How to vaccinate the world’s most vulnerable? Build global partnerships.

Pfizer's partnerships strengthen their ability to deliver vaccines in developing countries.

Susan Silbermann, Global President of Pfizer Vaccines, looks on as a health care worker administers a vaccine in Rwanda. Photo: Courtesy of Pfizer.
  • Community healthcare workers face many challenges in their work, including often traveling far distances to see their clients
  • Pfizer is helping to drive the UN's sustainable development goals through partnerships.
  • Pfizer partnered with AMP and the World Health Organization to develop a training program for healthcare workers.

Community healthcare workers are often the only point of contact with the health system in many underserved areas in the developing world. These noble public servants work within the community to bring health coverage closer to people who need it. Millions of babies around the world are at risk every day from vaccine preventable diseases and many of them live in very remote communities. This means that health care workers must sometimes travel long distances over mountains, across desserts and through rivers while carrying vaccine coolers.

These are some of the reasons why Pfizer is proud to partner with organizations that share a vision of increasing the health and well-being of children around the world. Susan Silbermann, Global President of Pfizer Vaccines, recently sat down with Big Think to discuss how the company is helping to improve vaccine access in developing countries.

Pfizer is helping to improve vaccine access

The constraints people face in other countries requires companies to develop more novel and innovative approaches to help improve vaccine access.

So the question for Pfizer was: Tell us what innovating a vaccine means to you?

Silbermann brought a vial to show Big Think what innovation looks like.

"This tiny vial is an incredible testament to scientific innovation. Until 2017, it provided one dose to vaccinate one child. But now it provides four doses and can vaccinate four children. By combining multiple doses into one vial we have reduced the storage space and the shipping requirements."

Innovations like this multi-dose vial are just the beginning of making it easier to get vaccines to children. Here are a few facts that Pfizer wants to help change.

  • Sub-saharan Africa bears nearly 25% of the disease burden in the world.
  • It only has 3% of the global health workers.
Pfizer feels it's critical to ensure more health care workers are trained on how to administer multi-dose vaccines.

The critical role of health care workers in the developing world

Photo: Courtesy of Pfizer.

A health care worker administers a vaccine in Malawi.

When Pfizer's new multi-dose vial (MDV) became available in 2017 in Gavi countries, it was a priority to ensure health care workers were properly trained. For this, Pfizer partnered up with the AMP and the World Health Organization to develop a pneumococcal conjugate refresher course and new training program for the multi-dose vial.

As part of the partnership program, Pfizer developed a "train the trainer" model that is a tiered system of training. For example, "master trainers" will go on to train the next round of health care workers.

Last year, Pfizer trained over 27,000 health care workers across 15 different countries. And this year, it's extended the program to an additional nine countries with the goal of reaching an additional 17,000 new health care workers by the end of the year.

A future dedicated to vaccine development

The overall impact vaccines are having on global public health are astounding. It's been estimated that vaccinations have prevented 26 million cases of childhood infections in the last decade alone.

Right behind clean water, immunizations are the most important health investment we have. Pfizer employees are passionate about vaccine development because they know it will translate into a tremendous public health impact.

Once logistical barriers and other obstacles are overcome, Pfizer believes that we will be working toward building a better future in communities around the world. One the best ways to remove barriers is through working with and supporting partners.

Why partnerships matter

Pfizer supports many projects that work to empower and equip community health workers. It recognizes that supporting health care workers is a critical part of achieving universal health coverage.

Silbermann talked with Big Think about making sure vaccines get to where they are needed.

"We have to make sure that vaccines get to those who need it. I have often said that our job doesn't end when we make a vaccine and ship it to a distribution center. What good is a vaccine if it isn't reaching the people who need it the most?"

Pfizer is a strategic partner of AMP Health (Aspen Management Partnership for Health), a cross sector, public private partnership to strengthen healthcare systems. AMP Health partners with Ministries of Health to help grow community health and immunization programs by providing leadership and management training and has worked in Ghana, Kenya, Malawi, Sierra Leone, and Zambia.

National governments in Sub-Saharan Africa are committed to deploying thousands of community health workers, but often don't have the strategic, managerial, or financial skills to run a large-scale program.

Pfizer believes that professional, supported community health workers play a critical role in reaching underserved populations and that partnering with organizations like AMP Health advances this objective.

The unsung heroes

Vaccines must stay refrigerated as they travel and be stored at very specific temperatures until they are used. Health care workers often worry about the vaccine refrigerators which can be old and if they were to break down the quality of the vaccines could be at risk.

Silbermann told us a story about how a healthcare worker in Ghana ensured vaccines were available in her clinic.

"Let me tell you a story about a healthcare worker in Ghana that we recently met. She works in a clinic in a small village in the Ho region of Ghana which is approximately three hours north of the capital. In her clinic, there is no electricity or running water. These two elements are critical to ensure safe and effective use of medicines. For example, vaccines need to be stored at a specific temperature to maintain their effectiveness and therefore are stored in fridges which are powered by electricity.

"Instead of storing the vaccines in her clinic, the healthcare worker travels one hour each way on the bus to get fresh vaccines and transport them in a cooler. She then works all day at the clinic administering these vaccines and seeing mothers, children and babies. Without the dedication of healthcare workers like this one in Ghana it is very likely that communities of children would not have the opportunity to be vaccinated."

Why is Pfizer so committed to vaccines?

Pfizer colleagues are passionate about vaccine development and innovation because they know it can translate into a tremendous public health impact. Immunization not only saves lives and improves health, it also unlocks the potential of a community—a vaccinated community is not only healthier, research has shown it is stronger and more productive.

Silbermann left us with this thought:

"When I think about the future, I know we can make a significant difference by ensuring that no logistical issue is an obstacle to a child getting vaccinated. But we can't do it alone. We need to work together to build on our experiences and capabilities to make the world a healthier place to live."

Here's what it takes to get vaccines from the lab to the field

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Your wardrobe won't be the only thing a bad diet will change in your life — new research published in Cell Metabolism shows that high-fat and high-carbohydrate diets physically change your brain and, correspondingly, your behavior. Anyone who has tried to change their diet can tell you that it's far more challenging than simply deciding to change. It could be because of the impact high-fat diets have on the hypothalamus.

Yale researcher Sabrina Diano and colleagues fed mice a high-fat, high-carb diet and found that the animals' hypothalamuses quickly became inflamed. This small portion of the brain release hormones that regulate many autonomic processes, including hunger. It appears that high-fat, high-carb diets create a vicious cycle, as this inflammation caused the mice to eat more and gain more weight.

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The main driver of this inflammation appeared to be how high-fat diets changed the mice's microglial cells. Along with other glial cells, microglia are a kind of cell found in the central nervous system (CNS), although they aren't neurons. Instead, they play a supporting role in the brain, providing structure, supplying nutrients, insulating neurons, and destroying pathogens. Microglia work as part of the CNS's immune system, seeking out and destroying foreign bodies as well as plaques and damaged neurons or synapses.

In just three days after being fed a high-fat diet, the mice's microglia activated, causing inflammation in the hypothalamus. As a result, the mice started to eat more and became obese. "We were intrigued by the fact that these are very fast changes that occur even before the body weight changes, and we wanted to understand the underlying cellular mechanism," said Diano.

In mice fed with a high-fat diet, the researchers found that the mitochondria of the microglia had shrunk. They suspected that a specific protein called Uncoupling Protein 2 (UCP2) was the likely culprit for this change, since it helps to regulate the amount of energy microglia use and tends to be highly expressed on activated microglia.

To test whether UCP2 was behind the hypothalamus inflammation, the researchers deleted the gene responsible for producing that protein in a group of mice. Then, they fed those mice the same high-fat diet. This time, however, the mice's microglia did not activate. As a result, they ate significantly less food and did not become obese.

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When human beings did not have reliable access to food, this kind of behavioral change would have been beneficial. If an ancient human stumbled across a high-fat, calorically dense meal, it would make sense for that individual to eat as much as they could, not knowing where it's next meal would come from.

But there were no Burger Kings during the Pleistocene. Humanity has been extraordinarily successful in changing its environment, but our genome has yet to catch up. The wide availability of food, and especially high-fat foods, means that this adaptation is no longer a benefit for us.

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