RWJF执行副总裁Julie Morita医学博士在美国众议院能源和商业委员会卫生小组委员会就卫生公平和美国疫苗推出发表证词
Chairman Pallone, Ranking Member McMorris Rodgers, Chairwoman Eshoo, Ranking Member Guthrie, and Members of the subcommittee:
Thank you for the opportunity to testify. My name is Julie Morita. I am the executive vice president of the Robert Wood Johnson Foundation, the nation’s largest health philanthropy, and I served on the COVID-19 Transition Advisory Board in my personal capacity. Previously, I served as: commissioner and chief medical officer of the Chicago Department of Public Health; an Epidemic Intelligence Service officer at the Centers for Disease Control and Prevention; and a member of the CDC’s Advisory Committee on Immunization Practices.
Our Foundation believes everyone deserves a fair and just opportunity to live the healthiest life possible. The pandemic—with more than 26 million Americans infected and 440,000 lives lost—illustrates the critical nature of our mission.
Vaccines offer real hope to eventually end the pandemic, but we must improve distribution by adhering to three fundamental principles: equity, accessibility, and coordination.
Equity
We must begin with equity. People and communities of color are disproportionately impacted by COVID-19. These populations historically and currently face discrimination, marginalization, and neglect. As a result, they are more likely to be denied basic necessities like a living wage, health insurance, and paid leave.
The CDC recommends that frontline and essential workers—predominantly people of color—be among those prioritized for vaccination due to high exposure risk. But today the country is consumed with total allotments and weekly averages instead of whether shots are getting in the right arms.
We must course correct quickly. Our Foundation believes an equitable response to the pandemic starts with collecting and reporting all COVID-19-related data by race, ethnicity, and socioeconomic factors. Yet most states do not publish vaccine data that includes race and ethnicity. Among states that do, the share of vaccinations among Black people lags behind their share of cases and deaths.
We can no longer accept the systemic racism that drives these disparities. Congress and the administration should encourage and enable all states to vaccinate priority populations first and to report vaccine data by race, ethnicity, occupation, and neighborhood.
Accessibility
Second, we must increase accessibility. Vaccines are only as effective as people’s ability to obtain them and willingness to take them.
Across our nation, those with means and privilege are increasingly getting vaccinated before those with the highest exposure risk. Necessities that some may take for granted—an Internet connection to make an appointment online; a car to drive to a large-scale vaccination site; the time it takes to navigate complex systems—are unaffordable for millions.
A fairer approach simplifies appointment systems and brings vaccines directly to priority populations. In Chicago, during the H1N1 pandemic, we partnered with pharmacies and federally qualified community health centers that provided care to the uninsured in neighborhoods with less access to healthcare providers. More than 700 locations in Chicago ultimately received more than one million H1N1 vaccines during a critical 12-week stretch.
We also established meaningful connections with trusted community partners to address vaccine hesitancy, which remains an issue today. More than one-quarter of Americans report they will not or likely will not get a COVID-19 vaccine. Notably, hesitancy rises to 1 in 3 among rural residents, Black adults, and essential workers.
Community groups, faith organizations, and other neighborhood pillars of trust play a pivotal role in helping people make appointments and understanding and addressing their concerns. Our Foundation is providing grant support to state and territorial health officials and community organizations to address vaccine hesitancy. As we await additional doses, funding and supporting critical local efforts will help us move to vaccine confidence and equitable distribution.
Coordination
Third, the incredible complexity and urgency of this vaccine rollout requires coordination and illustrates the unique role of the federal government.
I’m proud of how Chicago handled H1N1, but we did not do it alone. CDC’s clear guidance, additional funding, and technical assistance were invaluable. Without that support, our vaccine rollout would not have been as successful.
I’m encouraged that the administration—particularly Dr. Rochelle Walensky, the new CDC director—is committed to improving coordination at the federal level. Open lines of communication, increased transparency—such as more specific, accurate, and timely estimates of state allotments of vaccines—and ramping up our public health workforce will all help state and local health officials perform their heroic work.
Conclusion
The Robert Wood Johnson Foundation is invested in creating a more equitable nation during this pandemic and beyond. In the short-term, America’s ability to weather this crisis will require wearing masks, social distancing, washing hands, and additional support from Congress to help those hit hardest. Vaccines will eventually lead us to this pandemic’s end, but saving the greatest number of lives will require a recommitment from all of us to equity, accessibility, and coordination in vaccine distribution and all facets of our response.
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下列听证会证词由罗伯特·伍德·约翰逊基金会(RWJF)执行副总裁朱莉·森田博士美国众议院能源和商务委员会卫生小组委员会题为“复苏之路:增加Covid-19疫苗、检测和医疗供应链”的报告。
Pallone主席,McMorris Rodgers高级委员,Eshoo主席,Guthrie高级委员,以及小组委员会各位委员:
谢谢你给我作证的机会。我叫朱莉·森田。我是全国最大的健康慈善机构罗伯特·伍德·约翰逊基金会的执行副总裁,并以个人身份在COVID-19过渡咨询委员会任职。此前,我曾担任:芝加哥公共卫生部专员兼首席医疗官;疾病控制与预防中心流行病情报服务官员;也是疾病预防控制中心免疫实践咨询委员会的成员。
我们的基金会相信,每个人都应该有公平和公正的机会,尽可能过上最健康的生活。这场大流行病使2600多万美国人受到感染,44万人丧生,它说明了我们的使命的关键性质。
疫苗为最终结束大流行提供了真正的希望,但我们必须通过坚持三个基本原则来改善分配:公平、可获得性和协调。
股本
我们必须从公平开始。有色人种和有色社区不成比例的影响COVID-19。这些人群过去和现在都面临歧视、边缘化和忽视。因此,他们更有可能被剥夺基本必需品,如生活工资、医疗保险和带薪休假。
疾病预防控制中心建议一线和关键工作人员——主要是有色人种——由于暴露风险高,应优先接种疫苗。但如今,这个国家关注的是总分配和每周平均水平,而不是注射是否进入了正确的手臂。
我们必须迅速纠正航向。我们的基金会相信公平的回应首先要按种族、民族和社会经济因素收集和报告所有与covid -19相关的数据。然而,大多数州没有公布包括种族和民族在内的疫苗数据。在实行疫苗接种的州中,黑人接种疫苗的比例滞后在他们的病例和死亡份额背后。
我们不能再接受了系统性的种族主义这导致了这些差异。国会和行政当局应鼓励并使所有州首先为重点人群接种疫苗,并按种族、民族、职业和社区报告疫苗数据。
可访问性
二是提高可及性。疫苗的有效性取决于人们获得疫苗的能力和接种疫苗的意愿。
在全国范围内,那些有能力和特权的人越来越多地在暴露风险最高的人之前接种疫苗。一些人认为理所当然的必需品——上网预约;一辆开往大规模疫苗接种地点的汽车;对于数百万人来说,浏览复杂系统所花费的时间是无法承受的。
更公平的方法简化了预约系统,并将疫苗直接提供给重点人群。在芝加哥,在甲型H1N1流感大流行期间,我们与药店和获得联邦政府认证的社区卫生中心合作,为那些就医机会较少的社区的无保险人群提供医疗服务。在关键的12周期间,芝加哥的700多个地点最终接种了100多万支H1N1疫苗。
我们还与值得信赖的社区伙伴建立了有意义的联系,以解决疫苗犹豫问题,这在今天仍然是一个问题。超过四分之一的美国人报告他们不会或可能不会接种COVID-19疫苗。值得注意的是,在农村居民、黑人成年人和基本工人中,犹豫不决的比例上升到了三分之一。
社区团体、信仰组织和其他邻里信任支柱在帮助人们预约、理解和解决他们的关切方面发挥着关键作用。本基金会正在向州和地区卫生官员和社区组织提供赠款支持,以解决疫苗犹豫问题。在我们等待额外剂量的同时,资助和支持关键的地方努力将帮助我们实现疫苗信心和公平分配。
协调
第三,疫苗推广的复杂性和紧迫性令人难以置信,需要协调,并说明了联邦政府的独特作用。
我为芝加哥应对甲型H1N1流感的方式感到自豪,但我们并非孤军奋战。疾控中心的明确指导、额外资金和技术援助是无价的。没有这种支持,我们的疫苗推广就不会如此成功。
令我感到鼓舞的是,本届政府——尤其是新任疾控中心主任罗谢尔·瓦伦斯基博士——致力于改善联邦层面的协调。开放沟通渠道,提高透明度——例如对各州疫苗分配的更具体、更准确和更及时的估计——以及加大我们的公共卫生工作人员都将帮助州和地方卫生官员完成他们的英勇工作。
结论
罗伯特·伍德·约翰逊基金会致力于在疫情期间及以后建立一个更加公平的国家。在短期内,美国抵御这场危机的能力将需要戴口罩、保持社交距离、洗手,以及国会的额外支持,以帮助那些受灾最严重的人。疫苗最终将带领我们结束这场大流行,但要拯救最多的生命,我们所有人都必须重新承诺在疫苗分发和我们应对的各个方面实现公平、可及性和协调。
For more than 45 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are working alongside others to build a national Culture of Health that provides everyone in America a fair and just opportunity for health and well-being. For more information, visit www.ottomotal.com. Follow the Foundation on Twitter at www.ottomotal.com/twitter or on Facebook at www.ottomotal.com/facebook.
" data-isabstract="false" class="cmp-text">关于罗伯特伍德约翰逊基金会
45年来,罗伯特·伍德·约翰逊基金会一直致力于改善健康和医疗保健。我们正在与其他国家一道努力建立一种全国健康文化,为美国每个人提供公平和公正的健康和福祉机会。欲了解更多信息,请访问www.ottomotal.com.在Twitter上关注基金会www.ottomotal.com/twitter或者在Facebook上www.ottomotal.com/facebook.