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Written by Results Policy & Advocacy Manager, Mark Rice. Since early February, I have been a participant in a clinical trial for a potential oral COVID-19 vaccine. As we highlight the importance of vaccines during World Immunisation Week (24-30 April), I am sharing my experience to highlight how clinical trials are important in the development of safe and effective vaccines. The development of COVID-19 vaccines has occurred at a rapid pace, taking approximately one year from initial research to wide usage. Previously, the process for vaccine development could take up to 10 years from early research to wider usage. However, any approved vaccine has been through a series of trials explained below, and my experience reinforces that researchers developing vaccines aim to minimise any adverse impacts in the trial participants, and of course minimise the risk of any harm from the vaccines in use. Clinical trials are crucial in ensuring that new vaccines are both effective and safe but can only be possible if people are willing to volunteer and participate in the trial. To ensure everyone has access to free or cost-effective vaccines, we need more vaccine research. In the current scenario, “For everyone on this planet – or at least 90% – to get it, it’s going to be at least 2024,” says Adar Poonawalla, CEO of the Serum Institute of India that is currently producing the Oxford/AstraZeneca vaccine. It is therefore critical to continue vaccine research and trials in our quest for more effective and low-cost vaccine alternatives. I am very glad that I am part of the oral vaccine trial which if successful can be a strong alternative. The other concern is the public perception that COVID-19 vaccines are rushed. Experts confirm that the process has been sped up and not skipped. From my experience, as a participant, I was satisfied with the steps taken to ensure safety of the vaccine. As a public health professional I consider this an essential and should be the benchmark for future vaccine development. Stages at which we can be involved: The different stages of clinical trials, which any vaccine approved for use needs to go through, are: Phase 1: At this stage, a new vaccine or treatment is tested on a small group of people (usually 20-80) to evaluate factors such as safe dosage amounts and possible side effects. I have been a participant in a phase 1 trial, which involves weekly check-ups following the receipt of each dose of the trial vaccine, and identifying any symptoms or reactions I experience each day, whether they would be linked directly to the trial vaccine or not. After two months, the monitoring of any conditions or symptoms is less frequent, although I have some follow-up appointments to assess any longer-term impacts. Phase 2: At this stage, the new vaccine or treatment is tested with a larger group of people (several hundred) to determine whether the measure works as intended and to further evaluate its safety. Phase 3: At this stage, a new vaccine or treatment is tested with a large group (from several hundred to several thousand) and compared to other standard or experimental measures to see how effective the measure is and identify any adverse effects. Following this stage, a measure can be ready for introduction with the general population. Phase 4: Studies at this stage assess the effectiveness of a measure when it is in use, and also if the vaccine or treatment may have additional benefits or uses (eg, on other conditions). Why trial volunteers are important: As one of the nurses administering the trial vaccine to me noted, researchers can only learn some of the likely effects of a new vaccine or treatment from computer simulation and animal testing, and nothing can substitute for testing on humans. Therefore, while a person participating in a trial is taking some risks in receiving an experimental vaccine or treatment, and makes a commitment of time to attend check-ups and to monitor and record any symptoms, the reward is people like me are contributing to the development a vaccine or treatment that could prevent illness or even death for millions of people. Vaccine development and distribution Developing a market ready vaccine doesn’t automatically ensure that it reaches everyone in need and that everyone is willing to take a jab. Of course, there are several other actions which are required: Supporting all countries to obtain supplies of and have the capacity to administer the vaccines that are available. In the case of COVID-19, this means providing additional support to equitable distribution of vaccines among countries through investing in the COVAX facility. Donor countries including Australia pledged their support to COVAX and additional funding to support countries in need. Australian government pledged $500 million to support COVID-19 vaccination in the Pacific and South-East Asia leads to a safe and widespread availability of vaccines in the region. Fragile health systems, overburdened health staff and machinery need technical assistance in rollout and delivery of vaccines. Providing assistance to increase the capacity of health systems so countries can provide vaccines in the locations most in need and integrate vaccination with other health services. The importance of both the vaccine development and distribution stages is a reminder that everyone has a role to play in achieving the goal set out in the theme for World Immunisation Week this year – Vaccines Bring Us Closer.

The legendary Bruce Lee once said: “Under the sky Under the heavens There is but one family.” This is the reason why I, someone who lives in a malaria-free country, is acknowledging World Malaria Day. So should you. We cannot ignore a disease that killed over 400,000 members of our global family in 2019 (67% of whom were children). Living in a malaria-free country is not an excuse to ignore the issue and there’s a good reason for that: Malaria-free countries may not stay that way. COVID-19 has shown how unpredictable diseases can be, how they can quickly spread to every corner of the Earth and bring even seemingly invincible countries to their knees. Australia, in particular, is in a vulnerable position. Almost every country in the Asia-Pacific region (which Australia is in) experiences endemic levels of malaria. The Asia-Pacific region is home to a diverse range of malaria parasites, some of which are resistant to drugs. Some species of malaria-spreading mosquitoes in the region are resistant to insecticides. Not to mention, the high volume of people movement around the Asia-Pacific region (pre-COVID, of course) increases the risk of spreading. Although malaria doesn’t get the headlines that COVID-19 does, its threat to us is equally dire. It’s not all doom and gloom, however. Optimism is a key theme of World Malaria Day and the world has made a lot of progress against the disease. The number of malaria cases and deaths around the world has been declining since the year 2000, according to the World Malaria Report 2020 by the World Health Organization (WHO). Over 100 countries have been declared malaria-free by WHO – the most recent one being El Salvador in February of this year. Malaria vaccines are currently being developed along with many other research projects aimed at finding effective preventions and cures. Eliminating malaria from the face of the Earth is possible but it won’t happen without global awareness and investment. I urge you to join us in recognising World Malaria Day. Spread the word on social media, maybe buy a mosquito net for a family in need or message your local representative – tell them about your malaria concerns and why the government should support the fight against it. Your global family will thank you. Markos Hasiotis was a Results advocate in Melbourne. He works as a writer/researcher for several outlets and his goal is to spread beneficial information to as many people as possible and counteract harmful mistruths. He also volunteers in the sustainability and mental health sectors.

Results advocates are amazing! They are the heart of our grassroots activities, taking action to advocate for a world without poverty. Welcome to our grassroots highlight series, where each month we will be shining a light on one of our amazing advocates by asking a set of questions. First up, we have Julia Ferguson, a relatively new advocate to Results, but no less passionate. 1. Tell us briefly about who you are? I’m Julia, a lifelong local of South Western Sydney and a member of the Western Sydney Results group as of 2021! I majored in economics and development studies at UNSW and became interested in volunteering after getting involved in the student organization on campus. One of my big passions is travel, and I’ve been lucky to take several solo backpacking trips through Europe and South-East Asia. 2. Why are you passionate about ending global poverty? In my third year of university, I picked a development economics elective, which I found engaging enough to extend my degree by a year, so I could pick up a major in Development Studies and learn more about the challenges of global inequality and poverty. However, my interest in global poverty was also shaped by the stories I grew up hearing from my mother about her experiences being born and raised in Peru. Travelling to her birth country, and seeing the direct impacts of poverty, inspired me to reflect on my responsibilities as a global citizen. 3. Why did you join Results? With a move to live in London derailed by the global pandemic, I wanted to use my time in Sydney meaningfully. I was signed up for the Results newsletter and have seen some of the great outcomes Results has achieved. After seeing evidence of the success of the Results grassroots approach, the idea that I could also take action and have an impact on poverty reduction led me to apply when I saw the call for new volunteers. 4. What does Advocacy mean to you? To me, advocacy means utilising my personal agency to try and make positive changes in the global community of which I’m a part of. Advocacy in our Western Sydney Results group is about bringing together our skills and strengths as individuals in order to leverage greater outcomes in poverty reduction. 5. What do you hope to achieve with Results in 2021? As a tangible goal, I’d love to see our efforts in raising awareness about global poverty contribute to an increased commitment to foreign aid and global health funding in the 2021-22 budget! In terms of personal achievements, I hope that I gain more new experiences with Results and develop confidence in my advocacy skills. Also that I can be proud of my efforts as a global citizen in 2021.

Featuring Results advocate, and TB survivor, Demi Mason. A Perth woman went through 18 months of hell with a forgotten disease that up to one million Aussies unknowingly have in their bodies. While the world has been fixated by the COVID-19 crisis for the past year, a forgotten pandemic is raging around the world – and right here in Australia – with barely anybody noticing. Tuberculosis (TB) is preventable and treatable, yet still manages to kill 4000 people every day – with 700 of those children. It’s a disease caused by bacterial infection and commonly affects a person’s lungs, but can also affect other parts of the body and can cause serious illness. And, while it may sound like something that is only a problem in developing nations, there are up to one million people in Australia right now with a latent form of the disease. One Australian who knows the devastating toll the disease can take is 27-year-old nursing student and restaurant hostess Demi Mason from Perth. Read the full article here

Results advocate and GP Dr Janice Tan, explains how an ‘ancient disease’ mostly found thousands of kilometres away still impacts Australia. I am a GP in metropolitan Sydney. My patient, Rashid*, comes in today to talk about some recent stressors. The man, who is originally from a developing country, has just received word that there is a steadily rising number of cases of an infectious disease in his hometown. His father has also recently tested positive and has no access to appropriate healthcare. As the disease is highly infectious and easily spread through respiratory droplets, Rashid is worried that it will spread to the rest of his family. It may sound all too familiar, but the disease is not COVID-19. This is tuberculosis, an ancient disease that has stood the test of time. While cases in Australia and many first world nations remain low, tuberculosis remains at epidemic proportions in developing countries, including our Pacific neighbours. Read the full article here

The Drum theatre in Dandenong was lit up red in recognition of the 1.4 million people who die from tuberculosis each year. It was one of 50 buildings in Australia that showed support for a movement to end the TB pandemic on World Tuberculosis Day on 24 March. According to campaign organisers Results, TB is one of the deadliest airborne infectious diseases. It kills 4000 a day, including 700 children. Close to 15 million have succumbed in the past decade. In Australia, more than 1000 people required treatment in 2020. About 1 million carry the latent virus. Results International chief executive Negaya Chorley thanked Dandenong for its support against the “terrible disease”. Read the full article here

Manly Town Hall was lit red on Wednesday evening in solidarity with Results Australia as they fight against the global spread of Tuberculosis (TB). TB is a potentially serious infectious disease that mainly affects the lungs. The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes. Every day 4,000 people die from TB, largely affecting the poor and marginalised. The hall was lit to make a statement that TB is a major public health emergency, and it is time for the global community to act. Read the full article here

Op-ed by Results Head of Campaigns, Shiva Shrestha. As the world struggles to come to grips with COVID-19, there’s another pandemic that has been raging since the time of the pharaohs that will kill more than one million people this year – and every year that follows. On World Tuberculosis Day 2021, it is worth reflecting on the durability of an airborne organism that has killed billions of people since it was first recorded about 9000 years ago. This year, nearly 1.7 million people will die of tuberculosis, that’s 4000 people a day – including 700 children whose lives will be gone – up 280,000 from 12 months ago. Like COVID-19, tuberculosis is infectious and can be transmitted through the air; the bacteria is breathed in before attaching itself to the lungs. Once inhaled it literally consumes the healthy tissue leaving only blood and liquid waste, drowning the carrier from the inside. Like COVID-19, the disease is containable with vaccines, rigorous antibiotic treatment regimes and aggressive testing and tracing systems. And like COVID-19, tuberculosis hones in on those who are most vulnerable. While the bacteria remains latent in healthy carriers, it is rampant in poorer communities in the developing world, particular countries in our region like Papua New Guinea, Indonesia and Vietnam. But this is where the similarities between the diseases end. Read the full article here

FIFTY buildings nationwide, including Canberra landmarks such as Old Parliament House, will turn red tomorrow (March 24) to raise awareness for Australians suffering from Tuberculosis (TB). Last year, more than 1000 Australians required treatment for Tuberculosis, while another million carried a latent form of the virus, according to the Results Canberra Advocacy Group, who organised the campaign here in the ACT. The campaign will also see the Royal Australian Mint and Telstra Tower light up in recognition of the infectious disease that generally affects the lungs and kills about 4000 people globally, everyday, and close to 15 million in the past decade. Another million people will die this year and every year after unless action is ramped up to wipe out TB, says Canberra advocate David Bailey. Read the full article here

Op-ed by Results CEO, Negaya Chorley If women ruled the world, how would the past year have played differently? On International Women’s Day, it’s an intriguing question to ponder as we take stock of the successes and notable failures of the past 12 months. As mothers, aunties, grandmothers, and daughters, women think daily about the future and what it holds. We bring a longer-term perspective on politics and decision-making, recognising that short term thinking has stifled democracy and our ability to tackle the defining challenges of our time, most notably climate change. And yet despite representing more than half the world’s population, only 11 per cent of UN member states have female leaders, just 7.4 per cent of Fortune 500 companies are led by women and women represent only one quarter of COVID task forces around the world yet represent 75 per cent of those on the frontlines of the COVID-19 response. Read the full article here!

One of the simplest ways I find satisfaction from life is by dedicating my time towards a cause that I feel passionate about. I decided to join RESULTS Australia because of my passion for equitable healthcare and the idea that an individual can have power to create transformation through advocacy and leadership. Initially, I was a bit sceptical about how just talking with an MP would help us improve vaccination in developing countries or help alleviate global poverty. But, as I read more about RESULTS and attended meetings and informative webinars, I got to understand more about how RESULTS worked especially through campaigning and advocacy. I was particularly encouraged to know that through this work, I could change the lives of millions of children through Gavi. The weekly group meetings were fun and interactive in addition to being informative about the work done by RESULTS in the past and the goals for the near future. But, it was the team at RESULTS that made my experience invigorating. Even though the current situation of COVID-19 pandemic seemed like a huge challenge in the beginning, we as a team overcame that with resilience and positivity to bring about the change we envisioned. I look forward to working with my team members while knowing that this little effort will help make a difference. I particularly enjoyed meeting with MPs. Although the lockdown forced us to go online and confined us to Zoom meetings instead of face-to-face, I think we nailed it regardless. It was nerve-wracking at the beginning to secure the meeting, prepare for it by gaining all the information and be able to discuss it with the MPs with utmost confidence. And I didn’t know that a small action of discussing with MPs about what we are advocating for could bring about transformation and create hope. But, in the moment when the Australian Government announced the “$300 million for the Gavi Alliance”, I am sure we all felt that pride within us for taking one step each and making this a huge success. For me, there has been a perspective change since being a part of creating a change; I am now more concerned about equitable healthcare, public health, the health systems in other countries and how the developed economies are only as strong as the developing economies. I also learnt plenty from my experience as a grassroots advocate. Most importantly, I learned that people are not powerless; in fact we have a great deal of power and potential regardless of sometimes being told we may not have any because of various factors, such as economic status, sexual orientation, or employment status. Through advocating with RESULTS, I felt empowered to know the agency you have in your own life to make a global impact and how beautiful it is to share that experience with others. As rightly said by Elizabeth Andrew; “Volunteers do not necessarily have the time, they have the heart.” Dr Nikita Kherodiya (MBBS, MPH) is a RESULTS volunteer in Sydney. Being a healthcare professional from India has given me first hand experience in various health issues which can be improved; I want to work towards improving healthcare and making sure it reaches people who need it the most.