A health worker vaccinates an infant at a government health clinic in Desa Sigalapanag Julu, Indonesia.

Championing Global Immunization: Q&A with Dr. Bruce Gellin

As the Sabin Vaccine Institute’s new president of Global Immunization, Bruce Gellin, MD, MPH, the former US deputy assistant secretary for health, will lead the non-profit’s efforts to expand global vaccination during a time of great uncertainty for global health security and funding commitments. As one of the architects of the US National Vaccine Plan—a blueprint for immunization that can be applied to other settings, too—he comes to the task well prepared. GHN reached out to Gellin to hear how he will be looking at those plans from a global perspective.

You’ve said that your time as a Luce Scholar in the Philippines shaped your dedication to global health. What did you see there that inspired you? Spending a year in the Philippines as a Luce Scholar between my third and fourth year of medical school allowed me to see firsthand how difficult it can be for people living in poverty to get medical care, and therefore how important it is to prevent diseases whenever possible. It’s true for any disease, but infectious diseases are the most obvious. After all, what were once the “usual infections of childhood” are now called “vaccine preventable diseases.” That experience solidified my decision to focus on infectious disease with a focus on the impact of vaccines. I look back at that year and see it as the inflection point in my career path.

Previously, you led the development of the US National Vaccine Plan (NVP), which set out a 10-year vision of the US vaccine and immunization enterprise. Which aspects of the plan proved most challenging to advance?< When I arrived at HHS in 2002, I carried with me the current National Vaccine Plan that was written in 1994.  Less than a decade later the landscape had changed significantly and there was a compelling need for a fresh look at our challenges and our opportunities. When we updated the plan, there was more of a focus on the vaccine safety system and on the data needs for informed decision-making by parents, by patients and by policymakers, but perhaps the biggest change was to be explicit about the role of the US in global immunizations—and we included global immunizations as a specific goal. It sounds trite, but infectious diseases know no borders—and therefore it made sense to highlight the many activities that are underway building the science and the systems that support global immunizations. It’s not at all surprising that the US government’s efforts here underlie the role of vaccines and immunizations in our global health diplomacy.

What will it mean to you to look at the NVP from more of a global health perspective, in your new role? While the NVP is a US vaccine plan, it also provides a framework for any nation’s vaccine and immunization program. In my new role as president of Global Innovation at Sabin, I will be working with countries around the world to ensure that they have functioning systems to support increasingly complex and costly immunization programs.

What steps are needed to improve coordination among governments, NGOs, and the private sector needed to advance vaccine goals, particularly given the current political climate and funding shortfalls? What matters most is ensuring that decision makers have access to the best evidence, whether it’s scientific evidence, cost-benefit evidence or otherwise. Unless they have the right evidence, they’re not going to make the best decision. In order to advance vaccine goals, people need to understand the value of strong immunization programs and the value of having safe, effective vaccines accessible. Evidence matters. A large part of Sabin’s focus is helping to develop the evidence base to inform policies. This is always the case, but is accentuated in the current political climate and early signals about funding shortfalls – all highlighting the need to make the case for immunizations. 

 

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A health worker vaccinates an infant at a government health clinic in Desa Sigalapanag Julu, Indonesia. © 2013 Muhammad Yunus/Photoshare