Health expertise and cross-border co-operation can help to implement vaccination

It can take up to 20 years for a vaccine used in the developed world to be adopted by a country in the developing world.

The delays are often a result of the correct organisations not being involved in the decision to implement the vaccination programme, according to researchers from McKinsey, the consultancy company.

Michael Conway, a director of McKinsey’s Philadelphia office, Carlo Rizzuto, an associate principal in the London office, and Leigh Weiss, an associate principal in the Boston office, drew network maps – a series of diagrams that showed relationships and information flows between people. These maps illustrated vaccine programmes in Egypt, Mauritania, Mexico and Zambia. The researchers also interviewed decision-makers and stakeholders, including health ministry officials and representatives from nongovernmental organisations, about the introduction of vaccination programmes.

The result was three recommendations, which they suggested might accelerate the introduction of vaccination programmes in the developing world. The gave no indication about how long it would take.

Involve international experts

Egypt, Mauritania and Zambia failed to involve global experts on the specific diseases they were trying to combat. However, the researchers wrote in the McKinsey Quarterly for September that: “Stakeholders in the fourth country, Mexico, reported that international disease experts gave them a better understanding of the potential impact of the rotavirus vaccine on its population. Respondents in Mexico also indicated that these experts’ international stature helped to accelerate the decision to introduce the vaccine.”

Involve finance ministers

None of the countries managed to involve finance officials in the decision to introduce vaccination. If they were involved at all it was usually at the end of the process. Given the importance of funding, especially as many programmes rely on government resources, the researchers concluded that this was a cause for concern. “Health ministries and other leading national stakeholders should look for ways to involve senior finance ministry colleagues earlier in the process and include them in regular meetings about potential vaccine programmes,” they said in the paper A better way to speed the adoption of vaccines.

Foster cross-border co-operation

The McKinsey trio reported a “broad failure to share information across countries”. They recommended that international organisations should find new ways to share best practice and technical knowledge across countries in similar circumstances.

The researchers said that the network diagrams and supporting interviews revealed a lack of defined roles among the many people and organisations involved in rolling out a vaccination programme. This resulted in slow decision-making. This was also compounded by other problems, such as poor infrastructure and limited public health budgets.

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