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致力于让有色人种得到疫苗保护的流行病学家 | 盖茨笔记

Bill Gates 比尔盖茨 2022-05-21
If there’s one thing the world has learned about COVID-19 over the last year, it’s this: the pandemic will only end when almost everyone on the planet has been vaccinated against the virus.

如果说一件全世界过去一年学到关于新冠肺炎的事,那就是:只有当地球上几乎每个人都接种了新冠病毒疫苗,这场大流行才会结束。

Melinda and I have been fighting to expand access to health innovations for the last two decades, so we knew that making the vaccine accessible to all would be a massive challenge. Reaching everyone is going to take a ton of hard work—something that’s become even more clear in recent months. Fortunately, there are a lot of smart, passionate people taking on this problem all over the world. One of those heroes is Dr. Stephaun Wallace, an epidemiologist at the Fred Hutchinson Cancer Research Center. He’s spent the last year helping make COVID-19 vaccines work for everybody.

在过去二十年里,我和梅琳达一直在努力扩大健康创新的可及性,因此我们知道,让所有人都能用上这种疫苗将是一个巨大的挑战。覆盖到每个人将需要大量的努力,这在最近几个月中表现得更加明显。幸运的是,世界上很多聪明而富有热情的人正在着手解决这个问题。福瑞德·哈金森癌症研究中心的流行病学家斯蒂芬·华莱士博士就是这些英雄里的一员。他去年一年都在帮助使新冠肺炎疫苗对每个人起到保护作用。


Stephaun’s road to becoming an epidemiologist is an unusual one. As a kid, he wanted to become a lawyer and help under-resourced people in his community. He moved to Atlanta in his early 20s and created an organization that, among other things, provided assistance to young Black men who were HIV positive. That experience ignited an interest in health inequities and led to a career working to address them.

斯蒂芬成为流行病学家的道路是不寻常的。小时候他想成为一名律师,帮助在他社区中缺乏资源的人们。他在20多岁时移居亚特兰大并创建了一个组织,该组织的其中一项工作是向艾滋病毒阳性的黑人青年提供帮助。这段经历点燃了他对健康不平等问题的兴趣,并使他踏上了致力于解决这些不平等的职业征程。

Today Stephaun wears many hats through his work at Fred Hutch. When he’s not lecturing about global health at the University of Washington, he’s in charge of external relations for both the HIV Vaccine Trials Network and the COVID-19 Prevention Network. (He also found time to speak to my team about systemic racism’s role in the pandemic late last year.)

今天,斯蒂芬在福瑞德·哈金森中心身兼多职。当他没有在华盛顿大学讲授全球健康课程时,他就在负责艾滋病疫苗试验网络和新冠肺炎预防网络的对外关系工作。(去年年底,他还抽时间与我的团队讨论了系统性种族主义在大流行中扮演的角色。)

His work is all about reaching the people who are usually left behind. Growing up Black in Los Angeles, he experienced firsthand how race shapes every part of how society treats you—including the medical system. Stephaun understands why many Black Americans are hesitant to trust doctors and scientists, even though he now counts himself among their ranks. It’s tempting to look to history for an explanation—from the Tuskegee Syphilis Study to Henrietta Lacks—but the COVID-19 pandemic has made it clear that racial health inequities remain a huge problem.

他的工作全都关于帮助那些通常被遗忘人们。作为一名在洛杉矶长大的黑人,他亲身体验了种族是如何影响社会对待你的方方面面,其中包括医疗系统。斯蒂芬理解为什么许多美国黑人犹豫该不该信任医生和科学家,即便他现在已将自己视为医生和科学家中的一份子。你不禁会从历史中寻找一个解释——从塔斯基吉梅毒实验到海瑞塔·拉克斯——但是新冠大流行清楚地表明,种族健康不平等仍然是一个巨大问题。

“Acts of racism in the medical establishment are not just historical,” Stephaun says. “People are still very actively experiencing these very same sort of abuses and traumas today.” He points to the case of Dr. Susan Moore, a Black physician who died from COVID-19 last summer after her doctors allegedly dismissed her pain.

“医疗机构中的种族主义行为并非只在历史里。”斯蒂芬说,“人们在今天仍然经历着同样的虐待和创伤。”他提到苏珊·摩尔医生的案例——这名黑人医生去年夏天死于新冠肺炎,她的医生们被指控在她死前集体无视了她的痛苦。

One of the reasons why parts of the medical system often fail communities of color is because they’re not designed with them in mind. Stephaun is trying to change that. His work at Fred Hutch is particularly focused on improving the way clinical trials are run. He was working on potential HIV vaccines when the pandemic hit last year and quickly shifted to trials for most of the major COVID-19 vaccine candidates (as well as some treatments).

部分医疗系统经常帮不到非洲裔和拉丁裔的一个原因是,当初在设计系统时就没有考虑到他们。斯蒂芬正试图改变这种状况。他在福瑞德·哈金森中心的工作尤其关注改善临床试验的运行方式。去年大流行暴发时,他当时正在研究可能的艾滋病疫苗,但随即将工作转向试验大多数主要的新冠肺炎候选疫苗(及一些治疗方法)。

When you want to test a new vaccine or drug, you have to run rigorous clinical trials to make sure it’s safe and effective for everyone who might take it. Everything from age to race to baseline health can affect how a vaccine works in your body, so it’s important to study how a lot of different people react. Recruiting for a clinical trial can sometimes take longer than running the trial itself—time we couldn’t afford to waste in this pandemic.

当你想测试一种新疫苗或新药时,你必须进行严格的临床试验,以确保它对所有可能使用它的人都安全有效。从年龄到种族,再到基础健康状况,这一切都会影响疫苗在你体内起作用的方式,因此研究不同人群的反应非常重要。为临床试验招募参与者,有时可能比进行试验本身要花费更长时间,而时间是我们在这场大流行中浪费不起的东西。

The scientists at the COVID-19 Prevention Network knew they had to do a better job of recruiting diverse participants for the multiple COVID-19 vaccine trials they’re running in the Seattle area and globally—especially from Black and brown communities, who are suffering the hardest from the virus and desperately need vaccines that are safe and effective for them.

新冠肺炎预防网络的科学家们知道,他们需要更好地为在西雅图及全球开展的多个新冠肺炎疫苗试验招募不同背景的参与者——尤其是来自黑人和棕色人种社群,他们受病毒影响最大,迫切需要对他们安全有效的疫苗。

From the very beginning, Stephaun and his colleagues consulted with expert panels representing these communities to design the trials. They were deliberate about everything from using recruitment tactics tailored specifically for diverse communities to making scheduling more flexible to writing consent forms with accessible, non-scientific language.

从一开始,斯蒂芬及其同事就与代表这些群体的专家小组协商设计试验。从使用专门为不同群体量身定制的招募策略,到更灵活的日程安排,再到使用易于理解、非科学的语言编写同意书,他们都有经过深思熟虑。

The result was a more welcoming experience for all participants. Stephaun reports that the trials saw greater participation from communities of color than he’s used to seeing. He even participated in one of the clinical trials himself, hoping that it will convince more people who look like him that the vaccines are safe.

结果就是一个更受所有参与者欢迎的体验。斯蒂芬报告称,在这些试验中有色人种的参与度比以往更高。他甚至亲自参加了一项临床试验,希望这能让更多和他长得像的人相信这种疫苗是安全的。

Stephaun also hopes that the experience of the last year convinces political leaders, the media, and especially his colleagues to reexamine the connection between health and race in the United States. “The pandemic provides the scientific community an opportunity to think differently about how they engage and build relationships with communities of color,” he says. “This offers a reflective opportunity to think about who we are as a culture, as a society, and how we want to move forward.”

斯蒂芬还希望,去年的经验能说服政治家、媒体及其同事去重新审视美国国内健康与种族之间的联系。“大流行为科学界提供了一个机会,让他们以不同的方式思考该如何与有色人种群体交流并建立关系。” 他说,“这提供了一个反思的机会,让我们思考我们作为一种文化、一个社会的身份问题,以及我们想要如何前进。”


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