From the Big Catch Up, to the Big Transformation: Building Resilient Vaccine Health Systems for a Better Future

As we celebrate World Immunisation Week, we stand at a pivotal moment in global health. The COVID-19 pandemic has exposed the fragility of our global systems and the deep-seated inequities that exist in healthcare access worldwide. Despite significant strides in vaccine development and distribution, the pandemic has also brought to light the importance of data and actionable insights to address challenges such as vaccine hesitancy, disinformation, and systemic barriers to access.

As we move forward into 2023 and beyond, we have a unique opportunity not only to catch up on progress lost in routine immunisation but also to accelerate progress and make transformative strides towards a more equitable future. Our vision includes empowering hyperlocal actors to play an active role in building resilient health systems within their communities. Let us seize this opportunity and create a future where no one is left behind in the journey towards a healthier world.

WHAT WE KNOW: we need hyperlocal data systems that empower decision makers to deliver targeted vaccine campaigns

To achieve this, we believe we need to focus on five key principles:

1. Hyperlocal data systems: Data is not a tool, but part of an enabling environment. By shifting our mindset towards data as a hyperlocal system rather than a shiny tool, we can unlock a range of enabling mechanisms, such as governance & policies, partnerships & collaborations, capacity building, and advocacy. (see diagram below)
2. Data for decision-making: Hyperlocal data systems that empower state and district level actors are essential to improving immunisation coverage and targeting of vulnerable groups. We have found that decision makers who are closer to the action need support to shift from using data for reporting, to using data to design and deliver targeted vaccine campaigns that drive better vaccine uptake.
3. Collaborative effort: Shared ownership and incentivising key stakeholders is crucial to capturing learning on what approaches and interventions are scalable across different countries facing similar situations. The challenge lies in identifying where to focus, and which stakeholders to engage in order to drive systems change. By forming local partnerships and global alliances, and incentivising participation, we can create a collective forum and build a community-driven effort to address it.
4. Empowering locally-led change: To achieve lasting change, we need to empower locally-led initiatives by partnering with local stakeholders and building relationships to understand the challenges and gain buy-in. Trust is essential in this process. Treating partners as co-creators, considering their needs, and building relationships based on mutual respect will foster stronger working practices and lead to more successful outcomes.
5. Real-world testing of a portfolio of solutions: to effectively address complex and systemic challenges, we must move beyond concepts and take action by testing solutions in the real world. One way to do this is by implementing a portfolio of interconnected interventions instead of relying on single-point solutions, since no one tool will solve a systemic problem. This also creates learning opportunities for stakeholders, and helps identify scalable approaches and interconnected interventions that could work across different countries facing similar challenges.

WHAT NOW: principles in practice

At the Vaccine Data CoLab, we are putting these principles into practice in partnership with local organisations and global actors in order to build a world where hyperlocal data systems and local actors are empowered to use vaccine data to target with precision.

• We are working with local partners such as Dev-Afrique in Nigeria and the Infectious Disease Institute (IDI) in Uganda to produce vaccine data landscaping reports, convene strategy-to-action workshops, attract grantees who are much more local and networked into the ecosystem, build a portfolio of interventions that tackle the prioritise the country priorities and support achieving the overall vision and gain buy-in from the Ministry of Health (NPHCDA in Nigeria and UNEPI in Uganda). By involving local actors in the design and implementation of our interventions, we ensure that they are contextually appropriate and sustainable.
• Adopting a country-led portfolio approach in Nigeria and Uganda to identify common challenges and context-specific interventions that can be scaled across different countries facing similar challenges.
• Testing a mixed portfolio of interventions across the WHO’s seven systemic pathways to enabling systems change, with a focus on solutions that tackle multiple pathways and address interdependencies within the vaccine data system.
• Crafting learning opportunities for stakeholders to capture evidence of what works and develop recommendations for financial sustainability, to build a more resilient and sustainable vaccine data system.

By taking a portfolio approach, testing a mix of linked interventions, collaborating with local actors, and prioritising evidence-based learning, we are confident that we can make meaningful progress towards improving vaccine data for decision-making in Nigeria and Uganda.

Photos from workshops in Uganda (left, centre) and Nigeria (right) earlier this year.

WHAT NEXT: Stronger than the sum of our parts

The pandemic has taught us that global health challenges require collective action, collaboration, and innovation. As we rebuild and reimagine our health systems, we have a unique opportunity to come together and be greater than the sum of our parts.

The Vaccine Data CoLab is just getting started and already we are imagining better futures where:

• We bring global funders together and instead of duplicating efforts, we multiply impact by combining resources to drive focused investments in country-led systemic priorities
• We bring countries facing similar health data challenges together and create a network for learning and action that gives decision-makers space to discuss challenges and trial solutions to build the evidence needed to scale what works

So let’s harness this momentum and work towards building stronger, more resilient health systems that can withstand future shocks. Let’s invest in the innovations and partnerships needed to drive systemic change and ensure equitable access to quality healthcare for all. With the right resources and a shared commitment to action, we can make a lasting impact and create a better future for generations to come.