PATH's Geneva office has a striking view over the busy airport that helps ensure this modest-sized Swiss city maintains its status as a leading hub for international finance, global health, and diplomacy.
Looking out from our meeting rooms onto the well maintained runway, I can't help but admire the thinking, planning and investment that goes into airport systems. Linking air traffic control to flight scheduling, separating passengers from baggage and baggage from cargo, and managing security and safety are just a few of the challenges that must be overcome to make airports work.
Serving the vaccine consumer
In our work to ensure all children in the developing world receive lifesaving vaccines, we often have discussions with our partners and funders about how best to make the systems that support vaccination smarter. Traditionally, that has meant focusing on systems that develop safe and effective vaccines and ensure they reach children who need them. Yet while we have effectively mobilised around these critical supply and infrastructure needs, there has been little comparable investment in the systems that support the demand side of vaccination.
A focus on demand
By demand side, I mean strategies and approaches based on the needs of consumers seeking vaccines' protection for themselves or their children. These demand side interventions—such as investing in community health workers, advocacy, communications, community partnerships and mobilisation, and outreach—can seem less valuable to budget makers, especially when compared to infrastructure and commodity investments. Yet demand side investments are critical if we want to ensure that those who stand to benefit from vaccines actually take advantage of them. If we are serious about addressing inequities in vaccination, we need to support demand side programming.
It's not easy to get vaccines
In too many places, families must walk for hours to get vaccines. Once they reach a health facility, there's no guarantee of vaccination that day. Food, drink, and toilet facilities are often scarce. Health workers may not speak the local language and even when they do communication about the timing of follow up doses may be unclear. Ensuring a child is fully vaccinated requires time, commitment, and action from a well informed and determined parent or caregiver. It cannot simply be taken for granted.
A people-centred approach
The GAVI Alliance, a public-private partnership that provides vaccines and vaccine financing to the world's poorest countries, is now identifying priority areas for its 2016–2020 strategy. Many GAVI Alliance partners and stakeholders, including PATH, have proposed increasing support for demand side perspectives and programming.
Health programmes that promote a people-centred approach to systems have often identified creative solutions to overcome barriers not only in the demand side of operations, but also in supply side functions. Without the activism of cancer patients and people living with HIV, for example, many medications and diagnostics would have taken much longer to develop.
Strong partnerships and support
Getting vaccines to children requires strong partnerships—not just between the technical agencies, the donors, and the health services delivering vaccines, but also between these services and the mothers and caregivers of the children for whom the vaccines have been developed.
An airport with a state-of-the-art runway but disoriented and unhappy passengers is not fulfilling its mission. A vaccination system that doesn't provide protection isn't either. As the GAVI Alliance strategy discussions begin, let's ensure that demand side systems are as strong as supply side.
Andy Seale is director of advocacy and communications of PATH's Vaccine Access and Delivery Programme
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