By Dr. Mathuram Santosham
If you ask a scientist why it’s important to be an advocate, most scientists would probably be puzzled. After all, a scientist’s job is to research and study to find what works, test alternate hypotheses and document findings. Advocating is the job of an activist, they’d likely reply.
And they’d be partly right; advocacy is the job of an activist. But as scientists and medical providers, it is our duty to ensure that the knowledge that we have gained through research and best clinical practices is transferred to appropriate decision makers so that ALL children benefit from these life-saving interventions.
As a doctor, I have seen the grief of parents who have brought their children in for treatment for preventable diseases like pneumonia and diarrhea, only to be told they’ve arrived too late. As a scientist, I have conducted the research and know that vaccines against these diseases are effective and have the potential to prevent millions of unnecessary deaths in the next decade.
Rotavirus is one of these diseases. Today, rotavirus diarrhea is a leading killer of children in the developing world and the leading cause of hospitalization all over the world. Time and again, research has demonstrated that vaccines can protect children from rotavirus diarrhea or lessen its severity, yet introduction has been slow, especially in low-income countries where children need it the most. Only 41 countries have introduced the vaccine since it became available in 2006, including only a handful of countries in Africa and Asia, where the burden is greatest.
In the past three decades we have made tremendous advances in science that have allowed us to come up with numerous life-saving interventions. One of the most powerful interventions is vaccination. Vaccines have saved millions of lives in the past 50 years and have the potential to save millions more in the next 50 years. However, many children are deprived of life-saving vaccines, in my opinion partially because we have failed to appropriately communicate available knowledge to parents, healthcare providers, program managers and decision makers.
This is why Dr. Ciro de Quadros and I came together to form the ROTA Council, an organization of technical experts committed to providing the evidence policy makers need to accelerate the introduction of rotavirus vaccines in high-burden countries. Last week we hosted our second strategy meeting in Thailand during the 10th International Rotavirus Symposium, where we shared ideas to amplify our efforts. We also hosted an advocacy session during the Symposium to train and empower other scientists gathered from around the world on how to become advocates for rotavirus vaccines.
Last week’s Symposium offered a breadth of insights on the latest research including surveillance and modeling to confirm the burden of rotavirus mortality and morbidity, the ability of vaccines to reduce death and hospitalizations in real-world conditions, and the safety of the vaccines. There are several promising candidate vaccines in the pipeline from developing country manufacturers which, when ready, should improve vaccine availability and reduce cost. Important research also continues on rotavirus pathogenesis, immunity, vaccine performance and correlates of protection.
ROTA Council members gather for an annual strategy meeting in Bangkok.
Going forward, it is vital that we communicate data like we heard last week to the decision makers who must act in order to accelerate vaccine introduction. As scientists, medical practitioners AND advocates, we are in the unique position of being able to make the evidence come to life in ways that other messengers cannot. We are on the frontlines, conducting the research and treating the patients, and therefore we must add to our responsibilities the job of spreading the word so that policymakers are moved to act. We bring a double bank of knowledge that makes our voices incredibly powerful. The time has come for us as scientists to add our voices to the chorus calling for introduction of rotavirus vaccines.
Mathuram Santosham, MD, MPH, is Co-Chair of the ROTA Council and Professor of Pediatrics and International Health at Johns Hopkins University. He also serves as director of the Center for American Indian Health, director of the International Center for Maternal and Neonatal Health, and a Senior Advisor at IVAC.