Q&A with Bruce Gellin
Dr. Bruce Gellin, M.D., M.P.H., will join the Sabin Vaccine Institute as President, Global Immunization, on March 1, 2017. Read the press release. Dr. Gellin, a 15-year U.S. Department of Health and Human Services veteran, has served as Deputy Assistant Secretary for Health and Director of the National Vaccine Program Office since 2002. Among his roles, Dr. Gellin led discussions on behalf of the United States at high-level global and domestic policy advisory groups and was responsible for developing the National Vaccine Plan, our country's blueprint for all aspects of vaccines and immunization.
Why are you excited to join the Sabin Vaccine Institute as President, Global Immunization?
After 15 years at the Department of Health and Human Services and prior work in the government sector at NIH and CDC, now is a timely opportunity for me to move into a nongovernmental organization and continue my work in immunization. My dedication to global health is rooted in my experience in the field as a Luce Scholar in the Philippines and later working with the Rockefeller Foundation, UNICEF, the United Nation’s Development Program, the World Bank, and the World Health Organization to establish the Children’s Vaccine Initiative (CVI) which was launched at the World Summit for Children in New York City in September 1990. The vision of the CVI was to harness new technologies to advance the immunization of children. Since then I‘ve continued to champion the impact that immunizations can have across the lifespan and have helped policymakers to understand the health, economic and societal value of vaccines in the U.S. and around the world. Under new CEO Amy Finan, Sabin’s focus on the leverage points to not only expand immunization, but build capacity – whether it be training immunization managers, helping parliamentarians draft immunization legislation or assisting countries with the tools they need for evidence-based decision making – is just the kind of challenge that drives me. I’m excited about bringing a fresh approach to the organization at a time when Sabin is focusing on measurable ways to support and improve immunization programs. I’m ready to draw from my experience to help lead the team as we deepen and expand our impact.
What are the biggest challenges facing the global effort to expand immunization at this time?
There are a number of challenges that have impaired and frustrated efforts to increase global immunization rates. We need to improve in many areas – data quality and surveillance, oversight and management, country ownership and financing, and recognition by policy makers, community leaders and families of the full value of vaccines. Sabin works to address these issues at many levels, from the front lines with immunization managers to convening relevant local stakeholders, to providing tools for countries to make better-informed, evidence-based decisions.
The recent mid-term review of the Global Vaccine Action Plan was a reminder that the vision of the Decade of Vaccines won’t be achieved without concerted efforts on many fronts. Adding to the complexity is that a number of countries face graduating from Gavi support and the test will be how well they continue the progress they have made. In addition, many countries are working hard to balance the demands of polio eradication and introducing new life-saving vaccines. Any one of these is challenging enough, but together it’s clear that we are at a critical moment. We must guard against losing ground. This decade has seen a tremendous investment in immunization, yet there is much that needs to be improved, if we are to reach every child.
How has your past experience shaped your approach to expanding immunization around the world?
With training in infectious diseases and epidemiology, I’ve been focusing on vaccines – globally and domestically – for my entire career: as a clinician, a researcher and as a program manager. Beyond that, I’ve had the opportunity to have a seat at the policy table in the both public and nongovernmental sectors. These roles have solidified my instinct that collaboration is the absolute key to the expansion and strengthening of immunization programs. My new role as President of Global Immunization at Sabin will allow me to strengthen and expand the partnerships and relationships needed to assist countries as they assume responsibility for their immunization programs, ensure that people have the necessary data to make informed decisions and expand and improve immunization programs to reach every child.
How did your role at the U.S. Department of Health and Human Services (HHS) prepare you to assist low- and middle-income countries with immunization?
As Deputy Assistant Secretary for Health and Director of the National Vaccine Program Office, I was responsible for developing the National Vaccine Plan, which serves as the nation's blue print for all aspects of vaccines and immunization. Recognizing the global reach (and impact of immunizations) when we updated the plan in 2010, we added a new goal to the plan: to ensure a focus on the need to increase global prevention of death and disease through safe and effective vaccination. I then directed the National Vaccine Advisory Committee to develop a report and recommendations on global immunization that showcases the value of that effort, the broad range of expertise and experience needed to achieve the full value of vaccines and vaccination, and the many surmountable challenges that need creative solutions. Given Sabin’s unique niche, I’ll continue working to expand immunization globally, and am excited to have the opportunity to explore new approaches with partners who share our dedication to driving measurable improvement and increases in global immunization.
What aspect of vaccines and immunization will be most important in the coming years?
From the early days with the establishment of the Expanded Program on Immunization (EPI) it’s been clear that getting life-saving vaccines to those who need them has been a challenge. Fortunately, the landscape has changed and new partners and new resources have made a huge difference. The challenge now is sustaining the progress to-date and building on it. New vaccines for rotavirus, HPV and pneumococcal disease are improving the health of societies in all economies and new vaccines will only continue to have those positive impacts, as long as they are introduced and integrated into the current systems. The opportunity to eradicate polio is on the horizon, but getting there adds demands to any program. This is especially the case in more fragile systems. Setting goals and priorities will continue to be important, and developing the data to monitor progress and better manage programs will be required in many countries.
Why should immunization be a priority for Americans both here and around the world?
I know it sounds trite, but there are two things that we all know: prevention is better (and cheaper) than cure and infectious diseases know no borders. Putting those two together, vaccines are ever more important in a globalized world especially when resources are tight. There’s no better value for health or money. Given their long record of safety and effectiveness, vaccines have never been more important than they are now in today’s global, connected world. When I was in medical school, we learned and saw what were then called the “usual” childhood infections – these are now called vaccine-preventable diseases. Immunizations have and will continue to improve the lives of millions around the world, but getting current vaccines to all who need them remains a challenge. Investments in research have brought about a new generation of vaccines that will only add to that impact – and challenge. At the same time, new global threats – pandemic influenza, antimicrobial resistance and the regular emergence of new or newly recognized microbes like Ebola and Zika – reinforce all of the reasons why vaccines are a good investment.
What is the least understood challenge of your work?
Turning vaccines into vaccinations. Massive research and development efforts ensure that the vaccines that are developed are safe and effective. But all of the work from basic science and discovery to the testing of vaccines to ensure that they perform as expected is only part of the story. Getting vaccines from where they are manufactured to where they are most needed doesn’t happen without attention to every detail. The critical importance of the establishment of policies that support vaccination and programs that deliver vaccines to people and measure their impact isn’t fully appreciated. The last mile is often the longest mile. Sabin works with countries on these issues – from training immunization managers to providing the tools and data necessary for people, communities and countries to make more informed decisions. I believe these are areas that don’t often receive enough resources and attention. So, we’ve made insufficient progress on that last mile.