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To Build Back Immunity, Health Workforce Advocates Must Lead the Way

“If you just asked me on the night of the 15th of April what I was planning to do …” Hassan Hussain looked up from his virtual screen inside his Khartoum residence, briefly pausing, before continuing to tell early career nursing medical leaders gathered in Geneva for the 76th World Health Assembly (WHA76) about his plans to advocate for his country of Sudan’s Ministry of Health to provide a larger voice for nurses and frontline health workers in shaping greater access and equity to vaccines.

The morning of April 16 — as violent clashes erupted in Khartoum and later across the country between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RAF)  — Hassan’s plans were shelved, but his drive to positively benefit his community was even more steadfast.

In early April, Hassan and five other early career nurses and midwives had just completed a four-week storytelling and advocacy training delivered to the winners of the Nursing Now Challenge Global Solutions Initiative to become the newest members of the Nursing Now-Sabin Immunisation Advocacy Champions.

The winners of this challenge answered the call made by the first six Nursing-Now Sabin champions. These early career nurses and midwives together have already had an immeasurable impact on immunization advocacy, from the sidelines of the United Nations General Assembly to the White House to communities they serve every day. The mentorship of the first group was crucial for the new champions to hit the ground running with their advocacy work and recommendations  this month.

Hassan’s story underscores a crucial element that immunization programs face to reverse the largest sustained decline in routine immunization in 30 years and sustain high coverage of lifesaving and pandemic preventing vaccines. Vaccination does not happen in a vacuum or bubble separated from all other aspects of life and society, either from those delivering or those receiving vaccines and vaccine information.

Nobody understands and lives this more than the nurses, midwives, pharmacists, community health workers, doctors and other health workers at the forefront of vaccine delivery. Their first-hand observations lead directly to clear-eyed policy recommendations — which were flying from the virtual screens of champions to the leaders in Geneva meeting with ministers and global health agency leads during WHA76. Just a sample:

Aidah Nagirinya, who coordinates maternal and child health and nursing services in Kalungu district in rural Uganda, urged nursing and health workforce leaders on hand to utilize successful networks like Nursing Now Challenge to provide concrete pathways for leadership, advocacy and research in immunization.

Rukaya Mumuni, Senior Nursing Officer at the Ga West Municipal Hospital in Accra, Ghana, built off of Aidah’s recommendations, saying that given the numerous touchpoints nurses have with caregivers and community members, health ministries and global health institutions have an imperative to increase engagement of nurses in immunization policymaking.

Nursing Now-Sabin Immunization Advocacy Champion Niba Clinton (left) leads a group of early career nurses and nursing students he trained as advocates in a vaccine outreach campaign in Buea, Cameroon, on May 27, 2023. Photo: Niba Clinton Ambe

Niba Clinton Ambe, an early career nurse champion from Cameroon, recommended programs are launched for mentorship between early career frontline health workers and students of nursing, medical and other frontline health workforce cadres, as well as organize “train the trainer” sessions of storytelling for immunization advocacy to help support more health workers to become advocates as he has.

Which brings us back to Hassan. He is taking the counsel and advice of his colleagues toward immediate action to the acute issue facing his country. While simultaneously working to ensure infants in Khartoum receive recommended vaccinations; he and nursing colleagues founded a new advocacy collective. They are spreading a petition “end war in Sudan and allow health and humanitarian aid workers to safely access victims” and holding their first policy lab to discuss the protection of health workers in conflict settings.

Aidah put it best when discussing her fellow frontline health workers’ engagement in advocating for better policies and investments in immunization. She said many nurse and other health workers “have the will, the have the zeal to do, but maybe they are lacking on the how to do.”

The Nursing Now-Sabin Immunization Advocacy Champions and other health workforce champions are providing concrete pathways on the how to engage, but such pathways must become routine and widespread across health systems to reach the Immunization Agenda 2030 targets and ensure all families have access to the lifesaving benefits of immunization.