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

A health care worker administers a vaccine in Malawi.

Photo: Courtesy of Pfizer.

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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LGBT groups are saying that Facebook is endangering lives by advertising misleading medical information pertaining to HIV patients.

The tech giant's laissez-faire ad policy has already been accused of threatening democracy by providing a platform for false political ads, and now policy could be fostering a major public-health concern.

LGBT groups take on Facebook’s ad policy

According to LGBT advocates, for the past six months Facebook and Instagram users have been inundated with misleading ads about medication that prevents the transmission of HIV (PrEP), such as Truvada. The ads, which The Washington Post reports appear to have been purchased by personal-injury lawyers, claim that these medications threaten patients with serious side effects. According to LGBT organizations led by GLAAD, the ads have left some patients who are potentially at risk of contracting HIV scared to take preventative drugs, even though health officials and federal regulators say the drugs are safe.

LGBT groups like GLAAD, which regularly advises Facebook on LGBT issues, reached out to the company to have the ads taken down, saying they are false. Yet, the tech titan has refused to remove the content claiming that the ads fall within the parameters of its policy. Facebook spokeswoman Devon Kearns told The Post that the ads had not been rated false by independent fact-checkers, which include the Associated Press. But others are saying that Facebook's controversial approach to ads is creating a public-health crisis.

In an open letter to Facebook sent on Monday, GLAAD joined over 50 well-known LGBTQ groups including the Human Rights Campaign, the American Academy of HIV Medicine and the National Coalition for LGBT Health to publicly condemn the company for putting "real people's lives in imminent danger" by "convincing at-risk individuals to avoid PrEP, invariably leading to avoidable HIV infections."

What Facebook’s policy risks 

Of course, this is not the first time Facebook's policy has faced scrutiny when it comes to false or ambiguous information in its ads. Social media has been both a catalyst and conduit for the rapid-fire spread of misinformation to the world wide web. As lawmakers struggle to enforce order to cyberspace and its creations, Facebook has become a symbol of the threat the internet poses to our institutions and to public safety. For example, the company has refused to take down 2020 election ads, largely funded by the Trump campaign, that spew false information. For this reason, Facebook and other social media platforms present a serious risk to a fundamental necessity of American democracy, public access to truth.

But this latest scandal underlines how the misconstrued information that plagues the web can infect other, more intimate aspects of American lives. Facebook's handling of paid-for claims about the potential health risks of taking Truvada and other HIV medications threatens lives.

"Almost immediately we started hearing reports from front-line PrEP prescribers, clinics and public health officials around the country, saying we're beginning to hear from potential clients that they're scared of trying Truvada because they're seeing all these ads on their Facebook and Instagram feeds," said Peter Staley, a long-time AIDS activist who works with the PrEP4All Collaboration, to The Post.

Unregulated Surveillance Capitalism

To be fair, the distinction between true and false information can be muddy territory. Personal injury lawyers who represent HIV patients claim that the numbers show that the potential risks of medications such as Turvada and others that contain the ingredient antiretroviral tenofovir may exist. This is particularly of note when the medication is used as a treatment for those that already have HIV rather than prevention for those that do not. But the life-saving potential of the HIV medications are unequivocally real. The problem, as some LGBT advocates are claiming, is that the ads lacked vital nuance.

It also should be pointed out that Facebook has taken action against anti-vaccine content and other ads that pose threats to users. Still, the company's dubious policies clearly pose a big problem, and it has shown no signs of adjusting. But perhaps the underlying issue is the failure to regulate what social psychologist Shoshana Zuboff calls "surveillance capitalism" by which people's experiences, personal information, and characteristics become commodities. In this case, paid-for personal-injury legal ads that target users with certain, undisclosed characteristics. It's been said that you should be wary of what you get for free, because it means you've become the product. Facebook, after all, is a business with an end goal to maximize profits.

But why does a company have this kind of power over our lives? Americans and their legislators are ensnared in an existential predicament. Figure out how to regulate Facebook and be accused with endangering free speech, or leave the cyber business alone and risk the public's health going up for sale along with its government.

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