David Salisbury Interview: Technical Roundtable on Immunization and Polio Eradication in Ukraine

"What's happened in Ukraine is that the fear of vaccine safety issues has overwhelmed the reality of the fear of the diseases."

This is an interview of Professor David Salisbury CB, Associate Fellow, Centre on Global Health Security at the Chatham House in the United Kingdom (UK). He here presents his perspective on the poor state of the immunisation programme in Ukraine, arguing that the entire programme needs to be "picked up and shaken and almost started afresh". He said that the disastrous situation, which has been causing anxiety for years, particularly with regard to polio and measles, did not need to happen and does not need to continue. A well-designed action plan must be implemented that involves attention to supply-side issues: (i) Can you identify all children that need to be vaccinated? (ii) Can you provide vaccines for all children? (iii) Can you truly monitor all children who need to be vaccinated, showing in truth how well this has been accomplished? (iv) Can you performance manage?

On the demand side, Professor Salisbury discusses the low public trust in not just vaccination but in the health system of the country as a whole. He calls for a well-constructed communication strategy that starts at the top and goes down to the very bottom of the programme. To ensure that all health workers are "speaking from the same song sheet", they need to all be given the same information. The government programme must design communication materials and ensure they disseminated through the whole system. In the UK, when there was an issue with public trust of the measles, mumps, and rubella (MMR) vaccine, the solution was to work from the point of local health care providers. As members of community, these providers are trusted even if the government might not be. They can speak sincerely to parents, saying "I vaccinated my children", and this can be taken seriously.

Professor Salisbury also discusses the problem of internally displaced persons (IDPs) in Eastern Ukraine, as well as the role of the international community in serving as a coalition to support political will to stimulate the Ukraine government's overhaul of the immunisation programme.

Prior to his current position at the Chatham House, Professor Salisbury was director of immunisation at the Department of Health until the end of 2013. He was responsible for the national immunisation programme and led the introduction of many new vaccines. He works extensively with the World Health Organization (WHO), especially on polio eradication. He previously chaired the WHO's Strategic Advisory Group of Experts on Immunisation, the WHO committee that sets global immunisation policy. He also served as co-chair of the Pandemic Influenza group of the G7 Global Health Security Initiative. He trained as a paediatrician in Oxford and London, and is a visiting professor at Imperial College, London and a fellow of the Academy of Medical Sciences. He continues to lecture and advise on vaccines and vaccination as well as undertaking ongoing work in polio, malaria, and the development of new vaccines. He was made a Companion of the Order of the Bath in 2001.

The interview was one of several conducted to hear the insights of those who attended the Technical Roundtable on Immunization and Polio Eradication in Ukraine, June 8 2016, Washington, DC, United States (US). Organised by the Washington-based US-Ukraine Foundation with technical and logistical support from The Communication Initiative, the purpose of the meeting was to provide a forum for Ukrainian diaspora experts/professionals to discuss the immunisation challenges facing Ukraine and to amplify their voices and ideas for positive change. A small number of outside technical experts also provided global context and lessons learned from other regions. The principal outcome of the roundtable was a concise statement outlining the issues clearly and offering strategic recommendations for improving the health situation in Ukraine, with a particular emphasis on immunisation, vaccination, and polio. Click here for a summary of, and access to, the statement.

In addition:

• Click here for an overview of the Washington DC Roundtable Discussion on Immunisation for Vaccine-Preventable Disease and Polio in Ukraine.
• Click here for an interview of Patrick M. O'Connor from the same event.
• Click here for an interview of Boris Lushniak from the same event.
• Click here for an interview of Judyth Twigg from the same event.
• Click here to access a video of an October 9 2015 press briefing on the Ukraine outbreak by Ellyn Ogden, Coordinator of the United States Agency for International Development (USAID) for polio eradication.