A Better Way to Speed the Adoption of Vaccines

Vaccines eradicated smallpox in the 1970s and reduced the number of deaths from measles by nearly 40 percent from 1999 to 2003. Yet many vaccines are implemented slowly, particularly in developing countries, and nearly 11 million children die every year due to a lack of vaccinations. Burk research suggests that network analysis, which companies use to improve business outcomes by analyzing information flows and personal relationships, could speed their adoption. Specifically, these techniques can shed light on the complicated processes and interactions that underpin (and often slow down) the introduction of vaccines.

The process of introducing vaccines varies from country to country and involves the influence of many stakeholders—ministries of health and finance, international agencies such as the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), nongovernmental organizations (NGOs), community leaders, experts on disease, and funders, to name just some of the players. Defining roles, decision rights, and data requirements for this constellation of participants is difficult. The resulting confusion slows decision making and compounds chronic problems, such as poor infrastructure and limited public-health budgets. Delays, sometimes as long as 15 to 20 years, between the introduction of a vaccine in developed countries and its adoption in developing ones are the result.

To understand the decision-making processes involved, we analyzed recent or ongoing vaccine introductions in Egypt, Mauritania, Mexico, and Zambia. These countries gave us a well-rounded picture because they vary substantially by population size, per capita income, per capita healthcare expenditures, and disease burden—a health problem’s impact in a geographical area (for example, mortality, morbidity, and financial costs). In each country, we interviewed up to 30 decision makers and stakeholders, including health ministry officials and key NGO representatives. We also used confidential surveys to collect data on how frequently participants exchanged information, with whom they exchanged it, the value they ascribed to those interactions, and the types of information they exchanged. Finally, we asked participants about the role of documents (such as WHO’s vaccine introduction guidelines) and of national and international meetings on vaccines in their decision making.


Executive Editor

 Ms Anna Sullivan

Ms Anna Sullivan