Lessons on Eliminating Vaccine-Preventable Diseases: An Interview with Dr. Ciro de Quadros
Dr. Ciro de Quadros, Sabin’s Executive Vice President and Director of Vaccine Advocacy and Education, has led and implemented some of the most successful immunization campaigns in the history of public health. In a recent interview with Fiona Fleck, published in the World Health Organization (WHO) Bulletin, Ciro provides insight into more than 50 years of work to eliminate vaccine-preventable diseases and reflects on the lessons learned.
During the interview, Ciro describes his time working on Brazil’s smallpox campaign – his first experience with an immunization program.
“They sent me to head a health centre in the Amazon region, in a town called Altamira of about 4,000 people in Pará state. All we had was a community nurse, a laboratory technician, a sanitarian and an administrator to take care of the health of that community. Vaccine coverage rates were not very high, maybe about 50 percent or 60 percent…Our small team managed to increase coverage to nearly 100% during my first year.”
The success of Ciro’s first immunization program is due in large part to his development of a surveillance and containment strategy which ultimately became the final strategy of the global smallpox program. After Ciro’s experience in Brazil, he moved to the Pan American Health Organization (PAHO) to launch the Expanded Programme on Immunization (EPI) in the Americas.
“Most countries in the region didn’t even have an immunization programme and were just responding to outbreaks,” Ciro explains. “My task was to get the countries to organize themselves.” Ciro’s experience heading the WHO EPI programme in the Americas contributed to the region’s polio-free status in 1994.
“We brought together all the country managers and everyone else from the governments working on epidemiology…and we asked them: ‘What are the problems that you have when trying to implement immunization programmes in your countries and what are the solutions?’”He notes that this approach to identifying problems and solutions is still used by PAHO today.
Ciro ends the interview with advice and reflection on his career in immunization: avoid fragmentation of global health programs. Additionally, Ciro encourages the WHO to be more forceful on the Global Vaccine Action Plan (GVAP) -- a framework to improve health by extending the full benefits of immunization to all people.
“There are so many actors in the same field today: the GAVI Alliance, the [Bill and Melinda] Gates Foundation, the nongovernmental organizations and civil society – you need to coordinate them all,” he says.
Ciro’s advice – stemming from more than five decades of experience – has a significant impact on Sabin’s programs today. “You must have a clear goal,” he says. “Everyone needs to understand that goal, everyone must work together to achieve that, you must have permanent research and feedback to the field, and you must have the resources and political support.”
To read the full interview, please click here.