Prevention is better than cure

The ongoing struggle to reduce the cost of vaccines in developing countries like Ghana.

 

Monday saw me in Committee room 1 in Westminster amongst Parliamentarians and health and development activists at the start of World Immunisation Week. Now I am in Ghana where more than 50 years ago I was inoculated against polio. This has now been eradicated in Ghana by the sort of mass immunisation campaign that I am privileged to see launched here this week.

Today, in Ghana the target is two of the biggest child killers in the world pneumonia and diarrhoea. These two diseases account for an estimated 20 per cent of all under 5 deaths in the country, but are largely preventable through the introduction of the pneumococcal and rotavirus vaccines. In the UK we take for granted the access and availability of these vaccines and we have little experience of the fatal impact of these diseases. But pneumonia and diarrhoea each kill roughly 500,000 children under 5 every year and 85 per cent of the diarrhoea deaths caused by rotavirus are in the developing world. In Ghana the fatal impact of these diseases is very real.

I am travelling to Ghana with the GAVI Alliance. This unique partnership between governments, North and South, civil society, and private sector philanthropists and businesses has revolutionised the market in and delivery of vaccines globally and saved the lives of millions. The origins of GAVI's funding lie in the very special coming together of activists and government that led to the UK’s historic commitments to the UN 0.7 per cent of GDP target for development. This is an enduring achievement of the last Labour government. The good news is that this saw the advent of a new national consensus. The consequence of which is that David Cameron and Andrew Mitchell, who hosted the last funding conference for GAVI, have committed a further £814 million pounds to the cause. This recognises not simply the need I see so clearly demonstrated in Ghana and indeed throughout my work in Africa but also of the effectiveness of GAVI and its unique model. This builds local ownership whilst intervening in world markets to reduce the cost of vaccines to developing nations through innovative funding mechanisms. The IFFIm on which I worked with Gordon Brown during our time at the Treasury was the first of these. Designed and championed by a very special partnership between the treasury, the city, and civil society including the Vatican, it proved to be a groundbreaking approach to securing sustainable funding for development. I am now seeing first hand in Ghana the product of a next generation initiative, the Advanced Market Commitment (AMC), which is delivering life saving pneumococcal vaccines to the poorest countries at a 90 per cent price reduction compared to the cost in the US and EU. And it has accelerated the pace of delivery so that by 2015 an additional 700,000 lives ought to be saved.

The child that I saw my self struggling for breath in the arms of her father, whilst a weeping mother looked on at the Princess Marie Louise Hospital in central Accra ought not to be joined by countless others. Politics and the budget process that protects DFID’s spending are too often disparaged by so many in the sadly cynical and disillusioned country that we have become. Not least by so many young people who have been turned off completely by the whole process. We all need reminding from time to time why politics and the contest of ideas and values matter so desperately. And why we need to restore and revitalise our own politics.

One of GAVI’s strengths, as I see it, is that GAVI builds and supports local ownership and participation. A traditional leader in rural Ghana told us through his linguist, the original version of our own Number 10 spokesperson, why he had called together the village community to get vaccinated. Ghanaian health professionals had proudly outlined the “cold chain”, the logistical triumph that will ensure that children in the remotest parts of Ghana will still get access to the vaccine in good time and at maximum effectiveness. The Health Minister rightly outlined the Ghanaian taxpayers’ contribution to the funding of the whole process supported by GAVI. This is best practice in international development. Britain’s contribution ensures that somewhere in the world every 2 seconds a child is being vaccinated and a life is saved every 2 minutes from diseases that no child in the UK ever dies. On my way back from the medical field unit so similar to the one my mum took me all those years ago now, I saw a “Tro-Tro”, Ghana’s ubiquitous minivan taxi system. They are famed for the proverbs emblazoned on them with great colour and decorative flourish. This one simply said, “Prevention is better than cure". 

Paul Boateng is a former chief secretary to the Treasury, ex-High Commissioner in South Africa and a Labour peer

Paul Boateng, a former British high commissioner to South Africa, MP, cabinet minister and civil rights lawyer, is a member of the House of Lords and a trustee of the Planet Earth Institute

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The Tinder dating app isn't just about sex – it's about friendship, too. And sex

The lines between sex, love and friendship are blurrier than ever, as I found out quickly while using the app.

The first time I met someone using Tinder, the free dating app that requires users to swipe left for “no” and right for “yes” before enabling new “matches” to chat, it was an unqualified success. I should probably qualify that. I was newly single after five years in a committed relationship and wasn’t looking for anything more than fun, friendship and, well, who knows. A few weeks earlier I had tried to give my number to a girl in a cinema café in Brixton. I wrote it on a postcard I’d been using as a bookmark. She said she had a boyfriend, but wanted to keep the postcard. I had no date and I lost my page.

My Tinder date was a master’s student from Valencia called Anna (her name wasn’t really Anna, of course, I’m not a sociopath). When I arrived at the appointed meeting place, she told me I was far more handsome IRL (“in real life”) than my pictures suggested. I was flattered and full of praise for the directness of continental Europeans but also thought sadly to myself: “If only the same could be said about you.”

Anna and I became friends, at least for a while. The date wasn’t a success in the traditional sense of leading us into a contract based on exclusivity, an accumulating cache of resentments and a mortgage, but it had put me back in the game (an appropriate metaphor – people speak regularly of “playing” with the app).

According to Sean Rad, the co-founder who launched Tinder in late 2012, the service was invented for people like me. “It was really a way to overcome my own problems,” he told the editor of Cosmopolitan at an event in London last month. “It was weird to me, to start a conversation [with a stranger]. Once I had an introduction I was fine, but it’s that first step. It’s difficult for a lot of people.” After just one outing, I’d learned two fundamental lessons about the world of online dating: pretty much everyone has at least one decent picture of themselves, and meeting women using a so-called hook-up app is seldom straightforwardly about sex.

Although sometimes it is. My second Tinder date took place in Vienna. I met Louisa (ditto, name) outside some notable church or other one evening while visiting on holiday (Tinder tourism being, in my view, a far more compelling way to get to know a place than a cumbersome Lonely Planet guide). We drank cocktails by the Danube and rambled across the city before making the romantic decision to stay awake all night, as she had to leave early the next day to go hiking with friends. It was just like the Richard Linklater movie Before Sunrise – something I said out loud more than a few times as the Aperol Spritzes took their toll.

When we met up in London a few months later, Louisa and I decided to skip the second part of Linklater’s beautiful triptych and fast-track our relationship straight to the third, Before Midnight, which takes place 18 years after the protagonists’ first meet in Vienna, and have begun to discover that they hate each others’ guts.

Which is one of the many hazards of the swiping life: unlike with older, web-based platforms such as Match.com or OkCupid, which require a substantial written profile, Tinder users know relatively little about their prospective mates. All that’s necessary is a Facebook account and a single photograph. University, occupation, a short bio and mutual Facebook “likes” are optional (my bio is made up entirely of emojis: the pizza slice, the dancing lady, the stack of books).

Worse still, you will see people you know on Tinder – that includes colleagues, neighbours and exes – and they will see you. Far more people swipe out of boredom or curiosity than are ever likely to want to meet up, in part because swiping is so brain-corrosively addictive.

While the company is cagey about its user data, we know that Tinder has been downloaded over 100 million times and has produced upwards of 11 billion matches – though the number of people who have made contact will be far lower. It may sound like a lot but the Tinder user-base remains stuck at around the 50 million mark: a self-selecting coterie of mainly urban, reasonably affluent, generally white men and women, mostly aged between 18 and 34.

A new generation of apps – such as Hey! Vina and Skout – is seeking to capitalise on Tinder’s reputation as a portal for sleaze, a charge Sean Rad was keen to deny at the London event. Tinder is working on a new iteration, Tinder Social, for groups of friends who want to hang out with other groups on a night out, rather than dating. This makes sense for a relatively fresh business determined to keep on growing: more people are in relationships than out of them, after all.

After two years of using Tinder, off and on, last weekend I deleted the app. I had been visiting a friend in Sweden, and took it pretty badly when a Tinder date invited me to a terrible nightclub, only to take a few looks at me and bolt without even bothering to fabricate an excuse. But on the plane back to London the next day, a strange thing happened. Before takeoff, the woman sitting beside me started crying. I assumed something bad had happened but she explained that she was terrified of flying. Almost as terrified, it turned out, as I am. We wound up holding hands through a horrific patch of mid-air turbulence, exchanged anecdotes to distract ourselves and even, when we were safely in sight of the ground, a kiss.

She’s in my phone, but as a contact on Facebook rather than an avatar on a dating app. I’ll probably never see her again but who knows. People connect in strange new ways all the time. The lines between sex, love and friendship are blurrier than ever, but you can be sure that if you look closely at the lines, you’ll almost certainly notice the pixels.

Philip Maughan is Assistant Editor at the New Statesman.

This article first appeared in the 26 May 2016 issue of the New Statesman, The Brexit odd squad