Fourth Industrial Revolution

How should we prepare for the next pandemic?

A child receives a meningitis vaccination at the community center in the Al Neem camp for Internally Displaced People in El Daein, East Darfur October 8, 2012.

What does the Ebola crisis teach us about preventing future outbreaks of disease? Image: REUTERS/United Nations-African Union Mission in Darfur/Albert Gonzalez Farran/Handout

Orin Levine
Director of Vaccine Delivery, Bill & Melinda Gates Foundation
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Future of Global Health and Healthcare

This time last year, people around the world watched in disbelief as West Africa battled with one of the most destructive epidemics of the past century, an Ebola outbreak that claimed over 11,000 lives. One year on, leaders from the public and private sectors gathered at the Annual Meeting in Davos to make sure such a crisis never happens again.

As Gavi, the Vaccine Alliance, and Merck announce a new agreement to support the provision of a vaccine to protect against future deadly Ebola outbreaks, it is necessary for leaders around the globe to double down on their shared commitment to immunization in order to cope with existing and future health challenges. One of the most important lessons from the Ebola epidemic is that prevention must be the priority and that treating our way out of an epidemic simply costs too many lives and too much money.

As we welcome and applaud this new partnership, another innovation promises to leverage technology for better preparedness and effective prevention. The Better Immunization Data (BID) Initiative, a partnership led by PATH, is piloting systems that rely on simple yet effective technology to track vaccines from the lab to health clinics, even in the most remote areas, to collect vitally important data to enhance immunization and overall health service delivery.

Immunization data is essential to ensure life-saving vaccines are reaching everyone, especially in the case of highly contagious diseases like Ebola, measles or cholera, where a few individuals who slip through the system can undermine efforts to contain an epidemic. The case of polio is another instance in which a small number of people outside the immunization system can prevent the disease from being eradicated, like the outbreak in Ukraine last year. The BID Initiative seeks to implement vaccine data systems that can help health workers monitor, identify and reach these people and ensure the health of their communities.

The BID Initiative is currently being piloted in two African countries, including Tanzania, where last year vaccine-preventable diseases such as pneumonia and rotavirus claimed the lives of as many as 22,000 children under five years of age.

The system consists of a digital registry that creates an immunization schedule for each registered birth, which is updated online by health workers with new vaccinations using a barcode system. For facilities without access to electricity, simplified paper forms are used to record the data to make it easily transferrable to the electronic registry. The availability of this data allows health workers to keep track of vaccine delivery with great precision and to maintain adequate vaccine stocks.

The availability of immunization and health data will be central to redesigning health policy with a focus on prevention. Such data can allow for accurate budget planning and improve the impact of donor funds where they are most needed, and comprehensive immunization can in turn relieve the health system by lowering the volume of patients affected by preventable diseases. Once fully tested and implemented, the BID Initiative will be tasked with scaling the Tanzanian model to other countries facing similar challenges.

The leadership exhibited by the Tanzanian Ministry of Health in supporting the BID initiative is precisely what is needed to improve immunization coverage. At the first-ever Ministerial Conference on Immunization in Africa in Ethiopia next month, African leaders will reaffirm their commitment to ensuring every child receives life-saving vaccines. I urge the global health community and policy makers everywhere to leverage the power of data and technology to achieve this goal of building more sustainable, equitable and effective health systems based on preventing life-threatening diseases in the first place.

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