In Singapore for an immunization training ahead of the 6th annual Asian Vaccine Conference, journalists from seven Asian countries schooled public health advocates on how to generate interest in age-old killer childhood disease

By Rose Weeks

Journalists participating in a ROTA Council-led training session at the 2017 Asian Vaccine Conference in Singapore made it clear that despite compelling data, a diarrhea vaccine is not headline-worthy in itself.

Rotavirus vaccines are an available, cost-effective solution to help prevent millions of cases of rotavirus diarrhea and 200,000 deaths occurring each year. While over 85 countries in the world have introduced rotavirus into their national immunization program, 90 million children still lack access. Asian countries have lagged behind other regions in introducing the orally administered vaccine.

Rotavirus causes between 30-60% of all under-five pediatric diarrheal hospitalizations in Asia but the death rates tend to be lower than other high-burden regions. And few of Asia’s rapidly industrializing countries are still eligible for new vaccine co-financing support from Gavi, the Vaccine Alliance.

Vaccine price expected to drop

Journalists such as New York Times reporter Donald McNeil are now taking interest in mounting evidence demonstrating vaccine impact, and an expanding market for vaccines.

Two vaccines are currently available around the world with other vaccines licensed and used in three Asian countries. India has two nationally-licensed vaccines—Bharat’s $1/dose ROTAVAC and Serum Institute of India’s heat-stable Rotasiil—that are under consideration for pre-qualification by WHO many think will lead to a significant drop in price for rotavirus vaccines globally in the next five years. [ED UPDATE: ROTAVAC received pre-qualification by the WHO in January 2018.]

In Singapore, journalists met with pediatric leaders and scientists from Johns Hopkins University, the Asia Pacific Pediatric Association, CDC, the Chinese University of Hong Kong, the University of the Philippines, and the Bill & Melinda Gates Foundation.

As the event proceeded, it became clear that journalists had lessons of their own for advocates—here are 7 takeaways.

1. Diarrhea is seen as innocuous part of childhood

“People in India believe diarrhea is just a part of growing up,” said Sushmita Malaviya, a former journalist now working for PATH in India, in photo above, summarizing a major challenge to accelerate the adoption of rotavirus vaccine in many countries.

2. Almost everyone knew a child seriously sickened with diarrhea

Dr. Zul Ismail, a ROTA Council member and pediatric leader based in Kuala Lumpur, discussed a two-year-old child named Sufi who was hospitalized for days while she suffered repeated vomiting and diarrhea. Fortunately, with Dr. Ismail’s attentive treatment and a lot of intravenous fluids, she recovered after four days.

Dr. Mathu Santosham, ROTA Council chair and international health and pediatrics professor from the U.S., in photo above, asked if others in the room had children who had suffered from diarrhea.

“My daughter didn’t want to eat,” recalled Phi Van Anh of Vietnam National Television (below). “Fortunately, her diarrhea wasn’t caused by rotavirus, and we got medicine—a sachet” of oral rehydration solution. “She recovered after three days,” she said.

Sarantuya Altansukh of Mongolian National Broadcaster had a granddaughter who was hospitalized. Another participant shared that her daughter’s three-day diarrhea case was so serious that her growth suffered—her weight dropped and her doctor said she was “failing to thrive.”

“I had tears—I thought it had something to do with me,” she shared. 

3. Focus advocacy efforts on the value of human potential  

Speakers shared evidence on hospitalization and related costs borne by families, but the room perked up notably when Dr. Lulu Bravo, a ROTA Council member and pediatrician from the Philippines, said that multiple bouts of diarrhea during early childhood can diminish cognitive function. A recent study from Brazil showed that early childhood diarrhea episodes predicted cognitive delays in later childhood, even if children were not malnourished.

Journalists suggested that vaccine advocates document this more clearly since children’s grades are very important to parents.

4. Embrace short attention spans

“I worked with editors that had the memory of a goldfish,” said Nilanjana Bose, a former journalist who worked for a decade on India’s NDTV and CNN News 18.

Editors are driven increasingly by social media and website metrics, and journalists know many people experience stories on Facebook without ever going to the newspaper’s website.

“Make short videos,” suggested Tareq Salahuddin of The Daily Star in Bangladesh (pictured below)–“ like, four ways you can ward off diarrhea for your children.”

5. Compete with politics

In Asia’s extremely competitive media markets, it is hard for health to clamor over the noise of politics. Journalists said they’d worked hard on health stories only to have them tabled indefinitely for something more controversial.

“We compete with politics,” said Sheila Crisostomo in the Philippines Star, referencing the Philippines’ controversial president. Still, a good story can land important health issues onto politicians’ radars.

A headline by Ms. Crisostomo“Government hit for slow response on rotavirus”—got people’s attention and may have helped to expedite the launch of rotavirus vaccine.

The vaccine was introduced in 2012 in a limited way for 700,000 of the Philippines’s poorest children. It was found to be highly effective in the regions where it was used. However, it hasn’t been expanded nationally to date.

6. Translate your science in simple and clear language

“You all spend three years researching an issue and you expect us to write a story overnight,” said Manish Gautam, of Nepal’s daily newspaper The Kathmandu Post (photo above), pointing to the experts in the room. Others pointed out that journalists typically work on multiple stories and only have limited time to conduct research.

Tareq Salahuddin pointed to Orin Levine’s Huffington Post blogs as an example of how science and public health policy can be clearly shared.

7. Trust journalists to deliver your message

Dr. Salahuddin from Bangladesh summarized the situation toward the end of the day.

“We must convince policy makers that there is scientific evidence that children are dying needlessly when there are simple tools we can afford—like oral rehydration therapy we can make in our houses and provide to our children,” he said.

AIDS gets a lot of attention, “but there is no vaccine,” he noted.

In his previous reporting for The Daily Star, Dr. Salahuddin stressed the importance of preventing disease.

“While improvements in hygiene, sanitation and drinking water are important to prevent diarrhoea in general, they cannot stop the spread of rotavirus,” he wrote. That is why preventing rotavirus infections is essential. And vaccination is the best tool available today to protect children from rotavirus.”