Today, Health Affairs released its February 2016 issue, focusing on the complex series of events leading to the development, purchase and eventual delivery of vaccines. Sabin contributed two articles to this issue, which delve into how countries can set up their immunization programs – and their health systems as a whole – for long-term success.
 

Combining Global Elimination Of Measles And Rubella With Strengthening Of Health Systems In Developing Countries

This article explores the relationship between health system strengthening and the global efforts to eliminate measles and rubella. Measles and rubella elimination is a top priority of most low- and middle-income countries and a key goal of the Global Vaccine Action Plan (GVAP), led by the World Health Organization. The article addresses the criticism that elimination efforts don’t do enough to strengthen and sustain health systems.

Combining measles and rubella vaccination with efforts to strengthen the health system provides opportunities to improve health more broadly. Stronger health systems mean better preventive care and vaccine uptake, reducing outbreaks and the need for emergency immunization campaigns. This article describes obstacles to combining approaches in the areas of surveillance, human resource capacity and community engagement. To overcome these challenges, the world must learn from successful elimination campaigns. As in the case of polio, infrastructure and human capital built up for one disease can be repurposed to fight another. The same is true of community engagement, which relies on established trust and “long-term action-oriented partnerships.” The article also describes the important role of pediatricians to shape policy and inform the broader health community and the media.

This article was written by Sabin’s Executive Vice President, Dr. Jon Andrus, in collaboration with Stephen L. Cochi of the Centers for Disease Control and Prevention, Louis Z. Cooper of the Department of Pediatrics at Columbia University, and Jonathan Klein of the American Academy of Pediatrics.

Read the full article (available without a subscription through July 2016).
 

Routes Countries Can Take To Achieve Full Ownership Of Immunization Programs

This article features a central conflict of global immunization practices: Most lower- and lower-middle-income countries rely on significant external financing to support their immunization programs. Immunization costs are rising faster than government contributions, and many countries will soon become ineligible for new vaccine grants, due to their growing economies. In fact, countries eligible for financial support from Gavi spent an average of $7 per surviving infant for routine immunization in 2014, up from $6 in 2010. This is a fraction of the real immunization cost and a far cry from the estimated $60 it will cost to fully immunize a child by 2020.

In this article, Dr. Mike McQuestion, Director of Sabin’s Sustainable Immunization Financing (SIF) Program, and the SIF team explore strategies countries are taking to attain country ownership of their immunization programs, in line with the GVAP goals of making immunization a priority and achieving sustainable, predictable funding for immunization.

This article reflects the SIF Program’s examination of the performance of 22 countries across three categories: financing arrangements, budget and resource tracking, and legislation. Drawing upon the program’s findings, the article describes new practices developed by key public institutions, including case studies demonstrating the successful use of these approaches within the focus countries to progress toward country ownership of immunization. Case studies feature local advocacy initiatives in the Democratic Republic of the Congo, a blossoming public-private partnership in Uganda, subnational resource tracking in Mongolia and a new immunization bill in Nepal (more on that here).

Read the full article (available without a subscription through July 2016).