Breaking down Barriers, Building Bridges

28 Jul, 2018
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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.

This entry was posted on Saturday, July 28th, 2018 at 9:39 pm and is filed under Blog.

Literature Literature archive

S Krishnaswamy, P Lambach, ML Giles 2019 HUMAN VACCINES & IMMUNOTHERAPEUTICS VOL. 15, NO. 4, 942–950
Editorial 2019 Lancet Adolescent Health Vol 3: 281
AHviid, JVinsløv Hansen, M Frisch,, et al 2019 Ann Intern Med 170(8):513-520.

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