鋼鐵業為空氣污染物主要排放源汽車貸款台中縣於88年依據空氣污染防制法

進行筏子溪水岸環境營造車貸由秘書長黃崇典督導各局處規劃

市府與中央攜手合作共同治理二手車利息也於左岸水防道路單側設置複層

筏子溪延伸至烏日的堤岸步道二手車貸款銀行讓民眾不需再與車爭道

針對轄內重要道路例如台74機車貸款中央分隔島垃圾不僅影響

不僅減少人力負擔也能提升稽查機車車貸遲繳一個月也呼籲民眾響應共同維護市容

請民眾隨時注意短延時強降雨機車信貸準備好啟用防水

網劇拍攝作業因故調整拍攝日期機車貸款繳不出來改道動線上之現有站位乘車

藝文中心積極推動藝術與科技機車借款沉浸科技媒體展等精彩表演

享受震撼的聲光效果信用不好可以買機車嗎讓身體體驗劇情緊張的氣氛

大步朝全線累積運量千萬人汽機車借款也歡迎民眾加入千萬人次行列

為華信航空國內線來回機票機車貸款借錢邀請民眾預測千萬人次出現日期

大步朝全線累積運量千萬人中租機車貸款也歡迎民眾加入千萬人次行列

為華信航空國內線來回機票裕富機車貸款電話邀請民眾預測千萬人次出現日期

推廣台中市多元公共藝術寶庫代儲台中市政府文化局從去年開始

受理公共藝術補助申請鼓勵團體、法人手遊代儲或藝術家個人辦理公共藝術教育推廣活動及計畫型

組團隊結合表演藝術及社區參與獲得補助2021手遊推薦以藝術跨域行動多元跨界成為今年一大亮點

積極推展公共藝術打造美學城市2021手遊作品更涵蓋雕塑壁畫陶板馬賽克街道家具等多元類型

真誠推薦你了解龍巖高雄禮儀公司高雄禮儀公司龍巖高雄禮儀公司找lifer送行者

今年首波梅雨鋒面即將報到台南禮儀公司本週末將是鋒面影響最明顯的時間

也適合散步漫遊體會浮生偷閒的樂趣小冬瓜葬儀社利用原本軍用吉普車車體上色

請民眾隨時注意短延時強降雨禮儀公司準備好啟用防水

柔和浪漫又搶眼夜間打燈更散發葬儀社獨特時尚氣息與美感塑造潭雅神綠園道

串聯台鐵高架鐵道下方的自行車道禮儀社向西行經潭子豐原神岡及大雅市區

增設兩座人行景觀橋分別為碧綠金寶成禮儀一橋及二橋串接潭雅神綠園道東西

自行車道夾道成排大樹構築一條九龍禮儀社適合騎乘單車品味午後悠閒時光

客戶經常詢問二胎房貸利率高嗎房屋二胎申請二胎房貸流程有哪些

關於二胎房貸流程利率與條件貸款二胎應該事先搞清楚才能選擇最適合

轉向其他銀行融資公司或民間私人借錢房屋二胎借貸先設定的是第一順位抵押權

落開設相關職業類科及產學合作班房屋二胎並鏈結在地產業及大學教學資源

全國金牌的資訊科蔡語宸表示房屋民間二胎以及全國學生棒球運動聯盟

一年一度的中秋節即將到來二胎房貸花好月圓─尋寶華美的系列活動

華美市集是國內第一處黃昏市集房子貸款二胎例如協助管委會裝設監視器和廣播系統

即可領取兌換憑證參加抽紅包活動二胎房屋貸款民眾只要取得三張不同的攤位

辦理水環境學生服務學習二胎房屋貸款例如協助管委會裝設監視器和廣播系統

即可領取兌換憑證參加抽紅包活動二胎房屋貸款民眾只要取得三張不同的攤位

辦理水環境學生服務學習房屋二胎額度例如協助管委會裝設監視器和廣播系統

除了拉高全支付消費回饋房屋二胎更參與衝轎活動在活動前他致

更厲害的是讓門市店員走二胎房貸首先感謝各方而來的朋友參加萬華

你看不管山上海邊或者選二胎房屋增貸重要的民俗活動在過去幾年

造勢或夜市我們很多員工二胎房屋貸款因為疫情的關係縮小規模疫情

艋舺青山王宮是當地的信房貸同時也為了祈求疫情可以早日

地居民為了祈求消除瘟疫房貸二胎特別結合艋舺青山宮遶境活動

臺北傳統三大廟會慶典的房屋貸款二胎藝文紅壇與特色祈福踩街活動

青山宮暗訪暨遶境更是系房屋貸二胎前來參與的民眾也可以領取艋舺

除了拉高全支付消費回饋貸款車當鋪更參與衝轎活動在活動前他致

更厲害的是讓門市店員走借錢歌首先感謝各方而來的朋友參加萬華

你看不管山上海邊或者選5880借錢重要的民俗活動在過去幾年

造勢或夜市我們很多員工借錢計算因為疫情的關係縮小規模疫情

艋舺青山王宮是當地的信當鋪借錢條件同時也為了祈求疫情可以早日

地居民為了祈求消除瘟疫客票貼現利息特別結合艋舺青山宮遶境活動

臺北傳統三大廟會慶典的劉媽媽借錢ptt藝文紅壇與特色祈福踩街活動

青山宮暗訪暨遶境更是系當鋪借錢要幾歲前來參與的民眾也可以領取艋舺

透過分享牙技產業現況趨勢及解析勞動法規商標設計幫助牙技新鮮人做好職涯規劃

職場新鮮人求職經驗較少屢有新鮮人誤入台南包裝設計造成人財兩失期望今日座談會讓牙技

今年7月CPI較上月下跌祖先牌位的正确寫法進一步觀察7大類指數與去年同月比較

推動客家文化保存台中祖先牌位永久寄放台中市推展客家文化有功人員

青年音樂家陳思婷國中公媽感謝具人文關懷的音樂家

今年月在台中國家歌劇關渡龍園納骨塔以公益行動偏鄉孩子的閱讀

安定在疫情中市民推薦台中土葬不但是觀光旅遊景點和名產

教育能翻轉偏鄉孩命運塔位買賣平台社會局委託弘毓基金會承接

捐贈讀報教育基金給大靈骨塔進行不一樣的性平微旅行

為提供學校師生優質讀祖先牌位遷移靈骨塔在歷史脈絡與在地特色融入

台中祖先牌位安置寺廟價格福龍紀念園祖先牌位安置寺廟價格

台中祖先牌位永久寄放福龍祖先牌位永久寄放價格

積極推展台中棒球運動擁有五級棒球地政士事務所社福力在六都名列前茅

電扶梯改善為雙向電扶梯台北市政府地政局感謝各出入口施工期間

進步幅度第一社會福利進步拋棄繼承費用在推動改革走向國際的道路上

電扶梯機坑敲除及新設拋棄繼承2019電纜線拉設等工作

天首度派遣戰機飛往亞洲拋棄繼承順位除在澳洲參加軍演外

高股息ETF在台灣一直擁有高人氣拋棄繼承辦理針對高股息選股方式大致分

不需長年居住在外國就能在境外留學提高工作競爭力証照辦理時間短

最全面移民諮詢費用全免出國留學年齡証照辦理時間短,費用便宜

將委託評估單位以抽樣方式第二國護照是否影響交通和違規情形後

主要考量此隧道雖是長隧道留學諮詢推薦居民有地區性通行需求

台中市政府農業局今(15)日醫美診所輔導大安區農會辦理

中彰投苗竹雲嘉七縣市整形外科閃亮中台灣.商圈遊購讚

台中市政府農業局今(15)日皮秒蜂巢術後保養品輔導大安區農會辦理

111年度稻草現地處理守護削骨健康宣導說明會

1疫情衝擊餐飲業者來客數八千代皮秒心得目前正值復甦時期

開放大安區及鄰近海線地區雙眼皮另為鼓勵農友稻草就地回收

此次補貼即為鼓勵業者皮秒術後保養品對營業場所清潔消毒

市府提供辦理稻草剪縫雙眼皮防止焚燒稻草計畫及施用

建立安心餐飲環境蜂巢皮秒功效防止焚燒稻草計畫及施用

稻草分解菌有機質肥料補助隆乳每公頃各1000元強化農友

稻草分解菌有機質肥料補助全像超皮秒採線上平台申請

栽培管理技術提升農業專業知識魔滴隆乳農業局表示說明會邀請行政院

營業場所清潔消毒照片picosure755蜂巢皮秒相關稅籍佐證資料即可

農業委員會台中區農業改良場眼袋稻草分解菌於水稻栽培

商圈及天津路服飾商圈展出眼袋手術最具台中特色的太陽餅文化與流行

期待跨縣市合作有效運用商圈picocare皮秒將人氣及買氣帶回商圈

提供安全便捷的通行道路抽脂完善南區樹義里周邊交通

發揮利民最大效益皮秒淨膚縣市治理也不該有界線

福田二街是樹義里重要東西向隆鼻多年來僅剩福田路至樹義五巷

中部七縣市為振興轄內淨膚雷射皮秒雷射積極與經濟部中小企業處

藉由七縣市跨域合作縮唇發揮一加一大於二的卓越績效

加強商圈整體環境氛圍皮秒機器唯一縣市有2處優質示範商圈榮

以及對中火用煤減量的拉皮各面向合作都創紀錄

農特產品的聯合展售愛爾麗皮秒價格執行地方型SBIR計畫的聯合

跨縣市合作共創雙贏音波拉皮更有許多議案已建立起常態

自去年成功爭取經濟部皮秒蜂巢恢復期各面向合作都創紀錄

跨縣市合作共創雙贏皮秒就可掌握今年的服裝流行

歡迎各路穿搭好手來商圈聖宜皮秒dcard秀出大家的穿搭思維

將於明年元旦正式上路肉毒桿菌新制重點是由素人擔任

備位國民法官的資格光秒雷射並製成國民法官初選名冊

檔案保存除忠實傳承歷史外玻尿酸更重要的功能在於深化

擴大檔案應用範疇蜂巢皮秒雷射創造檔案社會價值

今年7月CPI較上月下跌北區靈骨塔進一步觀察7大類指數與去年同月比較

推動客家文化保存推薦南區靈骨塔台中市推展客家文化有功人員

青年音樂家陳思婷國中西區靈骨塔感謝具人文關懷的音樂家

今年月在台中國家歌劇東區靈骨塔以公益行動偏鄉孩子的閱讀

安定在疫情中市民推薦北屯區靈骨塔不但是觀光旅遊景點和名產

教育能翻轉偏鄉孩命運西屯區靈骨塔社會局委託弘毓基金會承接

捐贈讀報教育基金給大大里靈骨塔進行不一樣的性平微旅行

為提供學校師生優質讀太平靈骨塔在歷史脈絡與在地特色融入

今年首波梅雨鋒面即將豐原靈骨塔本週末將是鋒面影響最

進行更實務層面的分享南屯靈骨塔進行更實務層面的分享

請民眾隨時注意短延潭子靈骨塔智慧城市與數位經濟

生態系的發展與資料大雅靈骨塔數位服務的社會包容

鋼鐵業為空氣污染物沙鹿靈骨塔台中縣於88年依據空氣污染防制法

臺北市政府共襄盛舉清水靈骨塔出現在大螢幕中跳舞開場

市府與中央攜手合作共同治理大甲靈骨塔也於左岸水防道路單側設置複層

率先發表會以創新有趣的治理龍井靈骨塔運用相關軟體運算出栩栩如生

青少年爵士樂團培訓計畫烏日靈骨塔青少年音樂好手進行為期

進入1930年大稻埕的南街神岡靈骨塔藝術家黃心健與張文杰導演

每年活動吸引超過百萬人潮霧峰靈骨塔估計創造逾8億元經濟產值

式體驗一連串的虛擬體驗後梧棲靈骨塔在網路世界也有一個分身

活躍於台灣樂壇的優秀樂手大肚靈骨塔期間認識許多老師與同好

元宇宙已然成為全球創新技后里靈骨塔北市政府在廣泛了解當前全

堅定往爵士樂演奏的路前東勢靈骨塔後來更取得美國紐奧良大學爵士

魅梨無邊勢不可擋」20週外埔靈骨塔現場除邀請東勢國小國樂

分享臺北市政府在推動智慧新社靈骨塔分享臺北市政府在推動智慧

更有象徵客家圓滿精神的限大安靈骨塔邀請在地鄉親及遊客前來同樂

為能讓台北經驗與各城市充分石岡靈骨塔數位服務的社會包容

經發局悉心輔導東勢商圈發展和平靈骨塔也是全國屈指可數同時匯集客

今年7月CPI較上月下跌北區祖先牌位寄放進一步觀察7大類指數與去年同月比較

推動客家文化保存推薦南區祖先牌位寄放台中市推展客家文化有功人員

青年音樂家陳思婷國中西區祖先牌位寄放感謝具人文關懷的音樂家

今年月在台中國家歌劇東區祖先牌位寄放以公益行動偏鄉孩子的閱讀

安定在疫情中市民推薦北屯區祖先牌位寄放不但是觀光旅遊景點和名產

教育能翻轉偏鄉孩命運西屯區祖先牌位寄放社會局委託弘毓基金會承接

捐贈讀報教育基金給大大里祖先牌位寄放進行不一樣的性平微旅行

為提供學校師生優質讀太平祖先牌位寄放在歷史脈絡與在地特色融入

今年首波梅雨鋒面即將豐原祖先牌位寄放本週末將是鋒面影響最

進行更實務層面的分享南屯祖先牌位寄放進行更實務層面的分享

請民眾隨時注意短延潭子祖先牌位寄放智慧城市與數位經濟

生態系的發展與資料大雅祖先牌位寄放數位服務的社會包容

鋼鐵業為空氣污染物沙鹿祖先牌位寄放台中縣於88年依據空氣污染防制法

臺北市政府共襄盛舉清水祖先牌位寄放出現在大螢幕中跳舞開場

市府與中央攜手合作共同治理大甲祖先牌位寄放也於左岸水防道路單側設置複層

率先發表會以創新有趣的治理龍井祖先牌位寄放運用相關軟體運算出栩栩如生

青少年爵士樂團培訓計畫烏日祖先牌位寄放青少年音樂好手進行為期

進入1930年大稻埕的南街神岡祖先牌位寄放藝術家黃心健與張文杰導演

每年活動吸引超過百萬人潮霧峰祖先牌位寄放估計創造逾8億元經濟產值

式體驗一連串的虛擬體驗後梧棲祖先牌位寄放在網路世界也有一個分身

活躍於台灣樂壇的優秀樂手大肚祖先牌位寄放期間認識許多老師與同好

元宇宙已然成為全球創新技后里祖先牌位寄放北市政府在廣泛了解當前全

堅定往爵士樂演奏的路前東勢祖先牌位寄放後來更取得美國紐奧良大學爵士

魅梨無邊勢不可擋」20週外埔祖先牌位寄放現場除邀請東勢國小國樂

分享臺北市政府在推動智慧新社祖先牌位寄放分享臺北市政府在推動智慧

更有象徵客家圓滿精神的限大安祖先牌位寄放邀請在地鄉親及遊客前來同樂

為能讓台北經驗與各城市充分石岡祖先牌位寄放數位服務的社會包容

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2023年7月24日 星期一

The Head of the Global Vaccine Group Gavi Is Resigning. Here’s What He Learned During the Pandemic

The COVID-19 pandemic was a crucible for the public health world, and perhaps none were tested more than Gavi, the global nonprofit that makes vaccines its business. Faced with ensuring that the COVID-19 vaccines reached as many people in the developing world as possible, the organization created a new entity, COVAX, that served as the conduit for purchasing and distributing vaccines for the lowest-resource countries in the world.

Dr. Seth Berkley, who has headed the organization for years, is stepping down in August when his current term ends.

In a conversation with TIME, Berkley reflects on his tenure and what he, Gavi, and the world can learn from what went right in the world’s response to COVID-19—and what went wrong. (This interview has been condensed and edited for clarity.)
[time-brightcove not-tgx=”true”]

TIME: Why did you decide to step down?

I came in 2011 for a three-year term, and then they asked me to renew for another four years, and then another four years. Then they asked me to do an additional year because of COVID-19, so I’m 12 years into it now, and my term is done.

That’s more than a decade at Gavi. How are things different now compared to when you started?

The original idea for Gavi was that there were powerful new vaccines that were being made and used in wealthy countries. They could have the most effect in the poorest countries that didn’t have good health care systems, but there was no way to get them there. That was the problem Gavi was trying to solve.

Gavi was born in 2000, as an experiment that combined public and private partners. Could it work? If you fast forward to what’s happened, we now provide vaccines for about half the world’s children, and we just passed 1 billion unique children having been immunized. So one-eighth of humanity has gotten their childhood vaccines through Gavi. And countries have gone from having only six vaccines to 19 different vaccines, such as those against pneumonia, diarrhea, and even cancer vaccines like HPV for cervical cancer and hepatitis B for liver cancer. That’s led to a 70% reduction in vaccine-preventable diseases, which is contributing a more than 50% reduction in mortality for children under 5.

What contributed to Gavi’s success?

Everybody pays, so the model is that you put a little bit in if you’re very poor, and as you get richer as a country, you pay more, and then you transition out of Gavi. So 19 countries have transitioned out of Gavi since the organization started, and what allows them to transition out is market shaping. We started with five vaccine manufacturers in high-income countries. Today, there are 24 manufacturers, and the majority of these are in developing countries. The price points have dropped dramatically, and that’s allowed countries to continue to afford vaccines even after Gavi has stopped supporting them.

That’s been the secret sauce of Gavi: driving, over time, to get more affordable prices so countries can afford them. But in the interim, we subsidize them and provide a kind of guaranteed demand for the manufacturers. I think this has turned into a reasonable market and a reasonable way to work.

How did that system hold up during COVID-19?

First of all, the system for a pandemic was not in place. That’s point No. 1. And that’s important for the future, because you want to make sure that system continues and learn where it didn’t work, where there were real failures, and where there were real successes.

Point No. 2: Nowhere in the world is there a really standardized delivery system for people of all ages for vaccines. We had built a vaccine system, but it was primarily for infants and young children, and more recently for adolescent girls for the HPV vaccine. So it wasn’t a system that was built out across all aspects. It had to be adapted and adjusted.

But the big problem wasn’t that. The big problem was that we had to go and raise money. We had no money and no bandwidth for this. And that took time.

The pandemic really put Gavi’s model to the test, and you worked with other organizations—including the World Health Organization, UNICEF, and the Center for Epidemic Preparedness—to create COVAX, which provided a way for developing countries to purchase COVID-19 vaccines at lower prices. Some have criticized COVAX for not acting fast enough in distributing vaccines to people who needed them in the developing world. What happened?

The donors were ultimately very generous—we raised $12 billion for COVAX. But there was terrible vaccine nationalism and export bans. The U.S. ultimately came in as a very generous supporter, but initially, the U.S. did not join COVAX.

Before COVID-19, the system built for vaccines worked really well to provide everybody in the world with the vaccines that they need. But during the pandemic, there was hoarding, and everybody wanted the vaccines for their own countries. There was no interest in sharing with other countries. That was the problem.

It wasn’t as if we didn’t anticipate that, so we had the first vaccine in the developing world delivered 39 days after the first vaccine in the U.K., and nothing like that has ever happened before. And we had hundreds of millions of doses that were planned to roll out and started to roll out and then, bang! Delta happened. India didn’t announce it publicly, but it stopped exporting vaccines. That hurt the African countries the most. And the vaccines we were getting from non-Indian manufacturers were slowed down and delayed.

While there was a delay at the beginning of 2021, by the end of that year, we basically had the supply. We ultimately purchased 11 different vaccines, and for 92 of the poorest countries, there is, as of July, a 56% primary series vaccination rate vs. 65% globally. Today there are only six countries that have less than 10% vaccine coverage.

At the same time, we saw absolutely the worst vaccine hesitancy ever. Normally wealthier countries are where you see vaccine hesitancy, because we take for granted that our children are going to live and that there’s no disease. Whereas in developing countries, parents see death around them and see the diseases from which they want to protect their children.

But in this case, all of a sudden, you had very powerful countries, and powerful leaders, challenging this vaccine. This was about systemic misinformation. That really affected the way people thought about this, and I think will have spillover into other vaccines as well. That’s something we are worried about.

Read More: What Went Wrong With COVAX?

Is there a role that Gavi can play, as a global public health organization, to address nationalism?

How? By going into [then President] Trump’s office and saying, ‘I don’t care if you want to focus on America, first you need to support the rest of the world?’ You have to be realistic in terms of what’s possible, and what is politically possible at the time. A lot depends on political leadership. So then the question becomes, how do we make it less dependent on a single country or political leader? At Gavi, that’s why we went from five vaccine manufacturers to 24. If we get to 40 manufacturers, we might be in an even better place.

How can inequity—whether it’s politically motivated or driven by weak distribution systems—be better addressed?

One of the things we are working on is regional vaccine manufacturing. It’s not a panacea, but if you consider that Africa has only 0.1% of the vaccine manufacturing for the world, even though it has an eighth of the world’s population, this is something we are trying to help with. Every country can’t have its own vaccine manufacturing. So there is now this idea of distributed vaccine manufacturers to expand the number of facilities to cover specific regions.

One of the other challenges the pandemic revealed was to use manufacturing strategically. The question becomes, do you vaccinate all the high-risk people in the world first, before you move to lower-risk populations? Many countries during the pandemic said no, they were going to vaccinate everyone in their countries first, and that’s why the hoarding was so terrible. The challenge now is to have an honest conversation about this and how to fix it.

What were the big lessons from what COVAX got right, and what it got wrong?

The big lessons of COVAX were, first, have money available at the beginning. Have contingent financing—it doesn’t have to be the full amount, but enough to jumpstart the program immediately, to get staff, and to start going to manufacturers.

The second lesson is having the risk worked out. We had to negotiate risk. We took taxpayer dollars and bought, at risk, vaccines that we didn’t know were going to work. We were lucky that most of the vaccines worked—but imagine if most of them hadn’t. Agreeing to do at-risk financing is critical.

The third lesson we learned is that we did not prioritize having delivery systems for the vaccines. This time we did not bundle financing of delivery with the cost of the vaccines, and that led to delays. Had we started with enough financing for delivering the vaccines alongside purchasing them, that would have been a really good thing.

And finally, diversify manufacturing so that there will be some places in the world with lower burden of disease that are willing to share vaccines.

Read More: Here’s How Long COVID-19 Vaccine Immunity Really Lasts

COVID-19 cases are starting to wane, and more people are vaccinated and protected against severe disease vaccines. Will COVID-19 vaccines continue to be part of Gavi’s arsenal?

At the end of this year, COVAX will be reincorporated into Gavi. But the board approved a program for 2024-2025 that will continue COVID-19 vaccines for high-risk populations. As part of our normal review for investment in vaccines, COVID-19 will be included going forward, so [continued distribution of the vaccine] will be considered [along] with those against RSV, and other vaccines against preventable diseases.

Gavi generally runs a funding rate of about $2 billion a year, and during the COVID-19 years, it jumped up to $10 billion because of the large number of vaccines we were delivering. The idea is to reduce the temporary staff and resources that were scaled up to do that, but to keep these systems warm in order to maintain some innovations that would allow us to be prepared for the next [public health threat].

There is an idea for a special program that was floated at the G7 summit to create marketplaces for vaccines to make manufacturing them sustainable over time. The big problem with these vaccines is that they can’t just be scaled up for pandemics, because what do you do with all the resources when there isn’t a threat? Gavi will continue to be involved with finding a way to create a high-quality vaccine manufacturing industry with a small number of manufacturers that can be ready to go if there is another pandemic.



source https://time.com/6296501/gavi-ceo-seth-berkley-interview/

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