Year of the Dragon, Decade of the Vaccines

With the promise of change, high energy, and good times ahead, the fact that Chinese New Year fell the day before an important date for many of us working on immunisation seems like a good sign.

Today, the Decade of Vaccines Collaboration – a project that is bringing leading global health professionals and organisations together behind the shared goal of saving millions of lives through expanding immunisation – began a regional consultation on its Global Vaccine Action Plan.

Now, that may sound like a big meeting to discuss a document (and ok, that is essentially what it is) but after day one, I believe this event has the potential to make a huge difference, and that it is, genuinely, exciting. And here’s why…

Great potential

Take a conference centre in Rabat, Morocco, and fill it with some of the world’s leading experts on immunisation including, most importantly, those from countries that are home to the highest numbers of unimmunised children.

Add in a few NGOs, a few representatives from pharmaceuticals and a couple of translators, and give them all a shared objective to contribute to a global action plan that will guide our joint efforts towards the ultimate goal of ensuring that in the next decade all people, no matter where they are born, receive the full benefits of immunisation. Achieving that would save millions of lives.

If you have a big problem – and the fact that 24 million children miss out on routine immunisation every year is a very big problem – getting as many people with expertise as you can squeeze into a room to think collaboratively about solutions and bounce ideas off each other has great potential. Today I saw new alliances forming and watched participants challenge each other and share information and experiences.

Different perspectives

Three issues stick in my head that are the result of an exchange with someone from a different perspective to my own.

1. The concept of ‘not for profit’ is not as straightforward as it may first appear. Say a vaccine manufacturer develops a product and agrees to sell it at cost price without profit, job done. But what happens a week later when the price of a key component fluctuates or when the manufacturing plant discovers how to make an efficiency saving.  With complex supply and procurement mechanisms, reflecting these changes will not be as simple as changing a price on supermarket shelf.

2. Whoever is in charge of a country’s health budget is responsible for providing both preventative treatments (eg vaccines) and curative treatments (eg hospital care and drugs). Switching money from the second category to the first may save money in the long term, but would create a gap while the health service waits for the preventative treatment to take effect and for demand for curative treatment to fall.

3. Promoting one vaccine can have the result of reducing demand for other vaccines. An unforeseen and unintended consequence of fiercely marketing one vaccine can lead communities to think that they are completely covered after receiving the well-publicised one and demand for other routine vaccines drops.

First steps

The sceptics among us are likely to think that all these discussions will amount to nothing more than a really well-written action plan that will go on to clutter the desks of health ministers the world over for years to come.

And of course there is a risk of that, which is why I was pleased that throughout the day we were asked to think about specific actions– what can we do to turn these grand ambitions into reality; what resources will we need; who do we need on board; how will we make them deliver; how will we know when we’ve reached our goal.

But, ever the optimist, I’m inclined to think that today we took one of the initial steps towards something that could really be a game changer in immunisation. And if we get it right at the start, we are more likely to keep getting it right.

Let’s hope we have the luck of the dragon on our side.