Patrick M. O'Connor Interview: Technical Roundtable on Immunization and Polio Eradication in Ukraine

This is an interview of Dr. Patrick M. O'Connor, team lead (accelerated disease control, vaccine preventable diseases, and immunisation) at the World Health Organization (WHO)’s Regional Office for Europe. He here describes the landscape of the challenging immunisation situation in Ukraine, where there were 2 cases of circulating vaccine-derived poliovirus (cVDPV) in 2015. Dr. O'Connor's work covers 63 countries that make up the WHO European region, with oversight over diseases including polio, measles, rubella, etc. In terms of worrisome vaccine coverage, Ukraine has been on the radar screen for a number of years; the regional certification that looks over polio-free status has had the country on its list of high-risk countries for 5 years. Low vaccine coverage and major gaps in surveillance led to a drop to 17% coverage of polio vaccination, which is one of lowest in Europe, and probably globally. What is to blame for such poor numbers? Dr. O'Connor points to a lack of trust in the systems in place, due in part to a measles campaign in 2008 that was not handled well. In addition to lack of confidence, there was an issue 3-4 years ago with procurement of vaccines. Lack of demand and availability is a disastrous combination.

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.

Reflecting on the roundtable, Dr. O'Connor indicates that the recommendations that emerged (in the statement) represent the opportunity to take the technical aspects, including communication elements, that were highlighted in the 2 outbreak assessments that took place at 3 and 6 months after the appearance of the cVDPV cases. The roundtable puts those technical recommendations in a high-level political advocacy situation - both from within the government and from neighbours and partners. While transmission of polio has likely stopped, what is needed still is commitment for 12-24 months to ensure that strong systems are in place. The events of 2015 had the effect of helping make the health system in Ukraine more resilient. For example, the communication of activities that needed to happen - e.g., supplementary immunisation activities (SIAs) - in the aftermath of the outbreak proved confidence-building for parents in that they saw that the outbreak was controlled. Ukraine saw the response of the international community via the Global Polio Eradication Initiative (GPEI) to the outbreak; partners like WHO, the United Nations Children's Fund (UNICEF), the Centers for Disease Control and Prevention (CDC), the Gates Foundation, Rotary International, and others like the United States Agency for International Development (USAID) showed they can work together rapidly to implement clear protocols with good results. Dr. O'Connor suggests that we need to capitalise on this momentum on for routine immunisation (RI) so that long-term gains are sustained.

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 a summary of and access to the Statement on the Roundtable on Immunization for Vaccine-Preventable Disease and Polio in Ukraine.
• Click here for an interview of David Salisbury 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.