Heidi Larson, UNICEF

Vaccination in Tomorow's Society - Fondation Merieux

NEW COMMUNICATION ISSUES AROUND IMMUNISATION

Heidi Larson, Ph.D.Senior Communication AdvisorUNICEF New York

GLOBAL ENVIRONMENTNew vaccines, new issues,

new “costs” of vaccination

Global vaccine divide between developed and developing countries

GLOBAL ENVIRONMENT 2 Less visible disease threats -

immunization success - has lead to increased questioning around do we (still) need vaccines?

Additional questions around immunization technology - injection safety, waste management, immunization schedules, mass campaigns

GLOBAL ENVIRONMENT 3

At the same time, new threats - bioterrorism - and the return of an old vaccine against disease that was once declared as eradicated

GLOBAL ENVIRONMENT 4

Stronger rights-based, “right to know” environment - growing civil society demands on access to information

The public increasingly challenging “quality” and “safety” of commodities

Previously locally isolated adverse events now national/international media events

GLOBAL ENVIRONMENT 5 Increased and more rapid communication

channels Less-government controlled information

and more global and commercially driven media

Internet, e-mail, global and satellite TV More frequent global travel, more

exposure/understanding of different languages - “francophone issues”

GLOBAL ENVIRONMENT 6

Proliferation of research giving sometimes incomplete or controversial information

How to address the “incomplete” scientific evidence?

Why does it matter to UNICEF?

In 2001 UNICEF delivered over 2.8 billion doses of vaccine to ~ 100 countries

UNICEF supplies vaccines for over 40% of the world’s children

but,

. . . this equals only 5% of the world’s expenditures on vaccines

nearly 60% of vaccine is procured from developing countries manufacturers

Value of the vaccine market has doubled but value of basic vaccines has dropped by 40%

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The high social value of vaccines in contrast with their relatively low economic value, compared to pharmaceuticals (US$ 5 bn : US$ 300 bn)

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Rappuoli, Miller and Falkow, The Intangible Value of Vaccination, Science, vol. 297, 9 August 2002

Introduction of newer vaccines increases vaccination costs for infants, with vaccine costs increasing from 5% to 30% of the total

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LESS PUBLIC TRUST Publicly available information on

vaccines is confusing WHO, the USA and EU and vaccine

industry sometimes give different guidance and standards

Confusing information creates more public questioning

LESS PUBLIC TRUST 2

Politically, economically, ethnically and socially marginalised groups have less trust in government provided commodities/services - increasing rumours due to lack of trust in the provider (eg. OPV sterilizes, causes cancer and HIV/AIDS)

COUNTRIES IN TRANSITION

Immunization was previously imposed

by government as a “public good” for

the health of the public

There is new need for citizen demand

driven-services.

COUNTRIES IN TRANSITION 2

In many countries, immunization is a state-provided service - meaning it is also vulnerable to state budget cuts/constraints

Government health staff dedicated to immunization become de-motivated due to strained resources and lack of political support to immunization

COUNTRIES IN TRANSITION 3

Preventive services are less attractive

than specialized, treatment-oriented

professions that earn more money and

status

Previously government-provided

services such as public registries and

calls for immunization are less available

COUNTRIES IN TRANSITION 4

The health reform process is not followed by

adequate structural and behavior changes -

people not taking adequate individual

responsibility including responsibility for their

own health or the health of their own children.

Former state-provided services are changed

to privatized health care - mandatory and

“coercive” versus demand driven services

EUROPE OR DEVELOPING ECONOMY?

One of the issues facing the region is increasing questions as to whether countries should be procuring “European” or “African” vaccines

This vaccine divide has lead to increasing questions on quality - when everyone got the same vaccines there was a different level of trust

EUROPE OR DEVELOPING ECONOMY?

At the same time other products locally procured/produced are sometimes less questioned for quality and safety because they are local and therefore more trusted

Korean Samsung/Hyundai seen as a high-tech products and vaccines are not?

Vaccination in Tomorow's Society - Fondation Merieux

Heidi Larson, UNICEF

(RE-)branding immunization for “tomorrow’s society”

Re-establishing the value of immunization - a child right and a public good

Benefits (OVER risks) of immunization Immunization as an investment rather than

an expenditure Status of immunizer (as “local hero”)

vs. immunologist

(RE-)branding immunization for

Immunization service - public service - civic responsibility?

Democratization of demand through community based organizations and the media

Positioning Immunization in broader development context - ie. vaccines and national/global security

Vaccines - weapons of mass protection!

FIGHTING GLOBAL COMMUNICATION CHALLENGES ADD TO INCREASE OF COSTS OF VACCINATION PER CHILD

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Vaccine Operations Communications