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Communication Challenges During the Development and Introduction of a New Meningococcal Vaccine in Africa

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Communication Challenges During the Development and Introduction of a New Meningococcal Vaccine in Africa SUPPLEMENT ARTICLE Communication Challenges During the Development and Introduction of a New Meningococcal Vaccine in Africa Monique Berlier,1 Rodrigue Barry,2 John Shadid,3 Coimbra Sirica,4 Alison Brunier,5 Hayatee Hasan,6 and Enricke Bouma1 1Meningitis Vaccine Project, PATH, Ferney-Voltaire, France; 2Inter-country Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso; 3United Nations Children’s Fund, West and Central Africa Regional Office, Dakar, Senegal; 4Burness Communications, Bethesda, Maryland; 5Department of Communication Capacity Building, and 6Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland Background. A new group A meningococcal conjugate vaccine was developed to eliminate deadly meningitis epidemics in sub-Saharan Africa. Methods. From the outset of the project, advocacy and communication strategies were developed and adjusted as the project evolved in Europe, Africa, India, and the United States. Communications efforts were evidence-based, and involved partnerships with the media and various stakeholders including African ministries of health, the World Health Organization, UNICEF, Gavi, the Centers for Disease Control and Prevention, and Médecins Sans Frontières. Results. The implementation of an integrated communication strategy ensured the active cooperation of stake- holders while providing an organized and defined format for the dissemination of project-related developmental activities and the successful introduction of the vaccine. Conclusions. Early in the project, a communications strategy that engaged stakeholders and potential supporters was developed. The strategy was implemented and adapted as the project matured. Linked communication proved to be key to the successful wide-scale introduction of the PsA-TT (MenAfriVac) vaccine in Africa. Keywords. advocacy and communication; messaging; vaccine introduction; meningitis belt; crisis communication. Meningitis epidemics have plagued sub-Saharan Africa a result of MVP, a new conjugate vaccine against group A for more than a century, causing immense human suffer- Neisseria meningitidis, the PsA-TT vaccine (MenAfri- ing for families and communities. In 2001, the Meningi- Vac), was developed and provided African health author- tis Vaccine Project (MVP)—a partnership between the ities, for the first time, with an affordable, long-term World Health Organization (WHO) and PATH, with solution that protects against meningitis. Communica- support from the Bill & Melinda Gates Foundation— tions activities in support of MVP were essential and had was established with the mission of eliminating epidemic to be strategically adapted to the development and intro- meningitis as a public health problem in sub-Saharan Af- duction cycles of this long-awaited vaccine. This paper re- rica through the development, testing, introduction, and views the major strategic communications and advocacy widespread use of conjugate meningococcal vaccines. As initiatives that contributed to the success of MVP. EVOLUTION OF MVP COMMUNICATION Correspondence: Rodrigue Barry, DSJ, Inter-country Support Team for West Af- STRATEGY rica, World Health Organization, Ouagadougou, Burkina Faso ([email protected]). ® Clinical Infectious Diseases 2015;61(S5):S451–8 Initial steps focused on developing communication ma- © 2015 World Health Organization; licensee Oxford Journals. This is an open access article distributed under the terms of the Creative Commons Attribution IGO terials and a strategy targeting audiences in developing as License (http://creativecommons.org/licenses/by/3.0/igo/legalcode), which permits well as in industrialized countries (decision makers, unrestricted use, distribution, and reproduction in any medium, provided the original fi work is properly cited. In any reproduction of this article there should not be any health of cials, organizations and alliances, partners, suggestion that WHO or this article endorse any specific organisation or products. and the private sector). The foundation of all activities The use of the WHO logo is not permitted. This notice should be preserved along fi with the article's original URL. was communication based on scienti cevidence.Acom- DOI: 10.1093/cid/civ493 munications officer was hired at the project headquarters Communication Strategy of the Meningitis Vaccine Project • CID 2015:61 (Suppl 5) • S451 in Europe; a logo was designed; a website (www.meningvax.org) radio and television broadcasts, articles, regular updating of was created; an in-house scientific library was established; and a the MVP website, and production of quarterly electronic news- variety of fact sheets, question-and-answer documents, and bro- letters to keep stakeholders updated on the project’s progress. chures were developed in both French and English. Efforts were To enhance the scientific knowledge of journalists in clinical trial made to ensure consistent messaging within the WHO-PATH countries, MVP and partners organized a series of national work- partnership that constituted MVP. shops, inviting 20‒30 health communicators and journalists (from Close collaboration between researchers and the commu- TV, radio, and press) to each workshop in Mali, The Gambia (both nications team ensured that peer-reviewed findings could be re- 2006), Senegal (2007), and Ghana (2008). The workshops offered leased under embargo, resulting in widespread media coverage an introductory course on why a meningitis vaccine clinical trial of research confirming the impact of the vaccine in respected was taking place in their country, meningococcal disease and the media worldwide. epidemiology of meningitis, vaccine development, MVP, and vac- As the project matured, the focus shifted to advocacy for stake- cine introduction strategies. Whenever possible, the workshops holdersandpotentialsupporters.The projectteam visitedkeymen- included a visit to the clinical site so that journalists could tour ingitis belt countries to introduce the vaccine to healthcare the facilities and talk to the clinical team. Reporters were not expect- authorities and to meet local journalists. It soon became clear that ed to produce stories following the visit, but the tour was a way to manylocaljournalistswouldbenefitfromabetterscientificground- foster a relationship between the clinical site and the media. On the ing to help them understand the aim of the project. A better com- final day of the workshop, participants wrote communication plans prehension of the scientific and public health foundations of the aimed at facilitating the conduct of the clinical trial in their country. project would enable them to provide science-based reports as the However, as time went on it became apparent that lack of financial vaccine was introduced in Africa. To meet this need, regular media resources and qualified staff in media outlets made implementation workshops in Africa were included in the communications plan. of the proposed activities difficult. Nevertheless, these workshops encouraged country ownership STAKEHOLDERS and the formation of communication networks that later became the foundation of the successful promotion of the vaccine when it A phase 1 clinical trial was conducted in India, the country was rolled out. All participants in the MVP workshops became part where the manufacturer is based. After the completion of this of the “MVP communication network” and received the quarterly phase 1 clinical trial [1], the MVP clinical activities shifted to newsletters, which regularly apprised them of the latest news on the Africa, as did the communication activities. In 2004, a Project development of the candidate vaccine, and later, on its rollout. Advisory Group was convened that consisted of African health, Although these workshops were not repeated for subsequent scientific, and communication experts [2]. clinical trials in the same country, all clinical sites had access to An African communications officer with public health exper- “long-distance communication coaching” during the duration of tise was hired and based at the WHO Inter-country Support the trials. Both the Europe- and Africa-based communicators (IST) office in Ouagadougou, Burkina Faso. His role proved provided this assistance, which covered areas such as writing to be crucial in promoting and advocating for the vaccine’s communiqués for local use, developing visual aids for clinical use while reporting on the project’s progress from an African staff and trial participants, and responding to rumors and polit- perspective. Over time, the European and African communica- ical events that sometimes threatened the conduct of clinical tions officers developed a comprehensive communications plan studies. When needed, communication support was also provid- to complement the MVP operational work in target countries. ed to research partners. For example, when the London School During decades of meningitis epidemics, African public of Hygiene and Tropical Medicine and the Centers for Disease health officials, families, and communities in the meningitis Control and Prevention, Atlanta, initiated meningococcal car- belt countries had become increasingly frustrated at not being riage studies in Africa, communications plans were collabora- able to better protect their populations against meningitis epi- tively developed to explain research activities that local demics. Expectations were high that a new meningococcal vac- populations might have considered intrusive (eg, collecting oro- cine could offer a real
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