Professor Kimberly Thompson’s research at the University of Central Florida, and KidRisk.org focuses on preventive medicine interventions and global health policies. She was interviewed by Wycliffe Muga, Weekend Star Editor
Tell us about the Addis Ababa conference organized by the World Health Organization for African health and finance ministers taking place next week: What makes this conference special?
For the first time, the ministers of finance and health of all African countries will gather to discuss immunization on the continent. These individuals and their predecessors committed the resources required to end the transmission of all wild polioviruses in Africa, and now children in Africa can run, jump, and play without the fear of wild polio. This conference represents an opportunity to ask the question: What can Africa tackle next and how can African countries work together to meet the regional goal of similarly ending the transmission of measles by 2020?
Is there any specific outcome you are hoping to see from this conference?
I hope that Africa will lead the charge for global measles and rubella eradication. All of the regions in the world now have goals to eliminate measles transmission regionally. The Americas – all countries of the Western Hemisphere – successfully stopped transmission of indigenous measles and rubella. It can be done, just like polio, but the ministers attending this important meeting will need to make commitments and work together to make it happen in Africa.
African countries already benefit from significant reductions in deaths and disability because of their existing national immunization programmes.
However, as we learned from polio, we need to reach the people in all areas – particularly the hard-to-reach and under-served populations – to stop the transmission of measles and rubella. We found these populations in the process of polio eradication, and Africa can build on the momentum of polio to put an end to measles and rubella.
I know from reading your published research that you argue that immunization programmes are really the best and most affordable option for fighting disease in developing nations. Maybe you can enlarge on that.
Thanks for asking about this. Our research shows that when disease eradication is possible, then eradication is a much better option with respect to both health and financial costs than continuing to invest in ongoing control. All African countries already make significant investments in measles control, and some invest in rubella control with the remaining countries likely to add rubella control in the near future. Most Africans know about measles, in some cases due to tragic losses of family and friends, but rubella remains more unknown. However, when susceptible women become infected with rubella in early pregnancy, this may lead to congenital heart diseases, eye defects, deafness, and/or learning disabilities in their children, which can lead to expensive lifelong disability and early mortality. With some additional short-term investments and a continental commitment, Africa could eliminate measles in a few years, and it could eliminate rubella at the same time just by using a vaccine that contains both measles and rubella.
Many of our readers will not have heard of your organization, Kid Risk. Could you explain why you founded this organisation?
Kid Risk is a small, non-profit research organisation that focuses on improving children’s lives by performing analyses that help decision makers at all levels make better choices. We are unique in our use and integration of multiple analytical tools (economics, risk and decision analysis, dynamic infection transmission modeling), and our focus on high-stakes decisions that involve multiple stakeholders. We recognize the importance of answering both health and economic questions with rigorous, evidence-based analyses, and particularly in showing financial decision makers the benefits of their investments both in health and economic terms. It’s relatively easy to add up the costs of immunization programs, but much more difficult to count the cases and costs that do not occur. That’s where we come in.
What would you say is the most important piece of work you have been able to advance through KidRisk.org?
In 2007, we published an analysis that showed that polio eradication represented a better health and economic option than control, that India could stop wild poliovirus transmission if it intensified its immunization efforts, and that a wavering commitment to polio eradication would lead to higher long-term costs and more cases than finishing the job.
This work helped the polio eradication partners strengthen their commitment to polio eradication. India stopped all wild poliovirus transmission in 2011. For Africa, we performed several analyses of polio transmission in Nigeria and we talked with leaders of the Nigerian immunization programme about what it would take to stop poliovirus transmission there. When Nigeria stopped transmission of wild polioviruses in 2014, this led to the end of wild polio in all of Africa. Now Africa needs to keep polio immunity high to maintain elimination as we globally co-ordinate ending the use of some polio vaccines during the polio endgame.
And what would you say has been your biggest disappointment?
Transmission of infectious diseases that can be prevented by vaccines occurs when immunization coverage is too low, and the failure to vaccinate is a well-recognized and fundamental problem. All countries can find ways to reach and immunize all children in their borders, and it is in their interest to do so, but existing systems are falling short and often do not recognize the need to reach all the people. We can do better.
If you were to give one piece of advice to African health and finance ministers, about what should be done to improve children’s health on the continent, what would that be?
Invest in prevention. Immunization saves lives and money and leads to healthier and more productive populations. By building immunization into the annual national budget, health and finance leaders can create expectations for performance by their health systems to prevent disease. Finally, commit to making measles and rubella elimination in Africa a reality.
Any last word for our readers?
Please support national immunization efforts and get recommended vaccines. Every choice and action matters. Thank you.