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February 17, 2021

Global Health during the COVID-19 Pandemic: A Conversation with Dr. Bruce Gellin

By Jacqueline Christopher Waldman (C’24)

On Tuesday, February 9, 2021, Georgetown’s Conversations in Global Health class hosted Dr. Bruce Gellin, President of Global Immunization at the Sabin Vaccine Institute, to discuss the international response to the coronavirus pandemic. Dr. Gellin’s experience as the deputy assistant secretary for the Department of Health and Human Services' Health Program Office during the 2009 influenza pandemic makes his perspective invaluable when evaluating the global response to COVID-19. Over the course of the evening, Dr. Gellin shared his professional journey and provided insight into the successes of vaccine distribution, how to alleviate vaccine hesitancy, and the intersection of equity with the international response.

COVID-19 vaccines were developed during one-tenth of the time traditionally required for vaccine creation due to unprecedented collaboration between the public and private sectors. When asked about the current state of vaccine delivery, Dr. Gellin’s emphasis on communication and the balance between “speed and equity” highlights the necessity of a coordinated, balanced approach to resolving global health crises. His measured analysis and optimistic outlook demonstrate the importance of reflecting on what has worked during the distribution process when considering potential improvements.

When discussing individuals’ wariness towards receiving a vaccine, Dr. Gellin expressed the root of such hesitancy to be “more about the trust, than the misinformation.” I found this statement to be incredibly revealing of one of the greatest challenges facing global health. Vaccine hesitancy reflects something much deeper about people’s trust in the health care system. In order to gain such trust, Dr. Gellin explained that “health literacy is a part of it, but not the only part.” His commentary indicated the need for an approach that addresses the deeply rooted social factors that influence an individual’s decision against receiving a vaccine. Communication regarding vaccination is not one-size-fits-all and must consider the biases people may have in order to be convincing. I agree with Dr. Gellin that this socially-informed and community-based approach should be the new direction global health takes when addressing vaccine hesitancy.

Furthermore, Dr. Gellin expressed the importance of considering equity in vaccine distribution on both a national and global scale. He recounted from his experience during the H1N1 pandemic that higher-income nations struck contracts with vaccine producers, leaving lower-income nations only able to vaccinate small portions of their populations. This is not unlike what is happening now, as World Health Organization Director-General Tedros Adhanom described in his opening remarks at the 148th session of the Executive Board.

Yet, although more work must be done, Dr. Gellin explained that “we are doing much better than 10 years ago” in terms of equitable vaccine distribution because plans are being made to make contracts with nations who cannot forge contracts themselves. COVAX, a global effort to increase equitable access to COVID-19 vaccines, is leading this endeavor with a goal to “distribute two billion vaccine doses by the end of 2021.”

I agree with Dr. Gellin’s optimistic perspective that COVAX has potential to serve as a new institution that can increase vaccine equity worldwide. From our discussion, I was reminded of the necessity of reflection on current distribution efforts to ensure an effective and equitable approach to issues facing global health in the future.

Jacqueline Christopher Waldman (C’24) is an undergraduate with an anticipated double major in chemistry and government and a student in the Conversations in Global Health course.