What it takes to get vaccines from the lab to the field
Pfizer's Susan Silbermann explains the superhuman effort involved in getting vaccines to the people who need them most.
SUSAN SILBERMANN: Community health workers play an important role for the health of women and their families. Often they're the connection to the health care system and they educate women about the importance of interventions like vaccines and family planning. They also provide important health care through models like integrated community case management that address nutrition, malaria, diarrhea, and pneumonia.
Now 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, there's no running water. Now 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 they 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 for the day in a cooler. She then works all day at the clinic administering these vaccines and seeing mothers, children, and babies. Without the dedication of health care workers like this one in Ghana, it's very likely that communities of children would not have the opportunity to be vaccinated.
As a global company, you'd expect that we'd have a great passion for innovating to discover new vaccines, and we do that. What you might not expect is that we're also truly passionate about innovating on our existing vaccines, both in the vaccine vial and in the packaging they arrive in. We do this based on learnings about the constraints that face the people we are trying so very hard to reach. So what does innovation look like? Well, I brought a vial to show you. This tiny vial is an incredible testament to scientific innovation. Until 2017, it provided one dose to vaccinate one child. But now, this vial provides four doses so we can vaccinate four children. By combining multiple doses into one vial we've reduced the storage space and the shipping requirements. Innovations like this will help make it easier to get vaccines to children everywhere.
Here is a startling fact: Sub-Saharan Africa bears nearly 25 percent of the disease burden in the whole world, and yet they only have three percent of global health care workers. So one of the things we feel is really critical is ensuring that health care workers are trained to administer vaccines. For example, 2017 was the first year that Pfizer's new multi-dose vial became available in Gavi countries. In order to ensure the health care workers were appropriate trained we partnered with AMP and the World Health Organization to develop a pneumococcal conjugate refresher course along with the training program on our multi-dose vial.
In partnership with WHO and our implementing partner AMP, we developed a "train the trainer" model for our new multi-dose vial. The train the trainer model allows country ownership by starting with a small group of health care workers who then become master trainers. Then, in turn, they train the next level of health care workers until the training reaches the most remote villages. The materials are all engaging and easy to understand. The training finishes with a required knowledge test.
We have to make sure that vaccines get to those who need them the most. I've 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? Or if the health care workers aren't able to administer a new version of our vaccine, like our multi-dose vial? So when our new multi-dose vial became available in Gavi countries in 2017 we trained 27,000 health care workers across 15 countries. And this year we expanded the program to an additional nine countries with the goal of reaching another 17,000 health care workers by the end of the year.
I firmly believe that strengthening global partnerships between public and private stakeholders is essential to providing a brighter and healthier future for all. It's why I'm so excited to see all the focus and commitment around Sustainable Development Goal number three—good health and wellbeing. One of the most impressive private-public partnerships working toward that goal is being spearheaded by Gavi, the Vaccine Alliance. Now Pfizer is very proud to be a part of this effort, which is working to speed up access to lifesaving vaccines which are delivered by the teams from UNICEF and local ministries of health care working on the ground.
Working with Gavi, we at Pfizer have been supplying millions of doses of our vaccines to help protect the world's most vulnerable children. This partnership opens the door to good health for more children, helping to prevent disease, especially in communities where health care systems are still developing.
- The United Nations Sustainable Development Goals (SDG) are a set of 17 directives to be completed by a 2030 deadline, with the aim of significantly improving quality of life for all people on Earth.
- Pfizer has made a commitment to SDG #3: Good health and well-being for all.
- Africa bears 25% of the world's disease burden yet has just 3% of the world's health workers. So how do you get life-saving vaccines to world's most vulnerable?
- Pfizer partners with several organizations to help strengthen the ability to deliver vaccines in developing countries. By training local healthcare workers we can remove some of the obstacles in getting a child vaccinated.
- Recent innovations in Pfizer's vaccine technology, like the multi-dose vial, have reduced shipping and storage space, which is critical as vaccines need to be transported and stored at very specific temperatures.
- Developing countries make record demand for life-saving vaccines ... ›
- Vaccine Delivery - Bill & Melinda Gates Foundation ›
- Life-saving vaccines becoming more accessible - VaccinesToday ›
What can 3D printing do for medicine? The "sky is the limit," says Northwell Health researcher Dr. Todd Goldstein.
- Medical professionals are currently using 3D printers to create prosthetics and patient-specific organ models that doctors can use to prepare for surgery.
- Eventually, scientists hope to print patient-specific organs that can be transplanted safely into the human body.
- Northwell Health, New York State's largest health care provider, is pioneering 3D printing in medicine in three key ways.
The 'People Map of the United States' zooms in on America's obsession with celebrity
- Replace city names with those of their most famous residents
- And you get a peculiar map of America's obsession with celebrity
- If you seek fame, become an actor, musician or athlete rather than a politician, entrepreneur or scientist
Chicagoland is Obamaland
Image: The Pudding
Chicagoland's celebrity constellation: dominated by Barack, but with plenty of room for the Belushis, Brandos and Capones of this world.
Seen from among the satellites, this map of the United States is populated by a remarkably diverse bunch of athletes, entertainers, entrepreneurs and other persons of repute (and disrepute).
The multitalented Dwayne Johnson, boxing legend Muhammad Ali and Apple co-founder Steve Jobs dominate the West Coast. Right down the middle, we find actors Chris Pratt and Jason Momoa, singer Elvis Presley and basketball player Shaquille O'Neal. The East Coast crew include wrestler John Cena, whistle-blower Edward Snowden, mass murderer Ted Bundy… and Dwayne Johnson, again.
The Rock pops up in both Hayward, CA and Southwest Ranches, FL, but he's not the only one to appear twice on the map. Wild West legend Wyatt Earp makes an appearance in both Deadwood, SD and Dodge City, KS.
How is that? This 'People's Map of the United States' replaces the names of cities with those of "their most Wikipedia'ed resident: people born in, lived in, or connected to a place."
‘Cincinnati, Birthplace of Charles Manson'
Image: The Pudding
Keys to the city, or lock 'em up and throw away the key? A city's most famous sons and daughters of a city aren't always the most favoured ones.
That definition allows people to appear in more than one locality. Dwayne Johnson was born in Hayward, has one of his houses in Southwest Ranches, and is famous enough to be the 'most Wikipedia'ed resident' for both localities.
Wyatt Earp was born in Monmouth, IL, but his reputation is closely associated with both Deadwood and Dodge City – although he's most famous for the Gunfight at the O.K. Corral, which took place in Tombstone, AZ. And yes, if you zoom in on that town in southern Arizona, there's Mr Earp again.
The data for this map was collected via the Wikipedia API (application programming interface) from the English-language Wikipedia for the period from July 2015 to May 2019.
The thousands of 'Notable People' sections in Wikipedia entries for cities and other places in the U.S. were scrubbed for the person with the most pageviews. No distinction was made between places of birth, residence or death. As the developers note, "people can 'be from' multiple places".
Pageviews are an impartial indicator of interest – it doesn't matter whether your claim to fame is horrific or honorific. As a result, this map provides a non-judgmental overview of America's obsession with celebrity.
Royals and (other) mortals
Image: The Pudding
There's also a UK version of the People Map – filled with last names like Neeson, Sheeran, Darwin and Churchill – and a few first names of monarchs.
Celebrity, it is often argued, is our age's version of the Greek pantheon, populated by dozens of major gods and thousands of minor ones, each an example of behaviours to emulate or avoid. This constellation of stars, famous and infamous, is more than a map of names. It's a window into America's soul.
But don't let that put you off. Zooming in on the map is entertaining enough: celebrities floating around in the ether are suddenly tied down to a pedestrian level, and to real geography. And it's fun to see the famous and the infamous rub shoulders, as it were.
Barack Obama owns Chicago, but the suburbs to the west of the city are dotted with a panoply of personalities, ranging from the criminal (Al Capone, Cicero) and the musical (John Prine, Maywood) to figures literary (Jonathan Franzen, Western Springs) and painterly (Ivan Albright, Warrenville), actorial (Harrison Ford, Park Ridge) and political (Eugene V. Debs, Elmhurst).
Freaks and angels
The People Map of the U.S. was inspired by the U.S.A. Song Map, substituting song titles for place names.
It would be interesting to compare 'the most Wikipedia'ed' sons and daughters of America's cities with the ones advertised at the city limits. When you're entering Aberdeen, WA, a sign invites you to 'come as you are', in homage to its most famous son, Kurt Cobain. It's a safe bet that Indian Hill, OH will make sure you know Neil Armstrong, first man on the moon, was one of theirs. But it's highly unlikely that Cincinnati, a bit further south, will make any noise about Charles Manson, local boy done bad.
Inevitably, the map also reveals some bitterly ironic neighbours, such as Ishi, the last of the Yahi tribe, captured near Oroville, CA. He died in 1916 as "the last wild Indian in North America". The most 'pageviewed' resident of nearby Colusa, CA is Byron de la Beckwith, Jr., the white supremacist convicted for the murder of Civil Rights activist Medgar Evers.
As a sampling of America's interests, this map teaches that those aiming for fame would do better to become actors, musicians or athletes rather than politicians, entrepreneurs or scientists. But also that celebrity is not limited to the big city lights of LA or New York. Even in deepest Dakota or flattest Kansas, the footlights of fame will find you. Whether that's good or bad? The pageviews don't judge...
Average waiting time for hitchhikers in Ireland: Less than 30 minutes. In southern Spain: More than 90 minutes.
- A popular means of transportation from the 1920s to the 1980s, hitchhiking has since fallen in disrepute.
- However, as this map shows, thumbing a ride still occupies a thriving niche – if at great geographic variance.
- In some countries and areas, you'll be off the street in no time. In other places, it's much harder to thumb your way from A to B.
Technology may soon grant us immortality, in a sense. Here's how.
- Through the Connectome Project we may soon be able to map the pathways of the entire human brain, including memories, and create computer programs that evoke the person the digitization is stemmed from.
- We age because errors build up in our cells — mitochondria to be exact.
- With CRISPR technology we may soon be able to edit out errors that build up as we age, and extend the human lifespan.
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