NEW COMMUNICATION ISSUES AROUND IMMUNISATION Heidi Larson, Ph.D. Senior Communication Advisor UNICEF New York

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NEW COMMUNICATION ISSUES AROUND
IMMUNISATIONHeidi Larson, Ph.D.Senior
Communication AdvisorUNICEF New York
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GLOBAL ENVIRONMENT

• New vaccines, new issues, new costs
  of vaccination
• Global vaccine divide between developed and
  developing countries

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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

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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

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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

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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

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GLOBAL ENVIRONMENT 6

• Proliferation of research giving sometimes
  incomplete or controversial information
• How to address the incomplete scientific
  evidence?

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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
  worlds children

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but,

• . . . this equals only 5 of the worlds
  expenditures on vaccines
• nearly 60 of vaccine is procured from developing
  countries manufacturers

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Value of the vaccine market has doubled but value
of basic vaccines has dropped by 40
Mercer Management
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USA/EU manufacturers leaving the developing
country market1992 to 2001
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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)
Vaccines
Social Value
Pharmaceuticals
Rappuoli, Miller and Falkow, The Intangible
Value of Vaccination, Science, vol. 297, 9 August
2002
Economic Value
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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

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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)

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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.

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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

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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

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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

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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

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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?

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(RE-)branding immunization for tomorrows
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

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(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!

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