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Globally, COVID is raging like never before, with more new cases reported during the past week than during any other week, including the post-Christmas peak. At least 80,000 people have died in the past week. Fewer than 10% of the global population has received a vaccination shot.
Locally, here in the US everybody 16+ is now eligible for shots and about half of those eligible have already received at least one shot. Cases have been climbing in some areas but in general we're well below the post-Christmas peak and daily deaths have been slowly declining.
I have family and friends who are planning multi-household gatherings for next month, I have fully-vaccinated coworkers who have resumed air travel to see family.
The only thing I've done differently so far is I've ridden a mostly empty Metro train twice. But I should be fully vaccinated by the end of this month, 2P+7 on April 29.
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There were a handful of countries that practically eradicated COVID before the vaccines came along via strict behavioral changes. Now there are a handful of countries that are blunting COVID by vaccinating large portions of their populations. And then there's the rest of the world -- unwilling or unable to eradicate the virus via behavior changes, and lacking sufficient doses to vaccinate most of their population. In this "rest of the world" COVID is rampaging at record levels as I type, overwhelming hospitals, morgues, and funeral services.
It reminds me of HIV, how in the US, UK, France, and other rich countries widespread access to PREP & HAART (at an annual cost of $10,000 - $20,000 per person) means young gay guys routinely forgo condoms when fucking strangers, while in other parts of the world HIV continues to spread at the rate of two million new cases per year. In much of the world, the annual retail price of PREP/HAART is at least dozen times their per capita GDP -- nobody could afford to buy it -- although the rich countries have pledged to donate a supply of these drugs to some poorer countries.
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Wide disparities in health budgets and outcomes are not new phenomena, and there are plenty of nonprofit efforts to send medical resources to poor countries, including a global effort to share COVID vaccines, although most COVID doses are going to the paying customers right now -- most donations of COVID vaccines will come after the rich countries have vaccinated their own citizens.
In the US there's plenty of press speculation about how later this year we'll switch over to COVID booster shots based on the more recent COVID variants, while much of the rest of the world won't even have received their first version 1.0 shots.
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Should a citizen of a rich country forgo top-quality medical care because poor countries can't afford it? As a practical matter, if I do not show up for my second Pfizer dose on Thursday morning, they're not going to ship that dose to another country, that dose will already have been thawed and will need to be put in somebody's arm soon.
If I were to forgo a CT scan for my kidney cysts, it's not like they're going to fly that scanner to a poor country and scan somebody there instead.
Like with a lot of global problems, individual acts of sacrifice won't necessarily help. I've argued this repeatedly about global warming, that cutting your own emissions won't have a measurable effect on the pace of climate change, that only concerted, enforceable, drastic global action will solve the problem.
To share medical resources around the world doesn't require the same level of commitment as fixing global warming, there are plenty of charities that are making a difference in people's lives already. From time to time I donate to these sorts of charities, such as Doctors Without Borders. Prominent people like Jimmy Carter and Bill Gates have done good work extending health care solutions to poor countries. As a result we've seen human life expectancies rise significantly around the world, even in the poorest countries.
But so long as this is viewed as voluntary charity, it will remain a small percentage of global health care expenses. Mostly, people and their governments spend on health care for themselves. I know my own charitable contributions toward the health care of others are smaller than what my own health care costs.
I'm not sure what it would take to reorganize how people live, work, invest, and govern such that we acted globally with respect to tasks like protecting the environment and providing rich-country-level health care to everybody. But even these two goals are probably contradictory -- providing rich-country-level health care to everybody would probably make climate change even worse.
-----
One of the factors in the cost of healthcare is the defense of intellectual property rights. The cost of manufacturing PREP/HAART drugs for HIV is less than 1% of the list price, most of the difference is the result of monopoly pricing and goes to pay the professional staff and the shareholders. But this is only one of the factors, and even generic drugs can be too expensive for the poorest countries to provide to their citizens. When your entire GDP is only $500/person, and your government is corrupt, and a civil war is raging in the countryside, there's not a lot you can afford with respect to health care.
Perhaps if I were starting my career over today I'd go work for the World Health Organization (WHO), or a similar group. Global public health!
According to the WHO, global health care spending is around $8 trillion per year, which is 1000x WHO's budget of roughly $1/person/year. In the rich countries (OECD members) on average we spend $5,000/person on health care, but dozens of poor countries spend less than $50/person. This disparity is huge, health care as my readers experience it is practically nonexistent for hundreds of millions (or billions?) of people.
The groups that wanted to share HIV drugs with poor countries found there wasn't even an infrastructure for doing so -- no way to keep the drugs at the temperatures required, for example, they first had to build the infrastructure -- the "cold chain", the transportation network, the clinics, the staff, communications, then finding & monitoring the patients ...
I only know of these things from afar, I've never visited a poor country. Never been tasked with setting up an HIV clinic in Sub-Saharan Africa.
-----
Somehow I want to swap the responsibilities I already have for taking care of the entire planet and all of its inhabitants. Not sure how that's going to work during the years I have left. Somehow a career in public service hasn't been enough, I want to do a more important type of public service, while being paid even less LOL. Where would I be instead, if I'd spent the past 20 years working for the WHO. Won't I deserve a retirement after my career in public service? Heh. That guilt factor I'm worried about ... it will pile me into even more responsibilities than I have now.
Locally, here in the US everybody 16+ is now eligible for shots and about half of those eligible have already received at least one shot. Cases have been climbing in some areas but in general we're well below the post-Christmas peak and daily deaths have been slowly declining.
I have family and friends who are planning multi-household gatherings for next month, I have fully-vaccinated coworkers who have resumed air travel to see family.
The only thing I've done differently so far is I've ridden a mostly empty Metro train twice. But I should be fully vaccinated by the end of this month, 2P+7 on April 29.
-----
There were a handful of countries that practically eradicated COVID before the vaccines came along via strict behavioral changes. Now there are a handful of countries that are blunting COVID by vaccinating large portions of their populations. And then there's the rest of the world -- unwilling or unable to eradicate the virus via behavior changes, and lacking sufficient doses to vaccinate most of their population. In this "rest of the world" COVID is rampaging at record levels as I type, overwhelming hospitals, morgues, and funeral services.
It reminds me of HIV, how in the US, UK, France, and other rich countries widespread access to PREP & HAART (at an annual cost of $10,000 - $20,000 per person) means young gay guys routinely forgo condoms when fucking strangers, while in other parts of the world HIV continues to spread at the rate of two million new cases per year. In much of the world, the annual retail price of PREP/HAART is at least dozen times their per capita GDP -- nobody could afford to buy it -- although the rich countries have pledged to donate a supply of these drugs to some poorer countries.
-----
Wide disparities in health budgets and outcomes are not new phenomena, and there are plenty of nonprofit efforts to send medical resources to poor countries, including a global effort to share COVID vaccines, although most COVID doses are going to the paying customers right now -- most donations of COVID vaccines will come after the rich countries have vaccinated their own citizens.
In the US there's plenty of press speculation about how later this year we'll switch over to COVID booster shots based on the more recent COVID variants, while much of the rest of the world won't even have received their first version 1.0 shots.
-----
Should a citizen of a rich country forgo top-quality medical care because poor countries can't afford it? As a practical matter, if I do not show up for my second Pfizer dose on Thursday morning, they're not going to ship that dose to another country, that dose will already have been thawed and will need to be put in somebody's arm soon.
If I were to forgo a CT scan for my kidney cysts, it's not like they're going to fly that scanner to a poor country and scan somebody there instead.
Like with a lot of global problems, individual acts of sacrifice won't necessarily help. I've argued this repeatedly about global warming, that cutting your own emissions won't have a measurable effect on the pace of climate change, that only concerted, enforceable, drastic global action will solve the problem.
To share medical resources around the world doesn't require the same level of commitment as fixing global warming, there are plenty of charities that are making a difference in people's lives already. From time to time I donate to these sorts of charities, such as Doctors Without Borders. Prominent people like Jimmy Carter and Bill Gates have done good work extending health care solutions to poor countries. As a result we've seen human life expectancies rise significantly around the world, even in the poorest countries.
But so long as this is viewed as voluntary charity, it will remain a small percentage of global health care expenses. Mostly, people and their governments spend on health care for themselves. I know my own charitable contributions toward the health care of others are smaller than what my own health care costs.
I'm not sure what it would take to reorganize how people live, work, invest, and govern such that we acted globally with respect to tasks like protecting the environment and providing rich-country-level health care to everybody. But even these two goals are probably contradictory -- providing rich-country-level health care to everybody would probably make climate change even worse.
-----
One of the factors in the cost of healthcare is the defense of intellectual property rights. The cost of manufacturing PREP/HAART drugs for HIV is less than 1% of the list price, most of the difference is the result of monopoly pricing and goes to pay the professional staff and the shareholders. But this is only one of the factors, and even generic drugs can be too expensive for the poorest countries to provide to their citizens. When your entire GDP is only $500/person, and your government is corrupt, and a civil war is raging in the countryside, there's not a lot you can afford with respect to health care.
Perhaps if I were starting my career over today I'd go work for the World Health Organization (WHO), or a similar group. Global public health!
According to the WHO, global health care spending is around $8 trillion per year, which is 1000x WHO's budget of roughly $1/person/year. In the rich countries (OECD members) on average we spend $5,000/person on health care, but dozens of poor countries spend less than $50/person. This disparity is huge, health care as my readers experience it is practically nonexistent for hundreds of millions (or billions?) of people.
The groups that wanted to share HIV drugs with poor countries found there wasn't even an infrastructure for doing so -- no way to keep the drugs at the temperatures required, for example, they first had to build the infrastructure -- the "cold chain", the transportation network, the clinics, the staff, communications, then finding & monitoring the patients ...
I only know of these things from afar, I've never visited a poor country. Never been tasked with setting up an HIV clinic in Sub-Saharan Africa.
-----
Somehow I want to swap the responsibilities I already have for taking care of the entire planet and all of its inhabitants. Not sure how that's going to work during the years I have left. Somehow a career in public service hasn't been enough, I want to do a more important type of public service, while being paid even less LOL. Where would I be instead, if I'd spent the past 20 years working for the WHO. Won't I deserve a retirement after my career in public service? Heh. That guilt factor I'm worried about ... it will pile me into even more responsibilities than I have now.
