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Confidence Commentary: Blog archive

Breaking down Barriers, Building Bridges

Heidi Larson | 28 Jul, 2018

The theme of this year’s AIDS2018—International AIDS Conference, was on the theme of “Breaking down Barriers, Building Bridges.”  The opening plenary session included a presentation by AIDS physician, Dr. David Malebranche. As I listened to his presentation, there were moments that resonated with the tensions and debates around vaccines.

Here are some excerpts. The relevance to what is driving wavering vaccine confidence should be clear:

26 July 2018. 

“Most studies seem to focus on individual variables and cultural barriers…why don’t we study (people’s) experiences (with health services)?

“Maybe we are scared of what we are going to see when we look in the mirror. Maybe it is easier to get caught up in the shine of advancement so we lose sight of the (real) picture. Maybe it is easier to congratulate ourselves…maybe we are invested in the saviour complexes and refuse to consider the power differential.

[Chef Gordon Ramsay Photo on the screen]

“I want you to imagine…A restaurant opens up. 100 people come once and eat a meal. Two months later, only 40 eat another meal. Would the restaurant try to figure out what’s wrong with the customers?   They wouldn’t.

“The leadership would ask questions. Does the food taste good? More seasoning?  Where is the location? Is it convenient to our consumers? How are we advertising?

“And customer service? Are the staff treating the customers with respect and dignity?

“That’s what a true company(business) would do when they provide a service to the community.

“Unfortunately, most research ponders what’s wrong with the community first and looks at the medical community much later, if at all. They are “hard to reach”, “don’t trust doctors”, “uneducated.” 

“Maybe we should be asking what are the communities priorities? It means giving a bit of your personal self to your patients. Then can see you as a human being instead of a robot. (a number being counted).

“Unfortunately, our social and humanitarian advances lag woefully behind our scientific ones. Stop describing human beings in the (language of) journal articles. Instead of “retained in care” we should say “engaged in care”. Retained sounds like a prison. (HL: think of  the terms “compliant” and ” the “herd” here.)

“The science will never work to its potential if we don’t practice the art of medicine.”

Thank you to Dr. Malebranche.

From the Center for Vaccine Ethics & Policy
Vaccines and Global Health: The Week in Review
Partner in

Literature Literature archive

Pugliese-Garcia M, Heyerdahl L, Mwamba C, et a;. 2018 VACCINE 4 August 2018, In Press, Corrected Proof https://doi.org/10.1016/j.vaccine.2018.07.042
Jung M 2018 PLoS ONE Vol.13(7): e0200333.
E Usuf, G Mackenzie, L Ceesay, et al. 2018 BMC Public Health Vol18(1): 1

Videos Video archive

Key figures share their perspectives on a controversy that led to the suspension of Ebola vaccine clinical trials in Ghana.

Drs. Heidi Larson and Pauline Paterson of the Vaccine Confidence Project join episode 50 of the Public Health United podcast with Nina Martin, November 2017.

Drs. Larson and Paterson join a discussion on vaccine confidence at Hong Kong University.  September, 2015.

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