​Presenter: James Azam (SACEMA)

Title of talk: Measles outbreak response vaccination: the role of the vaccine supply chain in low-income settings

Abstract:

Measles is a viral infection, which mostly affects children. The disease is highly transmissible, spreading like wildfire in populations having little to no form of immunity against it. Even though measles is controlled with a safe, cheap and effective vaccine, it remains one of the leading causes of death among children under five years, especially in low-income countries. Consequently, it is a target for worldwide elimination by 2020. This target is achievable if vaccination coverage is maintained at high levels (more than 90%) worldwide. However, coverage in most low- and middle-income countries remain below par and outbreaks continue to occur even in settings that had achieved local elimination previously. Hence, it appears this elimination target is unlikely to be achieved by the set date. Low vaccination coverage in most low-income settings is partly explained by the inability of vaccination teams to reach certain populations in time, especially during outbreaks. One of the strategies outlined to eliminate measles is to mount quick and efficient outbreak response vaccination campaigns. This strategy calls for highly efficient vaccine supply chains that optimise efficient vaccine delivery and maximises response time. However, it is a well-known issue that most resource-poor settings continue to operate sub-optimal vaccine supply chains and health systems. For my PhD project, I am modelling vaccine supply chain decisions and vaccination strategies for reaching hard-to-reach individuals during measles outbreaks in low-income settings. I am employing an approach which links models of the measles vaccine supply chain (including the cold chain and other logistical processes explicitly as part of the system of vaccine delivery) to epidemiological models to assess how certain decisions in the supply chain affect outbreak progression. Through this approach, the findings will not only include information on which processes, components, strategies, and decisions in the supply chain are important and require improvement for efficient outbreak response in resource-scarce situations but also what resources and “costs” it will take to mount efficient responses in the bid to eliminate measles as soon as possible. In this talk, I will give a general overview of my project, the modelling approach, and a few initial findings.