2021 - The Year of Public Health Politics

 It has been exactly one year since I reflected on the success of public health in 2020. As predicted, 2021 has come with its own successes in public health. However, unlike 2020, the year 2021 is a roller coaster for the momentous up-and-down on the successful roll-out of the COVID-19 vaccination and the lack of equity in the distribution and access to the same vaccines. I had hoped that by the end of 2021, the global effort to equitably distribute and access vaccines is successfully rolled out. But, this has not been achieved. 

At the start of the year is the happiness of new vaccines that could potentially shape the public health response to the pandemic. The happiness was short-lived by the complete disregard to science over politics throughout the United States and other parts of the globe. The United States saw the January 6 insurrection or the so-called attack on democracy which vehemently derailed the success of vaccine introduction. Then came the conspiracy theories of vaccine hesitancy and the consequent denial to take the vaccines by millions of Americans. With the denial came the expansion of the vaccine to young people aged 14 through 16. The move significantly increased the number of people with access to the vaccine as more than 8million people in this group received the vaccines.  

Whereas the United States and Europe were tooting success in their vaccine roll-out, where more than 65% of Americans are fully vaccinated (as of December 31, 2021), less than 20% of Africans have been fully vaccinated. This is because of the lack of access to the much-needed vaccines on the other side of the globe. The COVAX facility which was set up to improve vaccine access and equity across the globe falls short of promised doses by the manufacturers, mostly in American and Europe. The Biden Administration has promised almost 1 billion jabs to the global vaccine initiative, it has only delivered less than a quarter of that number. This is where I believe public health practice became "politics" health because of the lack of collaboration or solidarity in sharing the jabs with other less developed countries.  Thinking that sharing the vaccine with others who equally need it during an ongoing pandemic is instead a political decision over health equity. 

Whiles America and Europe were almost celebrating the end of the pandemic due to successful vaccination, a new variant of the coronavirus, called Omicron was isolated and sequenced in Botswana and South Africa. The successful scientific breakthrough by these scientists was instead met with political decisions to ban travels from these 6 African countries immediately. Clearly, this is a missed opportunity to celebrate public health practice and to demonstrate global solidarity in sharing early warning information of disease outbreaks. We saw how the delay in sharing critical outbreak information by China in 2019 led to a global pandemic as the world was ill-prepared to collectively deal with the outbreak. The fact that my Southern African colleagues took immediate action to report to the WHO allows for a coordinated response to managing the Omicron variant.  As of today, the Omicron variant is made up of more than 70% of infections in the United States. So, the question is, has the travel ban on the 6 countries achieved intended results? No! When politics and lack of solidarity are allowed to detect public health practices, we end up with unresponsive interventions to prevention, detection, and pandemic control. 

As we welcome 2022 in public health, I envision a world with solidarity with each other and a coordinated response to public health practice. With the good news of Omicron not severe in hospitalization and the effect of boosters for Moderna and Pfizer as well as the positive outcome of the result of J&J in South Africa, the world would be back to pre-pandemic normal by the end of June 2022. This is with the caveat that developed countries would see the need to share unused vaccines with other countries through the global vaccines initiative for the world to be fully vaccinated. Disease anywhere is disease everywhere and so we cannot count our chickens before the eggs are laid.

Happy New Year 2022!