Tag Archives: equitable

WHAT ARE SOME OF THE CHALLENGES IN ACHIEVING EQUITABLE GLOBAL VACCINE ACCESS

There are several major challenges that make achieving equitable global access to vaccines difficult. One fundamental challenge is financial – it is extremely costly to research, develop, clinically test, mass produce, and distribute vaccines worldwide. Private pharmaceutical companies take on huge financial risks and costs to bring new vaccines to market. While governments and organizations like Gavi provide some funding support for vaccines in lower-income countries, there are still many countries that cannot afford to purchase large amounts of vaccines on their own. The costs of scaling up vaccine production and building out cold chain infrastructure is also enormous. With limited healthcare budgets, many developing nations struggle to purchase enough doses to satisfy global herd immunity thresholds.

Related to financial constraints is the issue of global prioritization during short supply situations. When new vaccines are first introduced or during a pandemic, there may not be enough supply initially to meet global demand. Wealthier countries that can pay top dollar often receive priority allocation from manufacturers in the short-term. This delays access for lower-income populations, though donation and redistribution efforts through Gavi and others help to address this over time. Global coordination on vaccine production and distribution timelines is challenging given commercial and geopolitical interests at play.

Health system weaknesses pose another hurdle. Even when vaccines are donated or subsidized, delivering them effectively to populations requires robust cold chain storage and transportation infrastructure, training for healthcare workers, and systems to conduct mass vaccination campaigns. Many developing nations lack optimal primary healthcare systems and face difficulties in keeping vaccines within recommended temperature ranges during storage and transit to remote locales. They may also have shortages of needles, syringes and other supplies needed to administer vaccines safely and at scale. Community distrust and lower demand further undermine vaccination programs in some contexts.

Intellectual property policies can also inhibit equitable access. Vaccine manufacturers depend on patents and clinical data exclusivity periods to recoup R&D investments. Some argue this delays the entry of lower-cost generic competitors in developing countries. There are efforts like the COVID-19 Technology Access Pool to voluntarily pool IP, but uptake has been limited. Compulsory licensing which allows governments to override patents in emergencies remains controversial. Striking the right balance between innovation incentives and ensuring timely availability of affordable vaccines is complex with arguments on both sides.

Then there are challenges related to mis- and disinformation online which can spread quickly worldwide. Unfounded claims linking vaccines to autism or other conditions have taken root in some communities and successfully lowered immunization rates. With a deluge of health advice online, it becomes difficult for local public health officials and community leaders to combat myths and allay fears. Digital platforms are criticized for not doing enough to curb the spread of provably false anti-vaccine narratives. At the same time, censoring speech risks further alienating hesitant populations. Nuanced messaging and building trust becomes ever more crucial.

The geopolitics of vaccines cannot be ignored. Donations and partnerships are sometimes influenced as much by diplomatic goals as pure public health priorities. Some nations may donate surplus doses to curry favor with recipient countries. On the other hand, vaccine nationalism where wealthy states secure enough doses for their entire populations before supporting global distribution efforts can undermine the cooperative spirit needed. There is an inherent tension between a country prioritizing its own citizens’ health versus contributing to slowing the worldwide pandemic that ignores borders. Overall coordination at multilateral levels remains a work in progress.

The multitude of financial, logistical, technological, informational, policy and geopolitical factors pose interconnected hurdles. Overcoming them requires not only more resources but innovative cooperation between governments, vaccine developers, health agencies and community organizations. Substantial progress has been made in global vaccine access in the past two decades, but achieving full equitable distribution in a crisis demands rethinking traditional R&D and supply chain models for the long run. With political will and collective action, many of these challenges can be gradually ameliorated.

HOW CAN POLICYMAKERS AND PROVIDERS ADDRESS THE CHALLENGES OF EQUITABLE ACCESS TO TELEHEALTH

There are several significant challenges to ensuring equitable access to telehealth, especially for underserved groups. Policymakers and healthcare providers must take a multifaceted approach to overcoming these barriers.

One of the most immediate barriers is the digital divide in access to broadband internet and technologies like smartphones, laptops, and tablets needed to utilize telehealth services. According to the FCC, an estimated 21.3 million Americans still lack access to fixed broadband service at threshold speeds. Those without home internet access are disproportionately low-income individuals, residents of tribal lands, people of color, older adults, and those living in rural areas.

Policymakers should increase funding and incentives for expanding high-speed broadband infrastructure, especially in underserved rural and tribal communities. The recently passed Infrastructure Investment and Jobs Act allocates $65 billion toward expanding broadband access across the country. Providers can work with community groups and patients to distribute free or low-cost tablets and mobile hotspots in areas without home internet access.

Lack of digital literacy remains a substantial barrier, as many individuals may not have the technical skills to operate telehealth platforms. Both policymakers and providers need to invest in digital skills training programs, offered either in-person or virtually, to help underserved groups learn how to use technologies like videoconferencing applications and patient portals. Community organizations like libraries can partner with healthcare entities to provide digital literacy classes and one-on-one technology assistance.

The affordability of Telehealth services and connectivity is another hurdle. While the infrastructure bill and some state policies have expanded access to affordable broadband internet plans for low-income households, data plans and connectivity costs can still prohibit regular telehealth use. Policymakers should consider expanding federal subsidy programs for health-related connectivity and mandate that telehealth services have no to low patient cost-sharing. Healthcare providers also need to offer flexible payment plans or work with community clinics to provide free telehealth access points for the uninsured.

Language and cultural barriers also marginalize many groups from equitable telehealth care. Both medical interpreters and culturally-competent health education materials must be made universally available. Policymakers should require and provider reimbursement programs should cover 24/7 access to qualified medical interpreters across all major languages, including ASL interpreters for deaf individuals. Healthcare entities must translate all telehealth informational materials and platforms into prevalent non-English languages and ensure culturally-tailored health messaging.

Privacy and security concerns could disproportionately deter underserved patients from engaging in telehealth. Policies like HIPAA and the Federal Trade Commission’s Telehealth rule help protect patient data privacy and security during virtual visits. More needs to be done to foster trust, especially among vulnerable groups. Providers must communicate clearly how they safeguard personal health information, obtain explicit patient consent, and provide multi-lingual privacy training. When developing new technologies, inclusive user-experience design and community oversight can help address privacy, automation bias and surveillance risk for marginalized populations.

Lack of access to sufficient broadband-enabled devices remains a hurdle for many. Beyond expanding low-cost options, providers should consider lending medical-grade tablets and laptops pre-loaded with telehealth applications for patient use, especially for those managing chronic illnesses requiring frequent care. Mobile health clinics equipped with telehealth capabilities could also travel to underserved communities to increase access points.

A comprehensive approach is needed involving coordinated efforts between policymakers, healthcare systems, community partners and patients themselves. By addressing barriers related to infrastructure, affordability, language, literacy, privacy and access to enabling devices – especially in marginalized groups – telehealth’s promise of expanded access to equitable care can be more fully realized. Ongoing community involvement and cultural competence will also be key to overcoming historical mistrust and building resilient virtual care models for underserved populations.

HOW CAN UNIVERSITIES ENSURE THAT ALL STUDENTS HAVE EQUITABLE ACCESS TO RESOURCES FOR THEIR CAPSTONE PROJECTS

Universities have a responsibility to provide all students with equitable access to resources needed to complete their capstone projects successfully. This is important to ensure fair outcomes and that a student’s access to resources does not determine their capstone results or chances of graduation. There are several steps universities can take to help achieve equitable access.

First, universities must identify what key resources students may need to complete their capstone work and ensure accessibility for all. This includes researching access to technology, research materials, mentorship/advising support, and funding if applicable. Universities should conduct student surveys or speak with program advisors to get a full understanding of resource needs. They can then evaluate what barriers may exist for low-income students, first-generation students, students with disabilities or other groups. Additional resources may need to be provided or funding assistance given to remove barriers to access.

Universities also need transparent policies and communications around capstone resource availability. Program websites, orientation sessions, syllabi and other materials should clearly outline all resources students are entitled to use. This helps ensure all students are aware of options available. If additional assistance is needed, there should be clear guidance on how to request support. Requests should be evaluated fairly through an equitable process.

Another important step is securing necessary capstone resources. This means budgeting adequately each year to maintain stocked libraries with up-to-date research materials across all academic subjects. It requires investing in sufficient computer labs, software and technical support staff to meet student demands. Distance learning students need equitable access too, so online research databases and tech support are crucial. Funding also needs to be set aside each year for unforeseen capstone costs like research supplies, travel for fieldwork etc.

Universities must think creatively about leveraging existing campus resources as well. For example, work-study jobs or vacant TA positions could be used by students needing funding for capstone materials. Computer labs could be kept open extended hours when capstone deadlines near. Research libraries may purchase access to additional online journals/databases during peak capstone periods. Underutilized existing resources, if made easily accessible, can significantly improve equity.

Providing advising, mentoring and capstone support services is also important for equitable outcomes. Low-income or first-gen students in particular may need guidance navigating capstone requirements, identifying community partnerships, research protocols etc. Universities should ensure adequate advising staff are available during all stages of the capstone from project selection to completion. Students facing obstacles should have a direct point of contact for troubleshooting issues promptly.

Equitable access also means flexibility when unforeseen conflicts arise. Life events like illnesses, family emergencies or financial hardships could impact a student’s capstone progress and timeline. Universities need supportive policies allowing deadline extensions or leaves of absence if warranted. When students return, they should face no disadvantage catching up or completing the impacted capstone work.

Assessing resource needs and tracking capstone metrics is important too. Universities must collect feedback annually to check that prior year resource allocations aligned with actual student use. Success and dropout rates should also be analyzed by student demographics to check for inequities. Adjustments may be needed to continually improve access and outcomes over time. External program reviews would further strengthen resource strategies.

With dedicated planning and budgeting, clear policies, leveraging of existing assets creatively and ongoing assessment, universities can systematically work to establish equitable access to key capstone resources for all students. This helps ensure every student has a fair opportunity to complete their program capstone successfully, regardless of their individual background or life circumstances encountered along the way. Equitable access is an important component of higher education institutions fulfilling their mission of serving all students.