Gates Package — page 1089

roll them out. By late summer 2021, the country was vaccinating roughly a million people a day, a much higher share of its population than most other lower-middle-income countries.18 Bringing it all together with logistics Countries that had recently been running large polio campaigns--as both Pakistan and India had done--had another advantage: their national and regional emergency operations centers. (You may remember these nerve centers of public health campaigns from Chapter 2.) When COVID hit, these EOCs were a natural model for coordinating COVID-related activities. In Pakistan, for example, health officials paused polio vaccination campaigns early in 2020 because of the transmission risk posed by vaccinators moving from one community to another. In March, though, they saw an opportunity: set up an emergency operations center for COVID modeled on the one for polio. Within a few weeks, more than 6,000 health workers who had been trained to watch for signs of polio were taught about COVID symptoms as well.19 A call center that had been set up to take reports of possible polio cases was repurposed for COVID; that anyone in the country could call a toll-free number to get reliable information from a trained professional. The EOC also logged case numbers, coordinated contact tracing and genetic sampling, and used its existing data-transmission systems to share this information throughout the government--all functions that had been built up during the polio campaign. The maps, charts, and statistics pasted all over the walls now counted COVID.20 This brings me to a criticism that I've been hearing for years. Trying to eradicate a disease is what people in the field call a vertical approach--that is, it goes deep on trying to end one disease. By contrast, a horizontal approach is one that can drive progress across many