India’s vaccine program, one of the largest in the world, was just taking off when the second wave of COVID-19 turned into a tsunami and hospitals and crematoriums were inundated. With such a large population, the fight against an unfamiliar enemy could only be won through mass vaccinations, a fact corroborated by top virologists. As the noise regarding the lack of vaccine availability reached a crescendo, another pressing issue started to unfold, that of vaccine hesitancy in rural India.

With the government aiming to vaccinate the entire eligible population by December 2021, vaccine supply is only half the dilemma. With almost 60% of the Indian population in rural areas, issues of accessibility and lack of manpower and infrastructure arose. The wall of suspicion, fake news, and rumors are still having an impact on vaccination rates in these areas.

https://economictimes.indiatimes.com/news/politics-and-nation/coronavirus-news-and-updates-live-january-13/liveblog/80242557.cms

Some of the Issues

Public Health Facilities: Although public health facilities have come a long way and played a primary role in managing the Covid-19 pandemic in rural India, there still are fewer takers than expected. Primary Health Centers in some areas are inadequately staffed with substandard infrastructure and facilities.

General Mistrust: People of rural India fear going to the vaccination center as they fear they will be subjected to testing and, if found positive, be incarcerated, never to return home.

Cultural and Religious Perspectives: People form opinions based on their deep-rooted beliefs that appear to clash with their cultural systems and values. Vaccine hesitancy in this context is often the result of inherited religious views that are seldom questioned.

Misinformation on Social Media: Dissemination of information through social media, especially fake news or fake information, is shared with vested interests or by miscreants. With the social media revolution using smartphones, it becomes a challenge to curb fake shares that further ignite vaccine hesitancy in rural India.

Side-effects and Questions on Efficacy: The media has played a stellar role in reporting issues faced in rural areas during the pandemic. However some reporting on side effects caused by the vaccines (i.e., clotting) led to a scare among those in rural areas. Reporting on the process of clinical trials and questions of efficacy has only added to the issue.

https://www.forbes.com/sites/joshuacohen/2021/03/08/covid-19-vaccine-hesitancy-is-worse-in-eu-than-us/?sh=4400e6b7611f

Curbing Vaccine Hesitancy in Rural India

The first and second waves of the pandemic led to an enormous loss of life and livelihood. Unemployment and economic growth has been stalled in its tracks. With the impending third and subsequent waves, the only safeguard is vaccination. While the nationwide rollout saw urban India accept immunization with open arms, rural India has lagged far behind due to hesitancy and availability.

With the government promising to vaccinate the entire adult population by December 2021, tackling the hesitancy is urgent. As history tells us, immunization programs like “Mission Indradhanush” have yielded encouraging results in tackling hesitancy and increasing acceptance. The way forward is through massive outreach programs through a PPNP (public-private, not-for-profit partnerships) framework to derive maximum value in the shortest-possible time. A multipronged strategy should look to –

To improve vaccination uptake and coverage, health education approaches and initiatives will be the most effective in changing attitudes. Some outreach programs that were used earlier and some new strategies that can be used are:

Stories on the Ground: The New Age CORONA WARRIORS

Community radio stations across India have braved lockdowns and played an important role in ensuring awareness about COVID-19 in rural communities. The mainstream media has poor reach in rural India, and rural community radios help to bridge the last-mile gap. To identify concerns of the public and provide authentic and genuine information, these stations have played an instrumental role as community media in India during the pandemic. The local flavor of these stations ensures that this mass media service has a unique position in rural hinterlands.

Alfaz-e-Mewat community radio station, an initiative of SM Sehgal Foundation, has been doing stellar work during this pandemic to spread awareness on public health. As per government officials, only 75,225 people of the 14-lakh population of Nuh were vaccinated before May 31, 2021, and there is concern among many to ramp up the drive. Nuh, one of the most “backward” areas in the country, has always looked at immunization programs with suspicion, driven primarily by lack of awareness among the people. Recently, the district administration of Nuh partnered with Alfaz-e-Mewat community radio to fight myths and disseminate information, using positive messaging to assuage the fears of communities.

Senior health officials on condition of anonymity told the Hindustan Times that villagers were reluctant to take the vaccine due to several rumors that it is poisonous and may lead to impotency. “When health workers visited some villages to appeal to the locals to take the vaccine, the villagers emerged with sticks, threatening to attack them. Some even assaulted them and pushed them out of the village, alleging that the vaccine is poisonous.”

Nuh deputy commissioner, Captain Shakti Singh, spoke highly of the efforts of the community radios work in collaborating in this endeavor. He shared that officials and volunteers have been on the ground, motivating people; and to widen our outreach, rural community radio is the best way to do it. “We want to use their audience base to communicate with the people and disseminate information around COVID and the vaccine.”

Alfaz-e-Mewat radio has a reach of 225 villages and is being used to reach locals to transmit information about vaccination from the district administration, chief medical officer and other influencers. Six to seven programs are dedicated to COVID-19. The station also broadcasts messages from the senior officials, including the deputy commissioner, easing fear around the vaccines.

Officials claim the initiative has helped increase the number of villagers reaching the vaccination centers in the district. Organizations such as UNICEF and Community Radio Association are also supporting projects on COVID-19 prevention, vaccination, and COVID-appropriate behavior.

The idea has been to reach out to maximum villagers and bust the myths, so that more and more people get vaccinated. Community media in India and the rural community radio broadcasting has helped in a big way, and the numbers are increasing. The coming together of district administration and radio stations has played a proactive role in creating awareness about the COVID-19 pandemic and the significance of vaccination, leading to an increased turnout.

The mainline print media covered the work being done by Alfaz-e-Mewat, S M Sehgal Foundation’s brainchild in this regard.

The local administration asked the rural community radio stations to reach out to the inhabitants who are resisting the vaccine due to various myths. Vaccine hesitancy due to illiteracy, misinformation, and rumors have been quite a challenge.

The efforts of the two radio stations in the district having dedicated programs on COVID-19 are gradually helping people to ease fear around vaccination and follow COVID-19 appropriate behavior.

The war against COVID-19 will be won and lost with all of us following COVID-appropriate behavior, as the pandemic plays out in the coming times. With public health systems gearing up in the urban areas, vaccination drives have to now pick up the pace in rural India. We cannot afford to be lax in this regard; and how we deal with rural India will have major implications in the future direction of India and its economic growth.

After all, we do not want this pandemic to end like the 14^th century “Black Death,” when millions met their end, especially when we have the tools (the vaccine) to fight it. Now the time has come to use innovative strategies and partnerships to ensure that hesitancy issues are put to rest.

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The COVID pandemic changed the way we looked at education worldwide. The crisis prompted governments to shut down schools and universities to protect community against transmission. With the pandemic waxing and waning, educational institutions still remain shut, and the government is in a quandary as to how to maintain continuity in learning. This was as if life had come to a standstill for the majority of the 700 million youngsters under the age of twenty-five. India leans heavily on the modernization and growth of its education system to propel economic growth and development for the future. This harbinger of hope had come to a standstill.

Source: https://bangaloremirror.indiatimes.com/bangalore/cover-story/student-of-the-year/articleshow/84330289.cms

Pre pandemic inequity

The Indian school system is the second largest in the world after China. Similarly the higher education system is the third largest in the world after the US and China. The National Education Policy 2020 set out a roadmap to expand the scope of school education and increase the GER in higher education to 50 percent by 2030. It also talked about the “Ensuring Equitable Use of Technology” through online and digital education.

The Covid Whammy and the widening divide: the reasons

The logical prolonged closure of educational institutions had a huge negative impact on students belonging to vulnerable sections of society. Offline learning and assessment transitioned online for obvious reasons, but this has only caused the chasm in educational inequity to become wider, particularly in rural areas.

Thanks to the Digital India campaign run by the government, the rapid growth in information and communication technology (ICT) has changed the way we live, interact, study, and work. However, with the peculiar and skewed demographics and social profiles in India, the ICT revolution has also led to a digital divide due to lack of technology access and the inability to harness it. In addition, the educators themselves are underpaid and ill equipped to handle such a radical change and a process that “excludes” and “discriminates.”

The issues that lead to digital divide in education, especially in rural areas, can be summarized as follows:

Tackling issues of accessibility in rural India

The pandemic has exacerbated the digital divide in education for learners in rural India, and the disparity in education has ballooned. A new dimension of technology has been added to the existing challenges in education.

Technology is the keystone to improving quality, access, and affordability in rural India. Given a proper policy direction, technology and infrastructure have the capability to bridge the ever widening chasm that exists. India is a multilingual, multicultural, and socially diverse country where a broad framework that fits all may not be a practical approach. Now that e-learning is the new normal, issues must be tackled on an emergent basis. The new education policy is the first step toward this and hopefully will evolve into something that is suitable for India’s needs. Urgent and immediate attention must be channeled to building infrastructure and developing human capital to create a synergistic environment for a more wholesome learning approach.

Some areas where urgent intervention or effort may be required:

Many projects are run concurrently by the government directly, or in cooperation with NGOs, to look at making education accessible and affordable for every citizen. Private organizations through CSR activities are contributing to tackling issues of inequitable development in general. Some of these initiatives:

The Zeal to Transform Rural Education. S M Sehgal Foundation
TRANSFORM LIVES One School At A Time

A model created by S M Sehgal Foundation, an implementing NGO, is called Transform Lives one school at a time.

The model has two components:

These interventions are fundamental in order to improve school education and create a better future for rural youth. A vibrant school should provide an effective and comfortable learning environment that instills a strong sense of confidence and hope, empowering the community to sustain and enhance the efforts.

As part of school transformation, classrooms are upgraded, drinking water is made accessible and basic infrastructure is also created and/or repaired.

Smart classrooms are constructed with innovative designs and equipped with a smart TV that can be connected to any android smartphone through screen mirroring. Teachers leverage this feature to show audio-visual educational content to students to aid their learning and make it an interactive and immersive experience for them.

As part of community empowerment, several initiatives are undertaken, e.g., training of School Management Committee (SMC), and the formation and training of community champions of the Village Development Committee (VDC), along with a cadre of adolescent schoolchildren as youth champions. The empowered panchayat ensures the continuity in the work related to improving the schools on a sustained basis.

Overall, around 70 percent of schools maintain their improved infrastructure. The first school to be renovated was in Santhawadi of Nuh district, Haryana, which is still being well maintained by the people eleven years since its renovation in 2009. The VDC and SMC hold regular 1–3 meetings per year to address school-related issues, even after S M Sehgal Foundation has completed the work and left the village. Youth champions take part in development initiatives of their village such as immunization drives, school enrollment drives, and others. The trained SMC has begun devising annual school development plans for submission to the district education officer and even the Bukharkha School, Nuh district, Haryana, received higher than the allocated funds from the highly impressed government functionary.

As a result of the Transform Lives one school at a time initiative, enrollment has increased by about 12 percent, and absenteeism has reduced by about 10 percent in the schools where it has been implemented.

Conclusion

The frenetic shift to e-learning due to the pandemic has brought the issues of inequality back into focus, this time due to the existing digital divide, however with digital India campaign and other initiatives, things can be transformed for the better.

The post Addressing the digital divide in education: Tackling rural accessibility appeared first on S M Sehgal Foundation.

Many of us had assumed that the controversy on the origin and spread of coronavirus had died down, but apparently it is not so. I was asked by a friend what I thought of it, and to give my technical opinion, since my background is in genetics and molecular biology. The request was to write it out in simple language so a layperson could understand.

The US is fortunate to have a scientist of the caliber of Dr. Anthony Fauci, who has guided several past administrations and remained at the forefront of US efforts to contend with viral diseases such as HIV/Aids  SARS, the Swine flu, MERS, Ebola, and now COVID-19. His advice over the years has always been based on solid scientific data and sound judgment.

A current controversy is about whether the COVID-19 coronavirus was intentionally made and escaped from the Chinese Wuhan laboratory, or has it spread naturally like other viruses, including other coronaviruses. The commonly accepted hypothesis was that COVID was transmitted from bats to humans through an intermediary wild animal, some of which are unfortunately sold commonly in the Wuhan wet market.

There is still no actual evidence that COVID-19 was made and escaped from the Wuhan virology laboratory. Maybe the first infected person was a researcher collecting or handling samples collected in the wild, which remains hard to exclude, but is less likely.

People all over the world are upset about this new controversy, and rightly so because of the social and economic havoc it has caused—first in the developed countries, and now in the developing world. The intentional escape hypothesis is merely speculation; and, in my humble opinion, pure fantasy.

The technical facts about COVID-19 are these: We should be grateful to the Wuhan Chinese researchers who immediately published the genetic structure of the new coronavirus soon after it was completed by them in early January 2020. It was first named COVID-SARS-2. Within a few days of the Chinese publication (probably within just a few hours), scientists in the West began the designs for what would eventually become the BioNTech (Germany) and Moderna (US) vaccines.

The only molecular biology one needs to know to understand this, is this: in nature, DNA molecules carry the genetic information that is embedded in the genetic letters of a sequence. The genetic unit is a “gene” that encodes the protein. The DNA of a gene is “transcribed” in a cell’s nucleus where enzymes produce a copy of the sequence as mRNA (the messenger RNA).The mRNA is translated by the cell’s machinery into a protein.

To start, western scientists designed a DNA sequence that encodes the COVID “spike” protein in bacteria. The DNA sequence was chemically synthesized and multiplied in standard microbes. Small quantities in grams of spike genes are produced and purified by growing the bacteria in fermentation vessels. From this, trillions of copies can be made as needed to produce the final vaccine.

From studies of other coronaviruses, it is already established that the spike protein is a major antigen. \Therefore the spike protein was an obvious target for the vaccine development.

These spike DNAs are used as templates to be transcribed into mRNA molecules. Specific enzymes carry out this assembly in vitro.

The mRNA is translated by the cell’s machinery into a protein. Lots of optimization is then incorporated by design in the DNA to increase the stability of the mRNA, or to increase its translatability to human cells.

The mRNA is finally incorporated in microscopic particles made of highly sophisticated lipids (like oil droplets) called nano lipid carriers. This formulation step is crucial to preserve the mRNA. The mRNA is now ready to transfer to vials for shipment and for vaccination.

BioNTech joined hands with Pfizer of the United States, because Pfizer has the world-class manufacturing capacity, the worldwide distribution network, and the financial depth to build additional facilities that might be needed for manufacturing and warehousing the vaccine. Strict quality control measures are followed at all key steps.

Upon injection into human tissue, the nanolipids fuse with the lipids of human muscle cells and deliver the mRNA into the cells, where it remains for a few days. The cells translate the mRNA into spike protein, which is exported from the cells. This triggers the immune response, as our body creates antibodies that recognize the spike protein, and when confronted with the COVID virus, they neutralize it.

Just 30 µg ( 0.000030 gram) mRNA is in a vaccine dose!

Viral vector vaccines

This same technology has already been used in the development of vaccines against Ebola, Zika, and others.

The key principle is that a functional spike gene itself is used to vaccinate. To deliver the spike gene, it is engineered within a harmless adenovirus that causes the common cold.  Oxford University, where AstraZeneca vaccine was developed, uses an adenovirus that infects chimpanzees (and to which humans do not have a preexisting immunity). Johnson & Johnson uses a rare variant of the cold virus as a carrier.

The vector’s DNA and the gene-encoding spike are stitched together by genetic engineering. The recombinant (naturally occurring recombination) virus is multiplied by infecting large batches of a cultured human cell line.

AstraZeneca uses a cell line grown from lung or kidney cells. The vaccine only contains purified recombinant adenovirus with the spike gene. The virus DNA is transcribed in the nucleus, where spike mRNA is produced and translated into spike protein. The protein translocates to the outside of the cells, and triggers the immune response, leading to COVID immunity.

Looking ahead 

The four vaccines on the market (Pfizer BioNTech, Moderna, AstraZeneca, Johnson and Johnson)  are the first of a long series of vaccines to come. Some are based on other technologies. More than 50 candidates are in clinical trials.

A lot of research now focuses on dealing with present and future variants of the virus and on reducing production and distribution costs.

There is no longer a technical impediment to produce. Before the end of 2022, the 10 billion doses of vaccines needed to protect the global population from COVID-19 will be available. The current global population stands at 7.9 billion and projected by the UN to be 10 billion by year 2057.

The science behind this technology goes back to 1953 when Watson and Crick first published the double helix structure of DNA for which they won a Nobel Prize. Since then, billions of dollars have gone into biotech research mostly by the public sector to advance the science. Yes, the vaccine was developed in one year, but the science behind it has a long history.

Costs/benefits

Johnson & Johnson and AstraZeneca both vowed to sell their vaccines on a nonprofit basis during the pandemic. Moderna, which has never made a profit and has no other products on the market, decided to sell its vaccine at a profit.

Unlike Moderna’s vaccine, Pfizer’s shot is not crucial to the company’s bottom line. Last year, Pfizer earned $9.6 billion in profits before the COVID vaccine had any discernible impact on its results.

Pfizer frequently points out that it opted not to take federal funds proffered by the previous administration under Operation Warp Speed, the initiative that promoted the rapid development of COVID-19 vaccines.

BioNTech received substantial support from the German government in developing their joint vaccine. And taxpayer-funded research aided both companies: The National Institutes of Health (NIH) patented technology that helped make Pfizer’s and Moderna’s so-called messenger RNA vaccines possible. BioNTech has a licensing agreement with NIH, and Pfizer is piggybacking on that license.

Pfizer has kept the profitability of its vaccine sales opaque. The United States, for example, is paying $19.50 for each Pfizer dose. Israel agreed to pay Pfizer about $30 per dose, according to multiple media reports.

The benefit can be summarized in one sentence: Success of the vaccine has saved humanity from prolonged suffering and saved the economies of the world.

I am grateful to Dr Jan Leemans, my friend and former colleague at Plant Genetic Systems in Belgium, for his expert technical input in writing this article.

—Suri Sehgal

(Dr Suri Sehgal, PhD, leading international crop scientist; chair of the Board of Trustees of S M Sehgal Foundation and Sehgal Foundation, USA)

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