Melissa Slogan

The Global Accountability Platform (COVID GAP) blog series. November 10, 2022 By Stephanie Stan Peru’s weak, fragmented, centralized health system hindered an effective COVID-19 response, especially in remote areas lacking infrastructure and adequate health services. The challenges particularly affected indigenous communities, which had a 3.18 times higher COVID-19 infection rate than Peru’s general population. Two-thirds of Peru’s indigenous communities lack a health post, leaving them without ready access to diagnostic tests, personal protective equipment such as masks, vaccination centers, and information on COVID-19 vaccines. In addition to inadequate infrastructure, interviews conducted in Summer 2022 through Duke’s Global Health Institute and the Duke Global Health Innovation Center identified cultural and geographic barriers to reaching Peru’s indigenous populations with pandemic countermeasures. For example, participants described traveling multiple days by boat to provide vaccinations to Amazonian communities and facing cultural and religious hesitancy…

The Global Accountability Platform (COVID GAP) blog series. October 27, 2022 By Nellie Bristol While global health experts have long urged heightened attention and funding toward pandemic preparedness, COVID-19 showed the world remained woefully ill equipped. Lacking an established system to ensure medical countermeasures reached everyone everywhere, urgent ad hoc efforts were undertaken, leading to the establishment of the Access to COVID-19 Tools Accelerator (ACT-A). Led by the World Health Organization, Gavi, Wellcome Trust, the Gates Foundation, and other UN and global health organizations, ACT-A has raised $23.7 billion and aided distribution of more than 1.7 billion vaccine doses. Nonetheless, it has struggled to meet expectations centered around the ambitious goals of globally equitable distribution of vaccines, therapeutics and diagnostics, as well as enhancing health systems in low resources settings. According to an independent assessment, ensuring…

The Global Accountability Platform (COVID GAP) blog series. October 13, 2022 By Nellie Bristol The Africa Centres for Disease Control and Prevention Health Economics Programme (HEP) is fast tracking research on the cost effectiveness of oral therapeutics to ensure data are available for decision makers as more of the drugs become available across the continent, HEP Acting Head Justice Nonvignon said in an October 7 interview with COVID GAP. While purchases of oral therapeutics remain low or nonexistent in low- and middle-income countries, including those in Africa, several efforts are under way to increase availability. Among those are a memorandum of understanding between Africa CDC and Pfizer to make Paxlovid available on the continent at cost and test-and-treat programs, including the Duke-associated COVID Treatment Quick Start Consortium and a USAID supported…

The Global Accountability Platform (COVID GAP) blog series. September 30, 2022 By Nellie Bristol Under COVID-19’s current course, yearly vaccination focused on high risk populations is most likely to prevent the most hospitalizations and deaths and prove more cost effective than aiming for regular full population immunization, Professor Azra Ghani of Imperial College said September 29. Speaking at a webinar hosted by the Andean Health Organization, Ghani cited mathematical modeling data showing the largest decreases in hospitalizations and deaths derived from providing annual boosters to those over 75. Additional benefit was seen in annual boosters for those over 60. While more frequent vaccination was considered, Ghani said, “We don’t see so much benefit in moving to six monthly vaccines,” she said. “That’s partly because we don’t see too much of a…

The Global Accountability Platform (COVID GAP) blog series. September 15, 2022 By Nellie Bristol   Ten countries in sub-Saharan Africa and Southeast Asia will partner with a new public-private collaboration to scale up COVID-19 test and treat operations for high risk populations, the COVID Treatment Quick Start Consortium announced September 7. Working with an initial donation of 100,000 doses of Paxlovid from Pfizer, the consortium aims to integrate the program into long term systems that will offer a range of antivirals, including generic versions as they become available. When administered within five days of symptom onset, Paxlovid has been shown to significantly reduce hospitalization rates and deaths from COVID among patients 65 and older, regardless of vaccine status or prior infection. Older individuals, along with health workers, the immunocompromised, and those…

The Global Accountability Platform (COVID GAP) blog series. August 31, 2022 By Nellie Bristol   Infectious disease physician and Duke Professor Paul Pronyk remembers watching helplessly in the late 1990s as HIV-exposed patients entered a clinic in South Africa where he could not provide the quick diagnoses required to begin treatment. The availability of a new rapid test was a game changer, he said, allowing clinicians to immediately determine patient status and offer treatments to HIV-positive pregnant women to protect their babies. Now, as head of the newly established Duke-National University of Singapore (NUS) Medical School Centre for Outbreak Preparedness, he sees the possibility of similar breakthroughs on a wider scale in South and Southeast Asia. “I’ve never been so excited about the potential for things to transform in a very fundamental…

The Global Accountability Platform (COVID GAP) blog series. August 18, 2022 By Nellie Bristol While the world developed and distributed COVID-19 vaccines with unprecedented speed, the required emergency focus, coupled with response inequities and disruptions caused by the pandemic itself, took an enormous toll on health services. Health workers burned out, access to care fell, and childhood vaccinations suffered the largest sustained decline in 30 years. While the pandemic’s trajectory remains unknown, the latest wave appears to have peaked, creating space to consider how to incorporate COVID management into routine services, help health systems recover, and use lessons and resources to increase preparedness. To move toward those goals, the World Health Organization (WHO) and UNICEF are developing a document outlining considerations for incorporating COVID-19 vaccination into national immunization programs and primary care. Among priorities is helping…

The Global Accountability Platform (COVID GAP) blog series. August 11, 2022 By Katharine Olson and Nellie Bristol COVID-19 has disrupted clinical care and supply chains throughout the world, testing the resilience and flexibility of health systems everywhere. Services for those living with HIV/AIDS are no exception. UNAIDS’ “In Danger” report, released last week at the 24th International AIDS Conference (AIDS 2022), highlighted the devastating impacts the “multiple and overlapping” crises of the last two years have had on people living with and affected by HIV. New data included in the report show shrinking resources and growing inequalities that could result in millions of new infections and AIDS-related deaths if the current course is not reversed. Galvanized by the dire projections and using the lessons and innovations fostered by the pandemic itself, conference participants,…