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Seeing public health and vaccine equity through a local and global lens

Courtesy of Dr. Tapati Dutta
Dr. Tapati Dutta, PhD, MA, Assistant Professor of Public Health, Fort Lewis College

While the U.S. is advising citizens to get a third COVID-19 booster shot, global health experts are urging people to look at the equity of vaccine distribution.

Dr. Tapati Dutta is an Assistant Professor of Public Health at Fort Lewis College in Durango. We met with her to hear an international perspective on vaccines.

Note: Both Flower and Dutta were masked for this interview. They may sound muffled at times.

Interview transcript:

Sarah Flower
Dr. Dutta, as a professor at Fort Lewis College, how has COVID-19 in this pandemic, changed the way in which you teach students about public health from a global perspective?

Dr. Tapati Dutta
A very important question and yes, tremendously, because at one point, the good part is that you had a real example of policy and science are playing out in real times. So we have ready examples of whether we are explaining concepts like global collaborations for global health, or we are explaining concepts like what is the difference between endemic versus pandemic, versus epidemic.

So there COVID helps us with live examples. That said, this semester onwards, I am needing to redo many of my, not just syllabuses, contextualizing syllabuses, but also the content of it, but also the methodology to deliver it, because as you might be aware some of the students are taking classes online, some of the students are taking classes in person.

The third thing I guess, is teaching has become much more empathetic, much more understanding because all of us are going through the same thing. There's nothing like the divisions of sub-populations have been blurred. So if I need to explain it with an example, it is like as much as we are understanding that students go through these personal crisis, livelihood level crisis, the crisis of not being enabled enough with technology, those are the same realities which we as faculties are also going through, which does affect our concentration.

But the good thing which has happened, at least for me, what I see is much more empathy has built up, much more truthfulness and honesty to express vulnerabilities. Like I haven't traveled home, which is India for me, for three years now. Now, when I share that with students, it is not just expression or building of empathy and building of relationship. It's also very direct and live example to explain to them that how your mental status or the other social determinants of health affect your health situation or health crisis, personally, I think it has made us better humans than much more empathetic souls.

Sarah Flower
Boy that is not always the case and what you hear, especially in America, with the division and what's been happening politically, but that's why I brought you on here, Dr. Dutta is to talk about equity. I think you know, right now, the World Health Organization is talking about booster shots for the United States. There's so much out there for the United States. While the World Health Organization is saying please hold, let's pause that till we get more of the entire world vaccinated. What is the story look like from your perspective as a professor.

Dr. Tapati Dutta
First the aspect of equity. Unfortunately, when we talk of equality versus equity, equity means a person who needed, you give things as per the need of the person. So somebody who needs, more you give that person or that country more as compared to somebody else, so it's not equal distribution. Unfortunately, in vaccine, this distribution, we are still looking into the aspects of equality. Has every country got the vaccines, received the vaccines, which the case is very disparate out there. Whereas in the US, as of today, I guess, around 55 to 60% of people have been vaccinated.

There are several countries especially in the African subcontinent, where not a single dose of vaccines have even reached. So, there is a huge disparity when we talk about even the aspect of equity in the context of access. Now, access is not the only component of equity, equity means many other things. Equity means affordability. Equity means understanding things. Equity means access to knowledge, equity means having vaccine acceptance and not just acceptance at an individual level, but at a social level also. So here comes the change of the transformation which COVID has brought in as compared to previous immunization or vaccination programs which were going on or which are going on in all countries. Vaccine used to be an individual decision, a person decided whether he or she would be vaccinated and would vaccinate his or her children or not.

Vis-à-vis COVID is the scenario because of its transmissibility, it should rather become a social norm because somebody else's vaccination actually impacts how much of transmission is happening or how safe the other person is including family or other members, colleagues. So that shift or that transformation needs to happen from an individual decision for healthcare, to vaccination or immunization being a social norm. That transformation has not happened equally across the globe, that does affect equity.

Now, you also brought into the terms of booster dose. Wonderful, I would say a great advance in science for the first time we are seeing where science is really advancing in leaps and bounds. But then when we put it in the frame or in the canvas of equity, and some of the issues which you raised, which comes why because some people have not got it. Some countries don't even know about it. Some people are still grappling with do I pay for it? Or do I not pay for it? In that context, a concept of booster obviously now raises those eyebrows of why you why the U.S. why, where it is being manufactured, people are not getting it. Vis-à-vis where the African subcontinent, should it now start manufacturing its own vaccines.

The recent Lancet study, thus mentioned that booster dose for the Pfizer vaccine those who had been vaccinated, a booster dose of the same vaccine is available and it's most useful for immunocompromised people. There's a whole lot of confusion for even people who are having access to the booster dose whether I should or should not take. While whereas the global tug of war lies why you and why you getting a booster dose whereas there are at least 10 countries in the world where the first access to vaccine is envisaged only in 2023. As late as 2023. The first vaccine might come if at all, it comes. Populated countries like China and India are envisaged that they would be somewhat vaccinated to some extent because they are indigenously manufacturing the vaccines by 2022 beginning of 2023.

Sarah Flower
This has been a very insightful few minutes. I wish we had more time together Dr. Dutta. But I would like for you to close out of any final thoughts or things that we need to add in for our listeners today in terms of global health and global public health, no less.

Dr. Tapati Dutta
For local people, I would say this is the flu season coming up, the flu shots are there available free of cost. So people who are entitled people who have the access to it should get their flu shots at an individual level, I think very important for us to be empathetic for the bigger world in terms of global health, in terms of understanding that there are several people actually out there who do not have the resources. Vaccines could be a bigger narrative, which is going on for some time now.

Very important, of course, but we need to also think about other things which might be affected: chronic diseases, immunization of children, education of children, especially primary school goers, that many students are reporting that they have forgotten simple concepts like addition and subtraction in math, or reading or foreign language. And with lack of digital technology there's no schooling actually happening. So I think it is future of children, future of people, lives, livelihoods. All of it put together a great opportunity to actually practice humanity, which we have been preaching all through.

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