Health care systems everywhere scrambled to respond to covid-19—it would be a waste if the new infrastructure isn’t kept running to handle other health needs, by way of a preventative, global adult-vaccination programme.

This could provide immunological coverage to soften the blow of future pandemics and address other disorders, from HIV and tuberculosis to obesity and heart disease.

Covid-19 has cost millions of lives and exposed weaknesses in public health care. We have a moral responsibility to learn from it, act and save others.

The pandemic has accelerated advances in vaccine development, manufacturing and delivery, as well as the build-out of technology systems, health centres and trained staff.

We can leverage this to initiate a vaccination campaign to fight infectious diseases and develop population-level immunity against respiratory diseases like influenza and pneumonia.

This could go beyond the traditional definition of a vaccine and include preventative and therapeutic injectables for HIV, cholesterol and blood-pressure management, contraception and other conditions.

As for the tools themselves, there is good news. Vaccine technology has progressed dramatically, in a revolution that began well before covid-19. Methods such as using RNA and adenovirus have made it much easier to develop new vaccines, and the evolution of adjuvants such as ASO1 (used in tuberculosis vaccines) and lipid nanoparticles mean that a new generation of tools will soon be available to tackle many of the most dangerous pathogens in the world.

For example, an annual injection of a medication based on small interfering RNA (siRNA) technology, called inclisiran, could reduce cholesterol. Similar siRNA compounds might be used to manage hypertension with an annual injection.

There are other long-acting, preventative injectable drugs, such as cabotegravir for HIV, and injectable birth control such as Depo-Provera. These interventions are preventative; equivalent to vaccines. They could be delivered by the same infrastructure as for covid-19.

Developing a global adult-vaccination programme out of the infrastructure built for covid-19 would be as profound a legacy for public health as the creation of the United Nations out of the ruins of the second world war was for international relations. It can prevent early death in millions of people each year and give better quality of life to many millions more, fueling stronger economies and societies. The world can emerge stronger and healthier for a relatively modest investment, provided we don’t waste this moment.

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He has a section that looks at confidence and incompetence.

There is a principal called the Dunning-Kruger effect in which a person who is incompetent is overly confident.

These persons are so incompetent that they do not recognize their own incompetence.

And they tend to surround themselves with underlings who praise them without being critical in any way.

And according to the Dunning-Kruger effect, these incompetent persons are overly confident.

The perfect job for them is politics.

Because as a politician they must appeal to the voters and seek and achieve approval that is mostly based on being overly confident.

And to really nail the approval, they might distort the truth somewhat to sell themselves to voters.

It is interesting to think of political leaders who have proven to be incompetent when stress tested by crises such as COVID 19 or economic failure of their economy.

Thanks Adam Grant for explaining the Dunning- Kruger effect to us.

Raymond Rupert patient advocate and part time health system disruptor.

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Hundreds of heads of state and global health leaders made an unprecedented commitment to work together to accelerate the development and production of new vaccines, tests and treatments for COVID-19 and assure equitable access worldwide.

“We will only halt COVID-19 through solidarity,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Countries, health partners, manufacturers, and the private sector must act together and ensure that the fruits of science and research can benefit everybody.”

Health leaders from the Coalition for Epidemic Preparedness Innovations (CEPI), GAVI-the Vaccine Alliance, the Global Fund, UNITAID, the Wellcome Trust, the International Red Cross and Red Crescent Movement (IFRC), the International Federation of Pharmaceutical Manufacturers (IFPMA), the Developing Countries Vaccine Manufacturers’ Network (DCVMN), and the International Generic and Biosimilar Medicines Association (IGBA) committed to come together, guided by a common vision of a planet protected from human suffering and the devastating social and economic consequences of COVID-19, to launch this groundbreaking collaboration.

They are joined by two Special Envoys: Ngozi Okonjo-Iweala, Gavi Board Chair and Sir Andrew Witty, former CEO of GlaxoSmithKline.

Gavi’s impact draws on the strengths of its core partners, the World Health Organization, UNICEF, the World Bank and the Bill & Melinda Gates Foundation, and plays a critical role in strengthening primary health care (PHC), bringing us closer to the Sustainable Development Goal (SDG) of Universal Health Coverage (UHC), ensuring that no one is left behind.

The fact that Canada, as a high income country, has entered into early contracts for preferred access to vaccines is being perceived to be two tier healthcare by the members of GAVI and the world community.

This is a wicked problem for the leaders in Canada as they exercise their duty to protect all Canadians.

We respect the challenge inherent in this wicked problem.

Raymond Rupert, patient advocate and healthcare consultant.

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