SDI

She's done it

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"UNICEF delivered over 43,000 doses of the R21/Matrix-M malaria vaccine by air to Bangui, Central African Republic, today, with more than 120,000 doses to follow in the next days. "
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Pretty rookie numbers, need to scale. To be seen how this translates to actual distribution and acceptance. But sure did feel good to read the news, so thought I'd share! No takes yet, feel free to add.

Also, "Around 4.33 million doses of RTS,S have been delivered to 8 countries so far – Benin, Burkina Faso, Cameroon, Ghana, Kenya, Liberia, Malawi, and Sierra Leone". 

I am a doctor who has treated patients with myiasis and would love to talk if that helps. As a physician in India, Myiasis as a surgical case is not uncommon, whereas it is unheard of in developed countries (I now know this might be because of the Panama worm-border in North America; previously, I just assumed it was better standards of living). You are not overindexing the 'yuck' factor of it, in fact, dial it up. I can tell a patient has worms in their wounds from over a mile; the stench adds to social stigma for the patient and makes it harder to seek treatment. I remember being the only person in a group of five assigned a patient stepping forward to dress a wound (I won't go into details of how that's done here) because I was the only person not retching uncontrollably. That patient was just an orphan kid who fell, scraped his knee pretty badly a couple of days ago, and never paid attention to the flies because flies are everywhere where he lives. The lethal cases do not differ much from what you would see in a zombie/horror movie. It's just wild to think that in this day and age, there are still people (and animals) being eaten by worms alive.

I wonder if a great additional question here is "How many humans would it help and how much?" Is it the same worm? What is the current estimate of the global disease burden, DALYs? Prima facie, it would seem that it is a slam dunk—kill two birds with a stone— health + animal welfare with a single intervention, but it is not discussed as such yet, which makes me think that either the two don't overlap or just hasn't been looked into it like that. If we assume human suffering gets more policy traction/funding than wild animal suffering, it seems beneficial to explore this.

Thanks for your work. 
The post mentions the work done in Goa, India, I would like to highlight the cost-effectiveness of the injectable rabies vaccine reported in the paper on the intervention done. "Elimination of human rabies in Goa". (I had read this paper once and thought the numbers were impressive. feel free to criticise it)

"The estimated mean cost per death averted and cost per DALY averted from 2013 to 2019 were 14,866 USD and 526 USD, respectively. During this period, the program was estimated to result in 2,249 DALYS averted and 80 deaths averted compared to no intervention. Over a 10-year projection (2013–2023), the intervention was estimated to prevent 121 human rabies deaths and 3427 DALYS at a mean cost of 567 USD per DALY averted."

Administering injectable vaccines does pose logistical issues; They report mean vaccination coverage in the 2016 campaign as 71.8% in all sighted dogs and 60.1% in roaming dogs. In 2017, intensive methods were applied state-wide, achieving an estimated coverage of 71.7% in all dogs sighted and 53.1% in the roaming population. Would improving operational efficiency in covering the free-roaming population of dogs with the traditional rabies vaccine be considered a good recommendation?

AFAIK @Joel Becker's introduction to EA was to find a good use for his earnings from his YouTube channel Messiseconds

Excellent post. I love to see legible, reader-friendly summaries of high-level work on the forum. About time everyone updated their baseline knowledge on UVC.

Also, huge +1 to reaching out to Max expressing interest if anyone wants to work on this and feel that they bring something valuable to the table (even if something might not be available right away). I did this about six months ago and actually ended up contributing to a project. And what a great work experience it was overall!

How long do you suggest one should spend filling out the interest form? 

I did end up in Mexico City. I plan to continue the job search from here while exploring independent contracting for some supplemental income and diverse project experience. 

- If anyone is looking for expertise in biosecurity/global health to help with ongoing projects, please reach out and delegate to me! I am new here, so I haven't gathered any "EA karma" from well-written posts yet. I would love to change that!
LinkedIn

- I am open to ideas in up-skilling for the most impactful work I can do as a physician-scientist. Open to ideas for skills to master and funds to apply for the same. 

- Also, EAs in the Americas, take a work-cation in CDMX! The weather is excellent, and the city is energetic and green. So far, a good group of EAs have been here after the fellowship ended. I would love to keep it up!

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