The Aletta Jacobs School of Public Health (AJSPH) can become an international leader in global comparative research into the economics of vaccination programs.

By Maarten Postma

Obviously, Public Health is about issues which have an impact on large population groups. At an increasing pace, these issues are balancing on the edge between medical and economic issues. As well as prevention and global health, affordability and equity can be considered part of the Public Health domain. Knowledge on bringing these issues together and to optimally incorporate the data and research relating to these domains with societal needs, can bring about huge leaps forward.  With this ambition, we have taken on the challenge and are founding the new research and training environment of the AJSPH. This expertise centre can be the ultimate vehicle for global comparative research, integrating valuable information acquired in society and providing socially justified solutions in return. The AJSPH is currently in an exploratory development phase within UMCG’s SHARE Research Institute. 

When I say that we should optimise our children's chances of healthy aging from birth, everybody will agree. And yet we are not doing this, for the Netherlands is lagging behind with its national vaccination programme. Whether and how we can eliminate the gap is not a medical question, though. It is an economic issue which revolves around cost effectiveness. The challenge is to develop efficient and effective models to solve that problem by using targeted research. If we manage to bring together all the existing data and initiatives within one multidisciplinary body, everyone will benefit – science, the field of practice and society. In light of our experiences with Big Data and specific studies into Healthy Ageing – research into health prospects in recognition of people's life course – Groningen would be the ideal location for this.

Research into new economic models

Life begins at birth. For the purpose of giving children the best possible health prospects, it was decided to vaccinate them proactively. Actually, working in the UK as an advisor for the government concerning the British national vaccination programme, I have come to the conclusion that the United Kingdom takes better care of its babies than the Netherlands does. Obviously, it shouldn't be that way. Let me be more specific. In late 2016, a tragic death was the cause for a new debate about whether children should be vaccinated against the rota virus, which causes five thousand young children to be hospitalized in the Netherlands each year. Despite the advice given by the World Health Organisation in 2009, the Netherlands does not vaccinate its children against this virus. When I was a member of the Dutch National Health Council, this subject was high on the agenda. While a majority of the Council was in favour of vaccination, the deciding factor appeared to be the feeling of the minority of the members that adding this vaccine to the vaccination programme was too expensive in comparison with the 'small' number of children who are seriously affected by the rota virus. This is not a message which parents of a child who has not survived this viral disease will wish to hear, though. We have carried out research into the virus and, using scientific models, been able to show that vaccination against it is cost-effective. Indeed, vaccination in the UK against the rota virus has long been a success. The Netherlands is much too cautious in this respect.

On the way to socially justified solutions

Based on my speciality, pharmacoeconomics, I argue in favour of more research: not so much more research into all sorts of individual vaccines, but comprehensive research into all the vaccination programmes which exist throughout the world. Our aim is to arrive at clear prioritisations and the best possible cost-effective programme for each separate country, optimally using available Big Data. If we intensify cooperation, we will make huge progress. I am not just thinking of the synergy between the various disciplines, I am thinking in particular of the synergy between science and the entire healthcare field, which has a huge amount of data available already. Social relevance in research is only achieved by sitting around the table with the field of practice as well as with policymakers. In my view, the Aletta Jacobs School of Public Health is the ultimate vehicle for global comparative research which will integrate valuable information acquired from society and will provide socially justified solutions in return.

The Aletta Jacobs School of Public Health is an initiative of the University of Groningen's Faculties of Economics and Business, Science and Engineering, and Medical Sciences. In the present exploration phase, which kick-started in March 2017, anybody who is interested in the Public Health domain is invited to share their ideas and inspiration. Please visit AJSPH-website