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A Nigerian Doctor’s Fight for Equitable Access to Vaccines

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A Nigerian Doctor’s Fight for Equitable Access to Vaccines

This interview is a part of our newest Girls and Management particular report, which highlights ladies making vital contributions to the main tales unfolding on this planet immediately. The dialog has been edited and condensed.


Dr. Ayoade Alakija, an infectious illness specialist primarily based in Nigeria, is co-chair of the African Union’s Vaccine Supply Alliance (AVDA). In December 2021, Dr. Alakija, nicknamed Yodi, was put in command of accelerating equitable entry to Covid-19 exams, therapies and vaccines for the World Well being Group’s international initiative often known as the Entry to Covid-19 Instruments Accelerator. She makes use of the time period “international north” to explain high-income nations and “international south” to explain low- and middle-income nations.

All through the pandemic you’ve got been essential about vaccine inequity, particularly in Africa. How did it really feel when the W.H.O. director-general Dr. Tedros Adhanom Ghebreyesus requested you to be particular envoy to the Entry to Covid-19 Instruments (ACT) Accelerator?

I had been one of the crucial essential voices at a number of the outputs of the ACT Accelerator. I had been agitator No. 1 for vaccine inequity. So my first thought was, “Oh my God, they are going to all hate me.”

It was a shake-up of the established order; a fox within the henhouse. When Tedros referred to as me to ask if I might do it, I mentioned, “Have you ever received the correct quantity?” After which I mentioned, “Oh, no, no, no.” So he requested me to consider it, saying, “Your voice is required, your steer is required.”

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I spoke to my husband, and he mentioned, “Yodi, you’ve got been on the forefront of claiming these of us from the worldwide south should be heard. They’ve invited you to that desk, you can not say no.”

Credit score…Alaye M

What does your position entail?

I function 16 to 18 hours a day, advising governments, well being ministers, finance ministers and the ACT Accelerator leads, coordinating with AVDA colleagues on vaccine shipments, deliveries and bottlenecks. There are additionally talking and media engagements I undertake to be able to advocate on the problem of vaccine fairness, and equitable entry to well being care instruments.

How can we obtain vaccine fairness?

Once we ascribe the identical worth to lives within the international south as we do to lives within the international north. We are able to solely obtain it once we don’t assume it’s OK for folks to be dying in Mombasa or in Kibera of illnesses that not exist in London or New York. Once we worth one another the identical. As a result of in the meanwhile there are those that are saying, “Oh, nicely, it’s not so dangerous in Africa. So perhaps we don’t actually need to vaccinate them. We’re not seeing the I.C.U.s being utterly overrun.” Nicely, that’s as a result of there aren’t any I.C.U.s. That’s as a result of there aren’t any well being facilities. That’s as a result of individuals are dying silently.

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You started your medical profession working with H.I.V. and AIDS sufferers, then determined to pursue your grasp’s diploma in public well being in your early 20s. Did you face any obstacles early in your profession?

Once I utilized to the London College of Hygiene and Tropical Medication to review public well being, I obtained a rejection letter saying, “This course tends to be for actually senior stage public servants, ministers or everlasting secretaries from totally different nations world wide. You might be very younger so we’re not accepting you on to this course.”

I used to be outraged. My husband and I have been residing in London on the time, so I marched into the college and demanded to see the dean, who on the time was Richard Feachem. I threw the letter on the desk and I mentioned, “What’s the that means of this? That is what I wish to do and I’m not leaving till I’m doing what I utilized to do.” He sat again in his chair and mentioned, “I actually stay up for the day you’re working the world.” He then directed me to somebody in admissions.

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You’ve been vocal in regards to the want for extra ladies in positions of energy in relation to the world’s Covid-19 response. How can we obtain that?

It has slapped me within the face a lot throughout this pandemic, the truth that the worldwide well being leaders are males. Lots of ladies are usually No. 2s, so that they don’t fairly have the decision-making energy, the voice.

I used to be at a convention in Rwanda, and there was a bunch of males who had invited themselves into this mentoring session that I used to be doing for younger ladies. They usually have been standing proper in entrance of the one desk within the room. So I tapped every on the shoulder and mentioned, “Excuse me.” They usually type of checked out me and mentioned dismissively, “Oh, yeah, hello.”

So I parted via them and I climbed on a chair, after which on a desk. The convention erupted. I received the mic and I mentioned, “Proper right here, that is what we’re speaking about. That even when you pull up a chair and also you type of get into the dialog politely, they take a look at you want, ‘eh?’”

So in the event that they don’t offer you a seat on the desk, pull up a chair. And in the event that they don’t make area, then get on the desk.

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Do you consider that Covid has disproportionately affected the lives of girls and ladies, particularly in Africa?

There may be one other silent pandemic happening right here with baby marriage — folks promoting off their daughters due to the financial influence of Covid. Folks can’t afford to feed their households, subsequently, it’s the ladies who must go.

Even for vaccines, the prioritization in communities signifies that if there are a couple of vaccines accessible within the nation, and individuals are prepared to go and get it, the person will go and get it. However the lady received’t.

How can we get extra vaccines in arms?

It isn’t so simple as hesitancy. Hesitancy is a operate of belief — belief in programs, belief in governments. There must be a extra common, extra constant, predictable provide of vaccines.

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We have now to additionally take a look at the broader strengthening of the well being programs. It must be a part of our supply of vaccines and our preparation for the following outbreak or the following pandemic or simply preparation for all times, actually.

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Video: Two Americans Are Awarded the Nobel Prize for Medicine

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Video: Two Americans Are Awarded the Nobel Prize for Medicine

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Two Americans Are Awarded the Nobel Prize for Medicine

Victor Ambros and Gary Ruvkun were awarded the Nobel Prize in Physiology or Medicine for their discovery of microRNA, which plays a role in organism development and gene regulation.

The Nobel Assembly at Karolinska Institutet has today decided to award the 2024 Nobel Prize in Physiology or Medicine jointly to Victor Ambros and Gary Ruvkun for the discovery of microRNA and its role in post-transcriptional gene regulation. Here are the two laureates.

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Sex, radiation and mummies: How farms are fighting a pesky almond moth without pesticides

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Sex, radiation and mummies: How farms are fighting a pesky almond moth without pesticides

In a windowless shack on the far outskirts of Fresno, an ominious red glow illuminates a lab filled with X-ray machines, shelves of glowing boxes, a quietly humming incubator and a miniature wind tunnel.

While the scene looks like something straight out of a sci-fi movie, its actually part of an experimental program to prevent a damaging almond pest from successfully mating.

A moth trap hangs from the branch of an almond tree.

(Gary Kazanjian / For The Times)

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With California almond growers reeling from dropping nut prices and rising costs, the pests have only added to their woes.

Every year, the navel orangeworm eats through roughly 2% of California’s almonds before they can make it to grocery store shelves. Last year, it was almost double that.

While that might seem small, if you do the math “it’s going to be a lot of millions of dollars lost to this pest,” said David Haviland, a Kern County farm advisor with University of California Agriculture and Natural Resources. “And that’s despite the control methods that people use,” he said.

California produces 80% of the world’s almonds, yet in 2022 the production value of the nut fell 34% compared with the previous year.

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Scientists say climate change could make the navel orangeworm problem even worse, with hotter temperatures allowing the moths to reproduce even faster. (Despite its name, the insect has largely left citrus farms unbothered and is in fact a moth.)

Traditionally, nut farmers have tackled the insect with chemical pesticides, or by destroying “mummies” — almonds left over after harvest. Mummies are a favorite winter shelter for the bugs.

However, research is increasingly showing that chemical pesticides are not only harmful to the environment but to people as well. One new study found that the impact of nearby pesticide use on cancer incidence “may rival that of smoking.”

“When you have to don a spacesuit, basically, to apply something, you’re definitely thinking, ‘This is not good,’” said Houston Wilson, an entomologist with UC ANR’s Kearney Agricultural Research and Extension Center and the mastermind behind the sci-fi shack.

“Across the board, folks want to get away from chemical controls,” he said.

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So farmers and researchers have been searching for other non-pesticide alternatives.

Removing almost every last mummy from every tree in an orchard can be effective, but since it must be done manually, it can become too expensive and complex for some growers.

Another tactic that’s been used since around 2010 is to cover orchards with disorienting levels of sex pheromones to confuse horny moths — a technique known as “mating disruption.”

But with limited budgets and climate change threatening to make the pest situation worse, researchers are studying another yet-to-be-proven approach: sterilizing almost a million moths a day with radiation and dropping them out of planes.

Houston Wilson looks over trapped moths at the Kearney Agricultural Research and Extension Center in Parlier, Calif.

Houston Wilson looks over trapped moths at the Kearney Agricultural Research and Extension Center in Parlier, Calif.

(Gary Kazanjian / For The Times)

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The idea behind the technique is that by flooding orchards with sterilized insects, they will mate with fertile insects and produce no offspring, reducing the overall population.

The simplest way to sterilize the bugs is to use radiation. Since their reproductive genes tend to mutate faster, the right dose can leave them relatively unfazed but unable to reproduce.

At the request of almond and pistachio farmers, the California Department of Food and Agriculture has been working with the Animal and Plant Health Inspection Service of the U.S. Department of Agriculture since 2018 to source sterilized moths from a Phoenix lab.

An X-ray machine designed to sterilize moths is shown at the Kearney Agricultural Research and Extension Center.

An X-ray machine designed to sterilize moths is shown at the Kearney Agricultural Research and Extension Center.

(Gary Kazanjian / For The Times)

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The lab sterilizes about 750,000 bugs per day, then chills the moths to put them to sleep and ships them off to California. The bugs are dropped from an airplane hundreds of feet in the air. Often too sleepy to fly, the insects crash into the hard ground or almond trees.

From there, the survivors have only one job: have sex.

Through this test program, the USDA hopes to perfect the best ways to get moths to reproduce in the lab and give them the right dose of radiation that will sterilize them but not severely injure or disorient them.

The program has yet to put a significant dent in the moth population, though, because they can’t produce enough sterile bugs.

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Right now, researchers are only finding a couple of sterile insects in traps for every hundred wild fertile moths. For the technique to be effective, they’ll need to deploy dozens of sterile bugs for every wild one.

Anisa Bel Guzman counts moths at the Kearney Agricultural Research and Extension Center in Parlier, Calif.

Anisa Bel Guzman counts moths at the Kearney Agricultural Research and Extension Center in Parlier, Calif.

(Gary Kazanjian / For The Times)

Matthew Aubuchon, national policy manager at the USDA’s Animal and Plant Health Inspection Service, estimated that the Phoenix facility could produce up to 8 million moths per day with enough staff working around the clock.

While opening more facilities in California would help, the program uses cobalt to produce high-energy radiation to sterilize the bugs — which is expensive and requires the lab to take extensive safety and security measures.

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Wilson’s sci-fi shack at Kearney might hold a solution that is cheaper and easier to scale.

Instead of using cobalt or other radioactive materials, Wilson’s team uses an X-ray machine to irradiate the pests. (Unlike a radioactive substance, an X-ray machine will not emit radiation when it is turned off.)

Then, the team puts their X-rayed bugs and the sterilized insects from Phoenix through a series of tests to determine which methods produce the healthiest, sterile moths.

The tests include gluing moths to the end of a stick suspended in the air. The stick rotates like a carousel as the moths flutter around and researchers record how well they can fly.

A red glow fills an insect wind tunnel.

Houston Wilson looks into an insect wind tunnel as researchers look for innovative ways to manage an invasive almond pest.

(Gary Kazanjian / For The Times)

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The researchers also place moths in a wind tunnel and release sex pheromones to see if the excited bugs are able to locate the smell. (Unfortunately for the insects, there are no potential mates at the end of the tunnel.)

While the team doesn’t yet produce enough X-rayed moths to test them in a full-blown almond orchard, they do send the Phoenix moths into their final test: releasing them into their seven-acre almond farm on the Kearney campus to see how good they are at actually finding fertile moths to mate with.

Houston Wilson looks over a navel orangeworm trap in an almond field in Parlier.

Houston Wilson looks over a navel orangeworm trap in an almond field in Parlier.

(Gary Kazanjian / For The Times)

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The researchers at Kearney may be in a race against time, however.

Scientists say it’s possible that climate change will continue to tip the weather in the moths’ favor. The metabolism of navel orangeworms — like many agricultural pests — is tied to temperature. The hotter it is, the faster they grow and reproduce.

A 2021 study found that the moths, which can have life cycles as short as just one month, may be able to squeeze in another generation each summer before holing up in nuts for the winter.

“For each additional generation, their population is increasing at an exponential rate,” said Tapan Pathak, an author on the study and a professor at UC Merced.

“If this additional generation is coinciding with … harvest,” Pathak said, “then they become unmarketable. That’s a huge economic loss.”

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However, the food web is complicated, and just because the warmer weather benefits the moths on paper doesn’t mean the moths will end up on top.

A closeup of an almond growing on a tree branch.

Every year, navel orangeworms eat through roughly 2% of California’s almonds before they can make it to grocery store shelves.

(Gary Kazanjian / For The Times)

“Navel orangeworm could be a nightmare … but it could also become less of a problem because all the things that eat it benefit more from the heat than the navel orangeworm,” said Haviland. “The crystal ball is certainly not clear enough to know what will happen.”

Researchers stress that successful pest control will require multiple measures.

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“What we’ve learned through integrated pest management is that the timing of one or staggering of different approaches together yields results for the growers,” said Aubuchon.

The tried-and-true non-pesticide method growers have been using since the moths’ unannounced arrival in the 1940s is to simply ensure all the almonds are either harvested or destroyed by the time winter arrives.

But for this method to be effective, there must be no more than two almonds left on every tree in an orchard. This can be hard to achieve in wet weather.

Rain makes almond branches soggy and flexible, which makes it hard to snap nuts off using an industrial shaker. Damp earth can also make it difficult for machines to get close to the trees.

Instead, workers must use poles to knock almonds off manually. As effective as this is, increasing labor costs mean some farms just can’t afford it.

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Anisa Bel Guzman counts moths at the Kearney Agricultural Research and Extension Center in Parlier.

Anisa Bel Guzman counts moths at the Kearney Agricultural Research and Extension Center in Parlier.

(Gary Kazanjian / For The Times)

While researchers say the sterile insect technique still has a lot of hurdles to clear before it will be widely effective, they say it holds great promise.

“You’re literally managing a pest by preventing it from being born in the first place,” said Haviland of both sterile insect technique and pheromone mating disruption. “To think that something like that was possible 10 or 15 years ago — nobody could imagine that growers would be using such innovative techniques as those.”

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The Tijuana River smells so bad, the CDC is coming to investigate

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The Tijuana River smells so bad, the CDC is coming to investigate

San Diego County residents will have an opportunity to share their pollution concerns about the Tijuana River when officials from the Centers for Disease Control and Prevention arrive later this month to conduct a health survey.

This is the first time that a federal agency is investigating the potential harm caused by millions of gallons of raw sewage pouring through the Tijuana River that have caused beach closures of more than 1,000 days. Residents living near the river say they have been suffering unexplained illnesses, including gastrointestinal issues and chronic breathing problems, because of the stench of hydrogen sulfide.

“We’re continuing to lean in and listen in on what our community residents are feeling,” said Dr. Seema Shah, the interim deputy public health officer with San Diego County. Supervisor Nora Vargas first wrote to the CDC back in May, formally asking the U.S. Department of Health and Human Services to look into the health complaints.

This week, the county began reaching out to thousands of residents to inform them that the CDC is coming in the hope that they will be more receptive to answering questions. “This is our chance to be able to communicate [pollution concerns] on a national level,” Shah added.

As part of what the CDC calls a Community Assessment for Public Health Emergency Response, 210 households will be surveyed about their mental and physical health, as well as the pollution’s effects on property values. The families will be randomly selected from 30 clusters of neighborhoods where San Diego County has identified air pollution complaints in the Tijuana River Valley.

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Around 30 officials from the CDC and 50 graduate student volunteers from San Diego State University’s School of Public Health will be going door to door to conduct interviews with local residents over a three-day period. Here are the times when the survey will be conducted:

  • Thursday, Oct. 17, 2024, from 2 p.m. to 7 p.m.
  • Friday, Oct. 18, 2024, from 2 p.m. to 7 p.m.
  • Saturday, Oct. 19, 2024, from 10 a.m. to 7 p.m.

The goal is to accommodate people’s schedules and, officials hope, catch them after work, Shah said. The volunteers are helping to bridge the language barriers with Spanish-speaking families.

“A lot of students, many of whom are bilingual, are from the community themselves,” said Paula Granados, an associate professor at San Diego State University’s School of Public Health, who’s been testing the Tijuana River for contaminants over the past month. “Our students are super excited. They want to help.”

The CDC could take weeks to months to release even the preliminary results from the survey, but for longtime residents like Bethany Case, this renewed attention already feels like a breath of hope.

“I just really want [this survey] to inform policy so that we don’t have to worry about our kids being sick,” said Case, the mother of two who’s lived in Imperial Beach for 16 years. For seven years she’s been an activist fighting to clean up the river as a volunteer with Surfrider, a nonprofit that works to preserve ocean access and cleanliness.

“I’m hoping that their survey shows that oftentimes it doesn’t just smell like sewage,” Case added. She doesn’t want the focus on the sewage to distract from the industrial waste that is dumped into the river that could be making people ill. “Oftentimes it smells like a chemical, it smells like a bite in the air, it burns your sinuses.”

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Granados said the CDC’s survey is only a snapshot of what was going on when the data were collected, and conditions could worsen for residents when rainy seasons flood the river once more. Granados wants residents to know that even if they aren’t picked to respond to this survey, SDSU will be conducting its own yearlong survey that they can answer multiple times at tjriver.sdsu.edu.

“There’s research that’s still ongoing,” Granados said, and all that data will help policy decisions in the future. “We’re just committed to the long haul, whatever it takes to support the community.”

The county and other federal and state representatives have been working to raise awareness around the pollution to a national level.

Next week, the San Diego County Board of Supervisors will consider a proposal by Supervisor Terra Lawson-Remer to petition the Environmental Protection Agency to label the Tijuana River a Superfund site in need of remediation.

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