Blind spots: how a lack of reliable data undermines development

(c)Markel Rodondo, Conakry, Guinea

Despite its critics, vaccines are the most cost-effective and efficient forms of preventing disease. Yet millions of kids die from vaccine-preventable diseases – like pneumonia and measles – every year.

Despite routine vaccination and vaccination campaigns, many developing countries have repeated outbreaks of disease.  In 2013, Médecins Sans Frontières vaccinated 2.5 million people in response to measles outbreaks; half of those were in the Democratic Republic of Congo. (MSF, 2014)

So where do governments and aid agencies go wrong in not getting the vaccines kids need?

A lack of data – in many forms – is crucial. And this is where governments, in a particular, have a responsibility to improve data collection. Many country governments have blind spots when it comes to how many of their nation’s children are properly vaccinated, or even where their people live.

As Kazungu and Adetifa observe:

Good quality vaccination data is required to understand inequities in access to vaccines. Most vaccination coverage estimates in LMICs are from administrative reports that tend to overestimate coverage, due to errors in the number of vaccine doses administered and/or invalid assumptions about the size of the target population of children. (Jacob Kazungu, 2017)

Much of this lies at the foot of governments. Morten Jerven argues – with good reason – that the interest, or more often the lack thereof, in gathering data on their populations’ health, wealth and wisdom is often down to whether its in the best interests of the politicians. As he states:

Data collection is often done in accordance with a governance imperative: statistics are collected and compiled in order to facilitate particular policy agendas. Conversely, a lack of data may signal and facilitate inaction. (Jerven, 2013)

Overestimation of vaccination coverage is unfortunately a common theme throughout many states in Africa. In 2009, Burkina Faso experienced a measles outbreak with over 50,000 cases – to the surprise of many, it turns out. “[the country’s] vaccine coverage estimates preceding this outbreak suggested the country was near elimination, not at risk for a large outbreak.” (Nita Bharti, 2016)

It’s not only a lack of data on vaccination coverage rates that have an impact on disease outbreaks. The ability of a country to be able to provide vaccines for their country’s children in the first place has an impact. The price a country pays for a vaccine is a large part of this. Pharmaceutical companies are notoriously opaque about pricing – and the pneumonia vaccine is a great example of this.

What each country pays for this vaccine is largely a secret. Countries of like-sized economic status – take the BRICS, for example – don’t know what each other is paying for the pneumonia vaccine.  This lack of data “impacts… international or national policy evaluation, and these evaluations in turn have direct implications for issues of governance.” (Jerven, 2013) In this case, whether or not a government can afford to buy a life-saving vaccine that could protect kids against a disease that kills a million children each year.

Médecins Sans Frontières launched a campaign – called A Fair Shot – in part to highlight this lack of data around the price of the pneumonia vaccine. Here’s a short, funny video that explains the part of the campaign where prices are hidden:

The campaign was designed to ask two pharmaceutical companies – Pfizer and GlaxoSmithKline – to reduce the price of the pneumonia vaccine to $5 per child in developing countries. In the early part of the campaign, it highlighted that countries don’t know what other countries are paying for the vaccine, therefore they had to negotiate a price with the companies ‘blind’.

To highlight the issue, and solve the problem, MSF, working with the Guardian newspaper, decided to crowdsource the prices of the pneumonia vaccine in different countries. They asked readers and supporters to visit their local pharmacy or hospital and ask for the price of the vaccine, and then report it to the Guardian or to MSF.

MSF and the Guardian used social media posts to boost this ask:

The request to ask the public to send data on vaccine prices worked. MSF and the Guardian were able to source prices for the pneumonia vaccine from countries and sources that had hitherto been unknown or unavailable.

While these blind spots – or lack of data – in vaccination exist, there are way around them. Governments can do more, “but data availability is a good indicator of political commitment.” (Jerven, 2013) Governments will source the data they require, and respond to the needs accordingly – but only if the political will to do so is there.

 

Works Cited

Jacob Kazungu, I. A. (2017, February 15). Crude childhood vaccination coverage in West Africa: Trends and predictors of completeness. Wellcome Open Research.

Jerven, M. (2013). Poor numbers: how we are misled by African development statistics and what to do about it. Ithaca: Cornell University Press.

MSF. (2014). International Activity Report 2013. Médecins Sans Frontières .

Nita Bharti, A. D. (2016, October). Measuring populations to improve vaccination coverage . Scientific Reports.