Inaugural Chair, Department of Global & Public Health
@McGill_SPGH
. Canada Research Chair in Epi & Global Health. Editor
@PLOSGPH
. Tweets: own views. He/him.
Dreams can come true
I fell in love with science as a kid
Growing up in a small town in 🇮🇳, I would long for science mags & books, even take 3 hr bus rides to a city to hunt them
40+ y later, I find myself in
@ScienceMagazine
&
@sciam
, 2 of the biggest science mags in the 🌎
Rich country problems:
- Vaccinate kids or not?
- Take Astra-Zeneca or not?
- Continue to mask or not?
- Travel again or not?
Rest of the world:
- Will we survive or not?
- When will we see any vaccines?
- Do our own leaders care?
- Does the world care?
20 yr ago, I received an email from a professor
@UCBerkeley
which changed my life.
It just said: OK, you're on.
I was puzzled. Found out later that he had agreed to supervise me & fund my PhD!
Today, I paid it forward & sent an email to a prospective student:
OK, you're on.
I have this growing anxiety that once people in North America & Europe get vaccinated, they will think the pandemic is over and forget about the rest of the world
Pandemic Gaslighting 101:
There's no pandemic, get back to work
It's a flu, get back to work
It's mild, get back to work
Kids are fine, get back to work
Take Ivermectin, get back to work
Economy is more important, get back to work
No need to test, get back to work
1/2
I am terrified that the anti-vax & anti-science lobby will derail years of progress we made in child vaccinations and pave the way for old infections like polio, measles and diphtheria to come back
How to NOT deal with a pandemic:
Big panic over a new variant that's not fully understood yet & punishing countries for reporting it
No panic over the 3+ billion people who've had little access to vaccines, tests & therapeutics
Privileged people in rich nations have no business declaring a global pandemic over
Not when 2.8 billion people are yet to get their first vaccine dose
Not when anti-viral drugs are so hard to access
Not when the virus keeps evolving (BA.2, 4, 5) & getting more transmissible
Reading a book which raises a tough question:
why do (many?) people in high income countries prefer to do global health work in low-income nations, rather than look uncomfortably inwards at inequities within our nations?
Treatments that are not proven & not routinely advised for COVID-19:
o Ivermectin
o Azithromycin
o Baricitinib
o Bevacizumab
o Convalescent Plasma
o Doxycycline
o Favipiravir
o Fluvoxamine
o Hydroxychloroquine
o Itolizumab
o Interferon alpha-2b
o 2-DG
The
#Hydroxychloroquine
story has some lessons for all of us:
1. If you are a researcher, don't oversell early results
2. If you are a journalist, don't hype the research
3. If you are a policy maker, don't make hasty decisions
4. If you are the public, listen to scientists
Even as some leaders are declaring the pandemic 'over,' spare a thought for 2.5 billion people who have not yet received a single shot of the Covid vaccine
“Pandemic of the unvaccinated” is actually two pandemics:
"Pandemic of people who choose to be unvaccinated"
"Pandemic of people who have no access to vaccines"
Solutions are different
Triple-vaccinated people in the global North are rushing to declare the pandemic over
when
ZERO (0%) of low-income country populations are triple-vaccinated
If you are double or triple vaccinated and are worried about
#Omicron
, spare a thought for the 3+ billion people who are still waiting for their first dose
Do more than spare a thought. Advocate for vaccine equity!
We (humankind) can fly a helicopter on Mars & land a probe on a comet.
But we cannot get
#COVID19
vaccines to all people in all countries?
We are never scientifically bankrupt. We are morally bankrupt.
You can’t make this up
Some Canadians are declining Moderna vaccines as boosters (they only want Pfizer)
Meanwhile, three in four African healthcare workers remain unvaccinated
From the annals of vaccine inequity:
12 year olds in high-income countries might get vaccinated in a few weeks/months
72 year olds in many low-income countries might not see a vaccine until 2022 or later
3.5 billion people in🌍 have not had a single Covid 💉
Meanwhile, rich nations are:
- throwing away expired vaccines
- giving booster shots
- offering lotteries to people who are hesitant
- hoarding doses for next year
𝙃𝙊𝙒 𝙒𝙄𝙇𝙇 𝙏𝙃𝙄𝙎 𝙋𝘼𝙉𝘿𝙀𝙈𝙄𝘾 𝙀𝙑𝙀𝙍 𝙀𝙉𝘿?
Don't need to isolate or rest, get back to work
Masks don't really work, get back to work
Pandemic is over, get back to work
We are moving on, get back work
Too late to vax the world, get back to work
We want our normal lives, so get back to work!
2/2
Who reads PhD theses?
True story: Before submitting, dude inserts $20 into the leather-bound thesis, which gets sent to univ. library.
20-yrs later, at his school reunion, dude visits the library.
Miracle
#1
: His thesis is still there
Miracle
#2
: the $20 bill is still there
Countries that are busy banning travel from 🇮🇳 should also be working out ways to help India during this massive humanitarian crisis
That is what global solidarity is all about
The shameful reality of global health
With this dismal level of
#COVID19
vaccine access, how can the African continent face the devastating Delta variant?
I'm truly blown away by some 'global health experts' who have absolutely no problems in advocating for 4th doses in rich nations, but say NOTHING about 2.8 billion people who have had zero doses
How 'global' is your 'global health'?
This is truly terrifying
The antivax movement might be focused on Covid right now, but they are coming after every single vaccine, even childhood vaccines that have saved millions of lives worldwide
Imagine a resurgence of polio, measles, whooping cough, childhood TB, etc!
We should not be seeing measles in 2024
We should not be seeing measles in 2024
We should not be seeing measles in 2024
We should not be seeing measles in 2024
We should not be seeing measles in 2024
#VaccinesWork
#Measles
Journal: Ready to submit your manuscript?
Me: Yup! (cracking my knuckles)
Journal: Do you have all these ready?
1. Your login details
2. Your ORCID ID
3. Manuscript
4. Each image as separate file
5. Cover letter
6. COI for each author
7. Author signatures for all
Seeing my mom after 2 years!
Thanks to the miracle of vaccines, she made it through the pandemic in 🇮🇳
All people everywhere deserve the same chance
#VaccinEquity
#VaccinesSaveLives
It would be so tragic if Canada allowed unused AstraZeneca Covid vaccines to expire, when there is time to send them to countries with a dire need right now
OMG! I just texted my high school chemistry teacher in India & asked him a question that my 12-yr old asked me.
He sent me this fully worked out solution. He is 72 & continues to be the amazing teacher he was 35 years ago!
#Respect
#teachers
Even as some of us are getting excited about not needing to use masks, the global pandemic is getting worse...
A pandemic ends when it ends everywhere. Let us all continue to advocate for vaccine equity & global solidarity.
Exciting news! Dr. Madhu Pai
@paimadhu
has been appointed as the inaugural Chair of the Department of Global and Public Health (DGPH), School of Population and Global Health (SPGH), Faculty of Medicine and Health Sciences (FMHS),
#McGill
University, effective Oct 1.
It's a "pandemic" when something bothers rich nations
It's "endemic" when it stops bothering rich nations but continues to ravage low-income countries (e.g. TB, malaria, cholera)
How will it go with Covid-19?
As India battles 3rd wave, I hope these drugs are not used for Covid:
Ivermectin, Azithromycin, Doxycycline, convalescent plasma, Hydroxychloroquine, Vit C & D, Zinc, Colchicine, Itolizumab, Bevacizumab, Lopinavir-Ritonavir, Interferon alpha-2b, Favipiravir
THEY DON'T WORK!!
The Delta variant is shredding past success stories to bits
Last year, Vietnam was a success story
Look at the trend now 👇🏾
Only 4% of the population has received 1 dose of 💉
Stunning visualization of Covid-19 vaccine inequity
Nearly all countries in Africa are at 2% or less coverage for a single dose
@MaxCRoser
@OurWorldInData
Everyone in public health:
We TOLD you:
1. To wash hands
2. Get vaccinated
3. Deliver universal health coverage
4. Do disease surveillance
5. Prepare for pandemics
6. Build solidarity, not walls
7. Invest in a stronger WHO
8. To not hide data
It took you a pandemic to wake up?
I wrote this while battling the Covid virus. Please read and comment!
How Many Variants And Deaths Are We Willing To Accept, Before We Protect The Whole World?
It has happened before with TB, malaria and AIDS
The Global North will 'move on' and the Global South will be left to deal with an 'endemic' killer infection
@NASAdoc
@Boghuma
@Fredros_Inc
& I wrote our first piece
@TheAtlantic
In my global health class today, I asked students: "What is global health?"
This answer grabbed my attention:
"Global health is dismantling systems of oppression to ensure equitable health for everyone"
I trained in medicine & public health for 15 years
Never took a course on POLITICS & its profound effect on health & determinants of health
Now learning the hard way because of Covid-19
The covid-19 crisis in India is a massive setback for the entire world.
India needs the global community’s support to survive this crisis.
My piece
@washingtonpost
with
@PrakashLab
Because of passport & visa privilege, global health meetings are becoming two-tiered:
Global North participants: in person, speaking, asking questions, socializing & networking
Global South: on Zoom, mostly off-camera, muted, asking questions via chat, or watching recordings
WOW!
This
#COVID19
guideline by DGHS
@MoHFW_INDIA
is what 🇮🇳 needs!
No antibiotics, anti-parasitic, plasma, Coronil, 2DG, Favipiravir & other unproven meds!
No routine CT scans!
O2, rational use of steroids, Remdesivir/Toci in specific, limited cases
2020: These were Covid success stories:
- Vietnam
- Thailand
- Australia
- Malaysia
- Taiwan
- Rwanda
- Kerala (🇮🇳)
2021: All are struggling!
Lessons:
1. Never declare success
2. Track variants
3. Maintain public health measures
4. Vaccinate, vaccinate, vaccinate!
If BA.5 is the worst variant of SARS-CoV2 we have ever seen, what happens to 80% of people in low-income countries that are unvaccinated?
We have failed to protect millions, even as the virus evolves and mutates...
A *pan*demic ('pan' means 'all') does NOT end when:
- I'm lucky enough to get 💉
- My country reaches high vaccine coverage
- When I can travel again
- When my kid(s) gets 💉
- When my family is safe
It ends, when it ends for ALL people on 🌍
Student interest in global health is at an all time high.
Student 'clubs' come up with these sorts of well-intentioned but dodgy ideas for 'global health missions' all the time:
If I were to teach an informal, free, online course on fundamentals of epidemiology for health & science journalists, would there be any takers?
Content would be a version of what I have at:
Israel ALSO bans travel from South Africa, Lesotho, Botswana, Zimbabwe, Mozambique, Namibia, Eswatini due to new “super” variant. This was our greatest fear & were almost prophetic in predicting that the world would eventually shut Africa out having denied us access to vaccines