting in the fastest GDP and life expectancy growth rates recorded (1). This approach represents one of the most successful blends of market and centralized economies in terms of human lifespan, albeit at the cost of restrictions on freedom and environmental degradation.

During the first two decades of the 21st century, the Cold War appeared to transition into a multipolar landscape, notably with the decline of Russia and the economic and geopolitical ascendance of China.

Meanwhile, humanity witnessed the diminishing impact of two major death tolls by the close of the 20th century: the AIDS pandemic (2) and the aftermath of the Soviet Union’s collapse (3). Globally, under-five and adult mortality rates decreased, and life expectancy continued its upward trajectory (4), increasing by approximately 0.5% annually. Concurrently, advancements in digital technology, particularly in understanding the human genome (5), as well as in applied technologies, nanotechnologies (6), and 3D protein mapping and engineering (7), pushed the boundaries of knowledge.

However, despite these advancements, the two primary global health challenges since the 1980s persisted: intra- and inter-generational inequities (sustainable equity) (8). The World Health Organization (WHO) continued to grapple with the elusive task of estimating inequities through inequalities across relevant stratifying variables (9), failing, even after 75 years, to adequately measure the only common health objective among nations (best feasible level of health) (10). Consequently, the burden of health inequity (11), representing the gap to the universality of the right to health, remained unmeasured.

Efforts to identify such a target faced challenges from UN development models (12) (with the best Human Development Indexes largely unreplicable and unsustainable), World Bank poverty thresholds (13) (falling short of enabling the aforementioned feasible health levels), and the OECD-DAC cooperation target of 0.7% from 1970, which stood at only 0.37% over 50 years later, in any case significantly below the redistribution rates necessary for economic equity and thus global health equity (14).

Why does such persistent reluctance exist to measure global health progress and challenge the persistence of anachronistic development, economic, and cooperation concepts?

While the transition from MDGs to SDGs aimed to standardize targets across all countries, bridging the gap between intra (MDGs and SDGs 1-11) and inter (SDGs 12-16, COP, and Biodiversity targets), and overcoming north-south polarization (15), it fell short of fully translating rhetoric into action, to put it diplomatically.

Meanwhile, global political and economic governance remained entrenched in the hands of the Security Council, dominated by World War II victors, and international financial institutions revolving around the US dollar, thus perpetuating US economic supremacy (16).

The low commitment to global fair governance does reflect the meager overall UN regular budget (17): less than 0.00002% of the world’s GDP. It is supplemented by ad hoc and earmarked funding primarily from Western development agencies and “philanthropy” linked to economic powers and vested interests. In the case of global health governance, under the World Health Assembly and the World Health Organization, regular contributions to the WHO’s budget do not reach 20% (18), with a growing influence of ad hoc contributions of mainly Western development agencies, philanthropic endowments or direct influence from pharmaceutical companies (19) whose profits primarily stem from patent monopolies (20).

Against this backdrop, Humanity grappled with three intertwined challenges: the economic speculative crisis of 2008-2010, the COVID-19 pandemic of 2020-2022, and ongoing conflicts in Ukraine and Gaza. Though seemingly disparate, these challenges share common roots that have hindered sustainable health equity progress since the 1980s and also contribute to the escalating existential threat of anthropogenic global warming:

1. Economic speculation, primarily driven by bargaining economic interests rather than creativity or production, has evolved into increasingly complex layers and holds greater power, particularly in the hands of massive asset managers (21). This system has been hoarding roughly 20-30% of GDP (22) and a significant portion of GDP growth over the past four decades, diverting resources away from global human justice and decoupling from global human wellbeing (23). Such speculative economy is a major part of what we earlier called “hoarding threshold” (24) and has been recently called “wasted GDP” (25). Furthermore, it exacerbates both economic intra (correlated with increasing GINI) and inter-generational (linked to climate change through global-scale production, trade, and consumption) inequity (26). Therefore, a more appropriate term for it would be “toxic GDP,” behaving akin to a cancer in the global economy and human harmony with nature. This dynamic continues to propel and dominate not only the global economy and lifestyles but also, linked to power-driven mass media and artificial intelligence, global human thinking. It perpetuates a biased economic governance that shields the primary speculative powers, often resulting in diminished or even nonexistent fiscal revenues (27). Western positions have opposed the development of a UN Tax Treaty aimed at addressing the unmentioned undermining effects of financial speculation (28).
2. The COVID pandemic exposed how global governance prioritizes capital over humanity. Despite significant scientific and economic investments in urgent global goods such as effective vaccines, the response was heavily biased in favor of big pharma, accelerating the rollout of their new patent-protected technologies, such as mRNA, (with remaining mid-long germ safety uncertainty) (29) primarily benefiting high-income countries and communities. This unequal access to vaccines exacerbated disparities and polarized humanity, reminiscent of the AIDS gap in the 1990s (30). In this instance, the disparity between those protected from the pandemic and those exposed correlates with individuals “working” behind screens, often closely associated with a speculative or toxic economy, versus those fulfilling essential needs such as food, water, energy, transportation, and vital public services. Global governance failed to establish binding frameworks for global goods, and exemptions to patent laws for public health purposes proved slow and ineffective, prioritizing profits over the health and lives of the majority (31).
3. Ongoing wars are related to a growing West-East and North-South divide and tension. The “north and west” has approximately one sixth of the world population, yet two thirds of the world’s GDP, of the military spending, of global carbon and ecological footprint and also two thirds of the veto power in the security council. Their oligarchic role in global economy and politics, as mentioned above, is progressively challenged (32). The most recent wars on Ucraine and Gaza, reflect reactions to the rupture of fragile balances of a NATO vs. Russia and its growing alliances with China, and the Arab league vs. Israel and its US Big brother. Western double standards (33) confronting Russia’s invasion while being supportive or complacent with Israel alleged genocide (34) undermine its former -at least intentional-multilateralism and human rights discourse. Meanwhile, the tension grows between the two major powers, the US and China, over the sovereignty of Taiwan (35), where also most chips (the neurons of global economy and communication) come from. Global political and military governance proved weak and biased as anachronic security council permanent members’ veto power (36) overruled the global cry to stop bombing innocent civilians, notably in Gaza.

The abovementioned crisis revealed an enhanced Humanity’s “broken deal”, unable to collectively limit toxic GDP and its impact on nature, develop global goods to confront increasing natural disasters and pandemics due to human’s destruction of nature and to prevent military, including nuclear threats, abuse by some. Economic, ecologic, knowledge, political and military global governance are either biased, void and/or broken.

As a result, human wellbeing, as gauged by life expectancy, dropped for the first time after the post war humankind (rhetoric?) deal (37) and is not picking up after the pandemic in many regions (38). Intragenerational health inequity, with a burden of some 16 million excess and unfair and preventable deaths per year remained high (39) while we expect comparable international demographic data to assess the post-pandemic trend in the present 2020-2025 period. The prospects of excess intergenerational mortality surpass 220 million excess deaths in the remains of the century, mainly in low polluting countries, communities and age groups (40).

These root causes of global human injustice and nature destruction have a common root: unempathetic (between humans and much lower with other forms of life), maniputaled and/or passive societies (41). The combination of economic, knowledge and military powers driven by greed, with passive and submissive societies fuels speculative and ecologically destructive global economic powers through blind consumption and savings, selfish protection of unfair individual, corporate and national privileges, unequitable access to what should be global public goods, and power market and media-driven voting, forced tax contributions to maintains the status quo and even military recruitment to kill unknown-others mandates by power greed far from the battlefields.

How can the present broken deal within Humanity and with nature, be restored?

If governments have proven incapable or unwilling to build human justice for the last 75 years, can individuals and societies roll back the rising intra and intergenerational gaps and restore the “broken deal”?

Interestingly, as biased governance frameworks interrelate so do the counter dynamics societies may put in motion. Enhanced conscience of our present largely collective blind consumption, savings, taxes and votes may trigger a new philosophy beyond anthroposophism towards biosophism, of simplicity, solidarity and respect for human and nature biodiversity (42).

Digital means can help know the individual (43) and collective economic (preventing toxic GDP/consumption) and ecological (preventing excess carbon and ecological footprint) ethical thresholds.

If “toxic GDP” shrinks and eventually collapses, political and military powers may follow.

A growing number, particularly among younger generations, seeks to break free from the relentless global urban rat race of excessive production and consumption (44, 45). A potential solution lies in fostering a new societal paradigm rooted in empathetic local governance, ecosystem-friendly production and consumption of essential needs, and collaborative digital innovation to advance human knowledge and create global benefits.

This transformative system could result in a significant reduction (around 40%) in GDP (considered as toxic share), while simultaneously narrowing the gap in inequality from the current international GINI coefficient of 0.6 and average national coefficient of 0.45 to a more equitable range between the thresholds of dignity and excess (below 0.15 GINI); while keeping carbon emissions and ecological footprints below ethical thresholds (approximately 1 metric ton and 1 hectare annually per capita, respectively). (39)

By ensuring that living standards exceed the dignity threshold (greater than $10 per person per day) (39) for all individuals and providing universal access to preventive and treatment services, as well as essential global goods such as life-saving knowledge, products, and devices, this approach could help achieve the elusive and often overlooked global health objective of attaining the best feasible level of health for all, thereby averting an estimated 16 million unjust deaths annually.

This global, peaceful revolution aimed at restoring sustainable equity has the potential to reverse the current troubling trends and steer humanity toward brighter horizons.

 

References

1)https://www.statista.com/statistics/1041350/life-expectancy-china-all-time/

2)https://www.unaids.org/en/resources/fact-sheet

3)https://academic.oup.com/book/10210/chapter/157873288

4)https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31833-0/fulltext

5)https://pubmed.ncbi.nlm.nih.gov/23284016/

6)https://www.iinano.org/frontiers/

7)https://deepmind.google/technologies/alphafold/

8)http://www.peah.it/2021/04/9658/

9)https://health-inequalities.eu/jwddb/who-health-equity-monitor/#:~:text=The%20WHO%20Health%20Equity%20Monitor,resources%20for%20health%20inequality%20monitoring.

10)https://treaties.un.org/doc/Treaties/1948/04/19480407%2010-51%20PM/Ch_IX_01p.pdf

11)https://www.peah.it/2015/10/understanding-measuring-and-acting-on-health-equity/

12)http://scielo.sld.cu/pdf/rnp/v18n36/1817-4078-rnp-18-36-87.pdf

13)https://www.binasss.sa.cr/eng.pdf

14)https://sdgpulse.unctad.org/development-financing/

15)https://www.undp.org/publications/transitioning-mdgs-sdgs

16)https://scholar.google.com/scholar?hl=fr&as_sdt=0%2C5&q=us+dollar+global.economic+governance+biased&btnG=#d=gs_qabs&t=1713263714000&u=%23p%3DK7uNOI1zKk8J

17)https://betterworldcampaign.org/resources/briefing-book-2022/united-nations-budget

18)https://www.who.int/about/funding

19)https://www.europarl.europa.eu/doceo/document/E-9-2020-002335_EN.html

20)https://www.sciencedirect.com/science/article/pii/S0954349X23000048

21)https://www.afr.com/companies/financial-services/how-asset-managers-came-to-rule-the-world-20230428-p5d3zk

22)https://www.investopedia.com/ask/answers/030515/what-percentage-global-economy-comprised-financial-services-sector.asp

23)https://www.epi.org/publication/charting-wage-stagnation/

24)https://www.sciencedirect.com/science/article/pii/S0033350617301610

25)https://www.nature.com/articles/s41599-023-02210-y

26)https://earth.org/gdp-climate-change/

27)https://www.cristianismeijusticia.net/sites/default/files/pdf/en170.pdf

28)https://taxjustice.net/press/un-adopts-plans-for-historic-tax-reform/

29)https://www.mdpi.com/1422-0067/24/2/1404

30)https://www.peah.it/2022/01/10563/

31)https://www.hrw.org/news/2023/04/19/proper-pandemic-treaty-would-value-universal-access-over-profit

32)https://geopoliticaleconomy.com/2024/02/26/western-dominance-ended-eu-josep-borrell/

33)https://mondediplo.com/2024/01/01editorial

34)https://news.un.org/en/story/2024/01/1145937

35)https://www.researchgate.net/publication/375000050_Will_the_US_and_China_Go_to_War_over_Taiwan

36)https://press.un.org/en/2022/ga12473.doc.htm

37)https://www.thinkglobalhealth.org/article/global-life-expectancy-declines-first-time-30-years

38)https://www.scientificamerican.com/article/why-life-expectancy-keeps-dropping-in-the-u-s-as-other-countries-bounce-back1/

39)http://www.peah.it/2021/04/9658/

40)https://www.peah.it/2018/07/5498/

41)https://journals.sagepub.com/doi/full/10.1177/0169796X211068451

42)https://www.peah.it/2023/12/12800/

43) https://g.co/kgs/MoYB7vQ

44)https://www.pas.va/content/dam/casinapioiv/pas/pdf-volumi/extra-series/es41pas-acta19pass.pdf

45)https://apnews.com/article/china-youth-lifestyle-nomad-thailand-086c064470a11365acfafbd4457ba166

 

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IN A NUTSHELL
Author's note
This article examines the impact of digital health on the management of infectious diseases, focusing on lessons learned during the COVID-19 pandemic. It highlights the rapid expansion of telemedicine and virtual consultations, as well as the crucial role of contact tracing applications in containing the spread of the virus. Additionally, it analyzes the use of big data and predictive analytics to understand and predict the dynamics of the pandemic. Future challenges and opportunities in the implementation of digital health solutions, as well as the importance of public education and awareness, are discussed. In conclusion, the transformative role of digital health in the global response to infectious diseases is acknowledged, emphasizing the need to continue learning and adapting to address future health crises

By Nicolás Castillo

 Biochemical. Private Laboratory Santa Clara de Saguier Sanatorium, Santa Fe, Argentina 

 Impact of Digital Health on the Management of Infectious Diseases

Lessons Learned during the COVID-19 Pandemic

 

 

Introduction

The COVID-19 pandemic has underscored the critical importance of digital health in the management of infectious diseases. In this context, telemedicine, contact tracing applications, big data analysis, and public education have emerged as fundamental pillars in combating the virus spread and ensuring continuity of medical care. This article examines the impact of digital health during the pandemic, highlighting lessons learned and outlining future directions for the management of infectious diseases.

Development

During the COVID-19 pandemic, telemedicine and virtual consultations became essential tools to ensure continuous access to medical care. The expansion of telemedicine allowed patients to receive medical attention without exposing themselves to the risk of contagion in clinical settings. This mode of care has not only proven effective in providing primary care and patient follow-up but has also promoted greater convenience and accessibility for users.

In parallel, contact tracing applications played a crucial role in containing COVID-19 outbreaks. These tools utilized geolocation and Bluetooth technology to identify and notify individuals who were exposed to the virus, thereby facilitating a rapid and effective response to mitigate virus spread. However, their effectiveness was hampered by challenges related to data privacy and widespread adoption by the population.

Big data analysis emerged as a powerful tool to understand the pandemic’s dynamics and guide public health interventions. By integrating epidemiological, mobility, and socioeconomic data, researchers could identify transmission patterns and anticipate virus spread, thereby informing decision-making on health policies. However, the collection and management of large volumes of data posed ethical and legal challenges, highlighting the need for robust safeguards to protect individuals’ privacy.

Public Education and Awareness

Digital health also played a crucial role in public education and awareness about COVID-19. Through online platforms and social media, accurate and updated information on preventive measures, symptoms of the disease, and access to health services was disseminated. However, the proliferation of online information also led to the spread of misinformation and conspiracy theories, underscoring the importance of promoting digital literacy and ensuring access to reliable sources of information.

Discussion

The COVID-19 pandemic has accelerated the adoption of digital health in the management of infectious diseases but has also revealed significant challenges that must be addressed to maximize its effectiveness. The digital divide, data privacy, and online misinformation are just some of the areas that require ongoing attention to ensure an equitable and effective response to future public health crises. At the same time, the pandemic has generated unprecedented momentum for innovation in digital health, offering opportunities to improve accessibility, efficiency, and equity in medical care. 

Conclusion

In conclusion, the COVID-19 pandemic has transformed the landscape of infectious disease management, highlighting the critical role of digital health in this area. By learning from the lessons of the pandemic and addressing outstanding challenges, we can harness the potential of digital health to strengthen preparedness and response to future health threats. It is essential to continue innovating and collaborating in the development of digital solutions that enhance the health and well-being of populations worldwide.

References

[PMID: 33053287] – Smith, A. C., Thomas, E., Snoswell, C. L., Haydon, H., Mehrotra, A., Clemensen, J., & Caffery, L. J. (2020). Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19). Journal of telemedicine and telecare, 26(5), 309-313.

[PMID: 32819220] – Hellewell, J., Abbott, S., Gimma, A., Bosse, N. I., Jarvis, C. I., Russell, T. W., … & Kucharski, A. J. (2020). Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts. The Lancet Global Health, 8(4), e488-e496.

[PMID: 33032487] – Ferretti, L., Wymant, C., Kendall, M., Zhao, L., Nurtay, A., Abeler-Dörner, L., … & Fraser, C. (2020). Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing. Science, 368(6491).

[PMID: 33046876] – Koonin, L. M., Hoots, B., Tsang, C. A., Leroy, Z., Farris, K., Jolly, B., … & Harris, A. M. (2020). Trends in the use of telehealth during the emergence of the COVID-19 pandemic—United States, January–March 2020. MMWR. Morbidity and Mortality Weekly Report, 69(43), 1595.

[PMID: 32354899] – Li, L., Xu, G., & Wang, H. (2020). Lessons from the experience in Wuhan to reduce risk of COVID-19 infection in patients undergoing long-term hemodialysis. Clinical Journal of the American Society of Nephrology, 15(5), 717-719.

[PMID: 33210924] – Joensen, L. E., Madsen, K. P., Holm, L., Nielsen, K. A., Rod, M. H., Petersen, A. A., … & Willaing, I. (2020). Diabetes and COVID-19: psychosocial consequences of the COVID-19 pandemic in people with diabetes in Denmark—what characterizes people with high levels of COVID-19-related worries? Diabet Med; 37(7): 1146-1154.

 

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IN A NUTSHELL
Author's note
This paper addresses the challenges faced in reaching Gray House children, residing in underserved areas such as urban slums and remote villages, during crucial vaccination campaigns. It discusses factors like vaccine hesitancy, logistical hurdles, and resistance to mandatory vaccination, proposing tailored communication strategies involving community engagement, influencer collaboration, and misinformation mitigation. Additionally, it emphasizes the significance of building trust, countering misinformation, and engaging diverse stakeholders to advance polio eradication efforts. The paper outlines strategies for effective communication, combating fake vaccination practices, and leveraging female influencers, providing a comprehensive framework for successful vaccination campaigns. It also presents a content framework, budget allocation strategy, and outreach plan, emphasizing adaptability and continuous improvement. Furthermore, the paper underscores the importance of evaluating campaign effectiveness and adjusting strategies accordingly to enhance vaccine uptake and accelerate progress towards polio eradication, promoting inclusivity, collaboration, and impact measurement

By Muhammad Noman

Healthcare System, CHIP Training and Consulting

Quetta, Balochistan Pakistan

Empowering Gray House Communities Towards Vaccination Efforts

 Navigating Fake Vaccination, Mobilizing Influencers, and Cultivating Trust

 

 

Introduction

In the pursuit of global health equity, Gray House children, residing in marginalized urban areas and remote villages, often face significant barriers to accessing vital healthcare services, including vaccinations against diseases like polio. Despite concerted efforts to eradicate polio, these children remain disproportionately affected due to socioeconomic factors and logistical challenges. Understanding the complex interplay of these factors is essential for designing targeted communication strategies to ensure that no child is left behind in the fight against polio. This paper explores the challenges faced in urban communities, the logistical hurdles of mobility, and the imperative for tailored communication strategies to effectively reach Gray House children. Additionally, it delves into the resistance to mandatory vaccination, the role of community leaders in dispelling misconceptions, and the necessity of countering fake vaccination practices. Through collaborative efforts and innovative communication approaches, stakeholders can move closer to the goal of polio eradication while safeguarding the health and well-being of vulnerable populations.

Understanding Gray House Children

Gray House children, residing in areas with limited healthcare access like urban slums and remote villages, are often overlooked in vaccination campaigns. Designing targeted communication strategies to reach them requires an understanding of the socioeconomic factors contributing to their invisibility.

Challenges in Urban Communities

Urban areas face a lack of awareness about polio vaccination importance, exacerbated by misinformation and rumours. This contributes to vaccine hesitancy, making it challenging to achieve high vaccination coverage.

Logistical Challenges of Mobility

The transient nature of urban populations poses logistical challenges for vaccination teams, resulting in missed opportunities for vaccination and gaps in coverage, especially among marginalized populations.

Tailored Communication Strategies

Engaging community leaders and utilizing mobile health clinics can facilitate dialogue and improve access to vaccination services in urban areas. Tailored communication strategies are crucial to ensuring that no child is left behind in the fight against polio.

Resistance to Mandatory Vaccination

Administrative pressure to administer polio doses sometimes leads to resistance among families in cities. Improved communication and trust-building efforts are necessary to address this reluctance and encourage participation in vaccination campaigns.

Engaging Community Leaders

Engaging with community leaders, religious figures, and influencers is vital to dispel misconceptions and build confidence in vaccination campaigns, ultimately encouraging families to participate willingly in immunization efforts.

Communication Challenges

Various obstacles hinder efforts to reach Gray House children and tackle fake vaccination concerns. These obstacles encompass language barriers, low literacy rates, and distrust in healthcare authorities, compounded by misinformation disseminated through social media and community networks. Cultural and religious beliefs also contribute to vaccine hesitancy, adding layers of complexity to communication endeavours.

Customized Communication Strategies

Effective engagement with Gray House children and the mitigation of fake vaccination concerns necessitate customized communication strategies. These strategies should address language barriers by utilizing multilingual materials and interpreters. Moreover, initiatives to enhance health literacy within communities, particularly in urban slums and remote areas, are imperative.

Building Trust and Countering Misinformation

Establishing trust in healthcare authorities through transparent and respectful communication is paramount. Simultaneously, countering misinformation with accurate and credible information is essential. Engaging religious leaders and community influencers to advocate for vaccination from a culturally sensitive perspective can help address underlying cultural and religious beliefs.

Moving Towards Polio Eradication

By addressing these communication challenges head-on, stakeholders can bolster vaccination uptake and advance toward the ultimate goal of polio eradication. Efforts to bridge communication gaps and foster trust within marginalized communities are integral to achieving success in immunization campaigns and safeguarding public health.

Strategies for Effective Communication

Effective communication strategies are essential for engaging with Gray House children and combating fake vaccination practices. These strategies should be culturally sensitive, community-driven, and inclusive of diverse stakeholders, including religious leaders, community influencers, and healthcare workers. Leveraging interpersonal communication, door-to-door outreach, and community mobilization efforts can help build trust and rapport with marginalized communities.

Engaging Community Influencers

Community influencers, including religious leaders, community elders, and local celebrities, wield significant influence in shaping public opinion and behavior, particularly concerning vaccination. Collaborating with these influencers can amplify pro-vaccination messages and combat misinformation within communities. Religious leaders, in particular, can leverage their authority to promote vaccination from a religious standpoint, addressing misconceptions and fostering vaccine acceptance among their followers. By involving a diverse array of influencers, stakeholders can effectively reach and mobilize communities to prioritize routine immunization, thereby advancing public health goals.

Healthcare Professionals as Influencers

Furthermore, healthcare professionals, such as child specialists, gynaecologists, and Lady Health Visitors (LHVs), serve as influential figures in promoting routine immunization. During check-ups, child specialists can educate families about the importance of vaccinations, addressing any concerns and emphasizing the health benefits for children. Similarly, gynaecologists and LHVs play crucial roles in educating pregnant women about vaccinations, including the Tetanus Toxoid (TT) injection and routine immunizations for their unborn child’s health. Leveraging the expertise and credibility of healthcare professionals as influencers can enhance awareness and uptake of vaccinations within communities.

Combatting Fake Vaccination Practices

Fake vaccination practices pose a grave threat to public health and undermine the integrity of polio eradication efforts. These practices encompass various deceitful tactics, such as falsifying vaccination records, distributing counterfeit vaccines, and coercing parents into refusing vaccination for their children. Addressing this issue demands a multifaceted approach that encompasses several key strategies.

Firstly, there is a pressing need to strengthen regulatory oversight to prevent the proliferation of fake vaccination schemes. This involves implementing stringent regulations and monitoring mechanisms to ensure the authenticity and safety of vaccines administered during vaccination campaigns.

Secondly, enhancing surveillance systems is paramount in detecting and responding to instances of fake vaccination promptly. Robust surveillance mechanisms can help identify areas or communities vulnerable to fake vaccination practices, allowing for targeted interventions and resource allocation.

Furthermore, promoting transparency and accountability within vaccination campaigns is essential for building public trust and confidence. Transparency in vaccine procurement, distribution, and administration processes can help dispel doubts and rumors surrounding vaccination efforts, while accountability mechanisms hold stakeholders accountable for their actions.

By implementing these strategies in tandem, stakeholders can effectively combat fake vaccination practices and safeguard the integrity of polio eradication initiatives, thereby ensuring the health and well-being of communities at risk.

Content Framework

Craft compelling messages emphasizing the importance of polio vaccination, addressing common misconceptions, and highlighting the benefits of immunization.

Budget Allocation

Allocate resources for influencer collaborations, content creation, and campaign monitoring, ensuring cost-effectiveness and maximum reach.

Identifying Influencers

Identifying influential figures within the community is crucial for effectively communicating vaccination messages and combating misinformation. Religious leaders, local celebrities, healthcare professionals, and community organizers are among the key influencers who can play a significant role in promoting vaccination. These influencers often have a wide reach and can effectively communicate the importance of vaccination to their followers and communities.

Religious leaders, in particular, hold significant influence over their congregations and can use their platform to dispel myths and misconceptions about vaccination. They can also emphasize the religious importance of protecting oneself and others from preventable diseases, aligning vaccination efforts with religious values and teachings.

Local celebrities are another influential group that can help promote vaccination. Their endorsement of vaccination can reach a broad audience and help counter misinformation spread through social media and other channels. Healthcare professionals, including doctors, nurses, and pharmacists, are trusted sources of information about vaccination and can provide accurate information to patients and communities.

Community organizers and leaders play a crucial role in mobilizing communities and raising awareness about vaccination campaigns. They can help identify and address barriers to vaccination, such as access issues or cultural beliefs, and ensure that vaccination efforts are inclusive and effective.

In addition to religious leaders and local celebrities, engaging female influencers such as teachers, lady doctors, and Lady Health Visitors (LHVs) can significantly impact vaccination uptake and combat misinformation. Female influencers hold unique positions of trust and authority within their communities, making them valuable assets in promoting vaccination campaigns.

Female teachers, as educators and role models, have direct access to children and their families. They can integrate vaccination messages into school curricula, conduct awareness sessions for parents, and address concerns about immunization in a familiar and trusted environment.

Lady doctors and healthcare professionals play a pivotal role in dispelling myths and fears surrounding vaccination. Their expertise and empathy enable them to address concerns effectively, provide accurate information, and encourage families to prioritize vaccination for their children’s health and well-being.

Lady Health Visitors (LHVs) are frontline healthcare workers who have established relationships with families in their communities. They provide essential maternal and child health services, making them trusted sources of information on vaccination. LHVs can conduct home visits, organize community events, and offer one-on-one counselling to promote vaccine acceptance and address any concerns or misconceptions.

Child specialists, including paediatricians and child psychologists, are also influential in promoting routine immunization. Their expertise in child health and development allows them to tailor vaccination messages to resonate with parents and caregivers. By emphasizing the benefits of vaccination for children’s long-term health and well-being, child specialists can motivate families to prioritize immunization.

Incorporating these influencers into vaccination campaigns can enhance community engagement, increase vaccine acceptance, and contribute to the success of polio eradication efforts by reaching marginalized populations effectively.

Outreach

Reach out to selected influencers with a clear proposal outlining the campaign objectives, content requirements, and expected outcomes. Ensure that influencers are aligned with the goals of the campaign and have credibility within their communities.

Launch Phase 1

Implement the initial influencer collaborations, monitoring key metrics such as reach, engagement, and audience response to gauge effectiveness.

Measuring Results

Analyze the impact of the campaign through metrics such as increased vaccination rates, community engagement, and changes in awareness and attitudes towards polio vaccination.

Launch Phase 2

Based on the success of initial collaborations, extend partnerships with influencers who demonstrate strong engagement and influence in their communities.

Adapt and Iterate

Continuously evaluate the campaign’s performance and refine strategies based on feedback and insights gathered from monitoring and evaluation activities. Adjust messaging and tactics as needed to optimize results and address emerging challenges.

Conclusion

In conclusion, addressing the challenges of vaccinating Gray House children in urban areas requires tailored communication strategies and engagement with community influencers. These children, often residing in marginalized communities, face obstacles such as misinformation, logistical challenges, and resistance to vaccination. By engaging religious leaders, healthcare professionals, and community organizers, stakeholders can build trust, dispel misconceptions, and enhance vaccine acceptance. Customized communication strategies, inclusive of diverse stakeholders, are essential for reaching these populations effectively. Moreover, combating fake vaccination practices demands regulatory oversight, surveillance enhancement, and transparency within vaccination campaigns. By leveraging the influence of key influencers and continuously refining communication approaches, stakeholders can advance toward the goal of polio eradication and safeguard public health.

 

LINKS OF INTEREST

   www.nhsrc.gov.pk

   www.polioeradication.org

https://dghs.punjab.gov.pk/extended_program_immunization   

   www.emro.who.int

   www.fda.gov

   www.immunize.org

   www.rotary.org

   www.cdc.gov

   www.vaccinetimes.com

   www.gatesfoundation.org

 

—

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IN A NUTSHELL
Author's note
…Outbreaks have costs to the health system, the family, and the patients. Vaccines are cheaper than the costs of epidemiological management, hospitalizations, etc. The support of the system is crucial for reaching protective coverages. Adequate planning, training, coordination, and especially sustained financing are crucial for a functional immunization program.

 By Francisco  Becerra-Posada, MD, MPH, DrPH

 Immunization Programs and Health Services

 

Most countries have a vaccination program that most probably started as an independent vertical program. There is enough discussion and evidence of the pros and cons of this kind of interventions. Some examples had a positive impact, as the smallpox eradication program, and others failed due to a lack of coordination.[1]

Either way, vertical programs do have to coordinate and use the health services. Health services, as part of the health system, are key for the success of any program. Immunization programs are not the exemption.

When managing immunization programs, coordination is essential for its success. From the planning stage to calculate the demand according to the cohorts, to the logistics and operational issues, it has to coordinate with many instances within the health system. If any of the different areas fails, vaccines do not get to the clinics and people are not vaccinated.

During the pandemic, many preventive programs, and actions, were not available due to closing of clinics, moving health personnel to clinical work to care for COVID-19 patients. However, in many countries’ vaccine coverages were not the desired ones to ensure protection to the population and a decrease of coverage was seen.

However, there are signs of recuperation. WHO states that from 18.1 million children that had zero doses in 2021, decreased to 14.3 million in 2022, close to the pre-pandemic value of 12.9 million in 2019. A slight increase, from 81% in 2021 to 83% in 2022 for measles vaccination, is still below the 2019 value of 86%. Vaccination against DPT (diphtheria, tetanus, and pertussis vaccine) recovered from 81 (2021) to 84% in 2022.[2]

Outbreaks, commonly in countries with weak immunization programs, are now being detected worldwide. There are various outbreaks worldwide and developed and high-income countries are reporting outbreaks. The US has recently reported measles outbreaks in various states.[3] Approaches to deal with them have varied, from very by the book approaches, to an unusual approach in Florida where health authorities diminished the problem.[4] Europe has recently reported a diphtheria outbreak with a focus on the Czech Republic and the first death by the disease since 1969.[5]

Health systems and services are important to ensure that vaccination programs are managed in and efficient and effective way. Cold chain has to be preserved and functional during the whole logistic chain, from the producer to the country, to the clinic, to the person’s arm. Vaccines have to be seen under a vision of life course. Health personnel, be it at the Primary Health Care setting to the specialized care, have a role to play as vaccine promotors. OB/GYN with pregnant women for influenza and diphtheria; internal medicine, cardiologist, pneumologist, with patients with hypertension, diabetes, obesity, should receive influenza vaccines on time.

Outbreaks have costs to the health system, the family, and the patients. Vaccines are cheaper than the costs of epidemiological management, hospitalizations, etc. The support of the system is crucial for reaching protective coverages. Adequate planning, training, coordination, and especially sustained financing are crucial for a functional immunization program.

 

References

[1] Cairncross S, Peries H, Cutts F; Vertical health programmes, Lancet 1999; 349 (supl III):20-22 https://doi.org/10.1016/S0140-6736(97)90079-9

[2] Vaccines and immunization, https://www.who.int/health-topics/vaccines-and-immunization#tab=tab_1

[3] Measles Cases and Outbreaks, CDC at https://www.cdc.gov/measles/cases-outbreaks.html

[4] Florida refuses to bar unvaccinated children from school suffering  a measles outbreak https://apnews.com/article/measles-outbreak-florida-school-ladapo-259440881f1d5e11dc69ed64ff055418

[5] Muerte por Difteria en Praga, república Checa. https://fundacionio.com/muerte-por-difteria-en-praga-republica-checa/ (in Spanish)

 

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