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<!DOCTYPE html><html dir="ltr" lang="en"><head><meta charSet="utf-8"/><meta name="viewport" content="width=device-width, initial-scale=1.0"/><meta http-equiv="X-UA-Compatible" content="IE=edge"/><script async="" src="//sandbox.piano.io/xbuilder/experience/load?aid=cJo8WPy0su"></script><script></script><script>var McKinsey = {"ArticleTemplate":"Legacy","DaysSinceCMSPublication":"98","DisplayDate":"8/1/2008","OriginalPublicationDate":"8/1/2008","SitecoreId":"{FBB1ECB9-2CAD-4A85-8E86-AB738CE6E6A7}","Title":"A better way to speed the adoption of vaccines","ArticleType":"Article","ContentType":"Article","ServerNumber":"","IsPageRestricted":"true","UserID":"","RegistrationDate":"","LoginStatus":"logged_out","JobTitle":"","CompanyName":"","blogTags":null,"enableRegWall":true}; var pageMetaInformation = {"CurrentLanguage":"en","AlternateLanguages":[{"DisplayName":"English","LanguageCode":"en","Url":"/industries/social-sector/our-insights/a-better-way-to-speed-the-adoption-of-vaccines"}],"NavigationLink":"industries","ActiveItemId":"{CB94E4CE-4FA1-4FBB-83A6-ABD01FA491EF}","OfficeCode":"","MiniSiteId":"{409CD1FB-CD8A-4FB3-8ABA-6CA10C79037C}"};</script><link rel="icon" href="/favicon.ico"/><link href="https://www.mckinsey.com/redesign/resources/css/styles-rc.css" rel="stylesheet"/><link rel="manifest" href="/manifest.json"/><link rel="dns-prefetch" href="//cdn.dynamicyield.com"/><link rel="dns-prefetch" href="//st.dynamicyield.com"/><link rel="dns-prefetch" href="//rcom.dynamicyield.com"/><link rel="dns-prefetch" href="//cdn.cookielaw.org"/><link rel="preconnect" href="//assets.adobedtm.com"/><link rel="preconnect" href="//connect.facebook.net"/><link rel="preconnect" href="//static.hotjar.com"/><link rel="preload" as="font" href="/next-static/fonts/bower/Bower-Bold.woff2" type="font/woff2" crossorigin=""/><link rel="preload" as="font" href="/next-static/fonts/mckinsey-sans/regular/McKinseySans-Regular.woff2" type="font/woff2" crossorigin=""/><link rel="preload" as="font" href="/next-static/fonts/mckinsey-sans/medium/McKinseySans-Medium.woff2" type="font/woff2" crossorigin=""/><link rel="preload" as="font" href="/next-static/fonts/mckinsey-sans/light/McKinseySans-Light.woff2" type="font/woff2" crossorigin=""/><link rel="preload" as="font" href="/next-static/fonts/mckinsey-sans/italic/McKinseySans-Italic.woff2" type="font/woff2" crossorigin=""/><link rel="preload" as="font" href="/next-static/fonts/mckinsey-sans/light-italic/McKinseySans-LightItalic.woff2" type="font/woff2" crossorigin=""/><link rel="preload" as="font" href="/next-static/fonts/mckinsey-sans/medium-italic/McKinseySans-MediumItalic.woff2" type="font/woff2" crossorigin=""/><meta name="apple-itunes-app" content="app-id=674902075"/><link rel="apple-touch-icon" sizes="57x57" href="/next-static/images/mck-touch-icon-57x57.png"/><link rel="apple-touch-icon" sizes="72x72" href="/next-static/images/mck-touch-icon-72x72.png"/><link rel="apple-touch-icon" sizes="114x114" href="/next-static/images/mck-touch-icon-114x114.png"/><link rel="apple-touch-icon" sizes="144x144" href="/next-static/images/mck-touch-icon-144x144.png"/><link rel="apple-touch-icon" sizes="152x152" href="/next-static/images/mck-touch-icon-152x152.png"/><link rel="apple-touch-icon" sizes="167x167" href="/next-static/images/mck-touch-icon-167x167.png"/><link rel="apple-touch-icon" sizes="180x180" href="/next-static/images/mck-touch-icon-180x180.png"/><meta content="no-referrer-when-downgrade" name="referrer"/><meta content="McKinsey & Company" property="og:site_name" name="site_name"/><meta content="A better way to speed the adoption of vaccines" property="og:title" name="title"/><meta content="Nearly 11 million children die every year due to a lack of vaccination programs. 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McKinsey research suggests that network analysis, a business-improvement technique, could change this." name="twitter:description"/><meta content="Article" property="contenttype" name="contenttype"/><meta content="https://www.mckinsey.com/~/media/mckinsey/industries/public%20and%20social%20sector/our%20insights/a%20better%20way%20to%20speed%20the%20adoption%20of%20vaccines/a-better-way-to-speed-the-adoption-of-vaccines_500_standard.jpg?mw=677&car=42:25" name="twitter:image"/><meta content="A better way to speed the adoption of vaccines" name="twitter:image:alt"/><meta content="public" name="accesslevel"/><meta content="false" name="excludefromclientlink"/><meta content="article" name="articletype"/><meta content="Michael Conway | Carlo Rizzuto | Leigh Weiss" name="authors-name"/><meta content="2008-08-01T00:00:00Z" name="itemdate"/><meta content="Monthly Highlights | Article | August 1, 2008" name="searchresults-tags"/><script type="application/ld+json">{"@context":"https://schema.org","@type":"Article","url":"https://www.mckinsey.com","publisher":{"@type":"Organization","name":"McKinsey & Company","logo":{"@type":"ImageObject","url":"https://www.mckinsey.com/~/media/Thumbnails/Mck_Logo"}},"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.mckinsey.com/industries/social-sector/our-insights/a-better-way-to-speed-the-adoption-of-vaccines"},"datePublished":"2008-08-01T02:00:00Z","dateCreated":"2016-07-15T05:49:30Z","dateModified":"2008-08-01T00:00:00Z","heading":"A better way to speed the adoption of vaccines","image":"https://www.mckinsey.com/~/media/mckinsey/industries/public%20and%20social%20sector/our%20insights/a%20better%20way%20to%20speed%20the%20adoption%20of%20vaccines/a-better-way-to-speed-the-adoption-of-vaccines_500_standard.jpg","description":"Nearly 11 million children die every year due to a lack of vaccination programs. McKinsey research suggests that network analysis, a business-improvement technique, could change this.","author":[{"@type":"Person","name":"Michael Conway","url":"https://www.mckinsey.com/our-people/michael-conway"},{"@type":"Person","name":"Carlo Rizzuto"},{"@type":"Person","name":"Leigh Weiss","url":"https://www.mckinsey.com/our-people/leigh-weiss"}]}</script><meta name="next-head-count" content="58"/><meta name="next-font-preconnect"/><script src="" id="gtag-manager" data-nscript="beforeInteractive"> (function(w, d, s, l, i) { w[l] = w[l] || []; w[l].push({ 'gtm.start': new Date().getTime(), event: 'gtm.js' }); var f = d.getElementsByTagName(s)[0], j = d.createElement(s), dl = l != 'dataLayer' ? 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class="AuthorsByLine_mck-c-authors-byline__author__XdrlD"><span class="AuthorsByLine_mck-c-authors-byline__no-wrap__Ced0j"><a data-component="mdc-c-link" href="/our-people/michael-conway" class="mdc-c-link-inline___7DRrt_8032924 mdc-c-link-inline--secondary___YKoOK_8032924"><span class="mdc-c-link__label___Pfqtd_8032924">Michael Conway</span></a> </span></span><span class="AuthorsByLine_mck-c-authors-byline__author__XdrlD"><span class="AuthorsByLine_mck-c-authors-byline__no-wrap__Ced0j">Carlo Rizzuto<span> </span></span></span><span class="AuthorsByLine_mck-c-authors-byline__author__XdrlD"><span class="AuthorsByLine_mck-c-authors-byline__no-wrap__Ced0j"><a data-component="mdc-c-link" href="/our-people/leigh-weiss" class="mdc-c-link-inline___7DRrt_8032924 mdc-c-link-inline--secondary___YKoOK_8032924"><span class="mdc-c-link__label___Pfqtd_8032924">Leigh Weiss</span></a></span></span></div><div class="mdc-u-grid-col-md-start-8 mdc-u-grid-col-md-end-12 mdc-u-grid-col-lg-start-8 mdc-u-grid-col-lg-end-11 ArticleContent_mck-c-article-content__share-tools__kWRRw"></div></section><section class="mdc-u-grid mdc-u-grid-col-md-12 mck-u-animation-blur-in-400"><div class="mdc-u-grid-col-md-start-2 mdc-u-grid-col-md-end-12 mdc-u-grid-col-lg-start-3 mdc-u-grid-col-lg-end-11"><div data-component="mdc-c-description" class="mdc-c-description___SrnQP_8032924 mdc-u-ts-5"><div class="mck-u-links-inline">Nearly 11 million children die every year due to a lack of vaccination programs. McKinsey research suggests that network analysis, a business-improvement technique, could change this.</div></div></div></section><main data-layer-region="article-body" class="mdc-u-grid mdc-u-grid-gutter-xxl"><div class="mdc-u-grid mdc-u-grid-col-1 mdc-u-grid-col-md-12"><div class="mdc-u-grid-col-md-start-2 mdc-u-grid-col-md-end-12 mdc-u-grid-col-lg-start-3 mdc-u-grid-col-lg-end-11"><div class="mdc-o-content-body mck-u-dropcap"><div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="DownloadsSidebar_mck-c-downloads-sidebar__iFmyt mck-o-xs-right-span"><div data-layer-region="downloads-right-rail"><h3 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_8032924 mdc-c-heading--title___5qyOB_8032924 mdc-c-heading--border___K8dj3_8032924"></h3><div><div data-component="mdc-c-link-container" class="mdc-c-link-container___xefGu_8032924"><a data-component="mdc-c-link" href="#/download/%2F~%2Fmedia%2Fmckinsey%2Findustries%2Fpublic%20and%20social%20sector%2Four%20insights%2Fa%20better%20way%20to%20speed%20the%20adoption%20of%20vaccines%2Fa-better-way-to-speed-the-adoption-of-vaccines.pdf%3FshouldIndex%3Dfalse" class="DownloadsSidebar_mck-c-downloads-sidebar__download-link__fPqFQ mdc-c-link___lBbY1_8032924" target="_self" data-layer-event-prefix="Download Link" data-layer-action="click" data-layer-report-type="" data-layer-file-name="a-better-way-to-speed-the-adoption-of-vaccines" data-layer-report-name="a-better-way-to-speed-the-adoption-of-vaccines>"><span data-component="mdc-c-icon" class="mdc-c-icon___oi7ef_8032924 mdc-c-icon--size-md___yi5fA_8032924 mck-download-icon"></span><span class="mdc-c-link__label___Pfqtd_8032924"> (PDF-592 KB)</span></a></div></div></div></div> <p><strong>Vaccines eradicated smallpox</strong> in the 1970s and reduced the number of deaths from measles by nearly 40 percent from 1999 to 2003. Yet many vaccines are implemented slowly, particularly in developing countries, and nearly 11 million children die every year due to a lack of vaccinations. McKinsey research suggests that network analysis, which companies use to improve business outcomes by analyzing information flows and personal relationships, could speed their adoption. Specifically, these techniques can shed light on the complicated processes and interactions that underpin (and often slow down) the introduction of vaccines.</p> <p>The process of introducing vaccines varies from country to country and involves the influence of many stakeholders—ministries of health and finance, international agencies such as the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO), nongovernmental organizations (NGOs), community leaders, experts on disease, and funders, to name just some of the players. Defining roles, decision rights, and data requirements for this constellation of participants is difficult. The resulting confusion slows decision making and compounds chronic problems, such as poor infrastructure and limited public-health budgets. Delays, sometimes as long as 15 to 20 years, between the introduction of a vaccine in developed countries and its adoption in developing ones are the result.</p> <p>To understand the decision-making processes involved, we analyzed recent or ongoing vaccine introductions in Egypt, Mauritania, Mexico, and Zambia. These countries gave us a well-rounded picture because they vary substantially by population size, per capita income, per capita healthcare expenditures, and disease burden—a health problem’s impact in a geographical area (for example, mortality, morbidity, and financial costs). In each country, we interviewed up to 30 decision makers and stakeholders, including health ministry officials and key NGO representatives. We also used confidential surveys to collect data on how frequently participants exchanged information, with whom they exchanged it, the value they ascribed to those interactions, and the types of information they exchanged. Finally, we asked participants about the role of documents (such as WHO’s vaccine introduction guidelines) and of national and international meetings on vaccines in their decision making.</p> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-disruptor1up mck-o-md-center mck-u-inline-module-border-top mck-u-inline-module-border-bottom mck-u-screen-only" data-layer-region="disruptor-1up"><div class="mdc-u-grid mdc-u-grid-gutter-md mdc-u-grid-col-lg-12 mdc-u-grid-col-md-12 "><div class="mdc-u-grid-col-md-span-12"><header data-component="mdc-c-header" class="mdc-c-header"><div class="mdc-c-header__block___i1Lg-_8032924"><h3 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_8032924"><div>Would you like to learn more about our <a href="/sitecore/service/notfound.aspx?item=web%3a%7b458771a3-8553-45cf-bc15-4ea0029986ac%7d%40en">Social Sector Practice</a>?</div></h3></div></header></div></div></div> <p>The survey findings allowed us to construct network maps—illustrations that identify relationships and knowledge flows among individuals and groups. We hoped that the maps would show us how national and international roles are connected and which roles are central and valuable. In this way, the maps might help stakeholders understand how to improve decision-making processes and thus hasten the introduction of vaccines.</p> <p>Our analysis showed that decision makers in Egypt, Mauritania, and Zambia didn’t actively engage global experts on the specific diseases these countries were targeting. The experts who participated in the decision to introduce the hepatitis B vaccine in Mauritania, for example, were all local medical and research specialists, primarily in its National Central Hospital. By contrast, stakeholders in the fourth country—Mexico—reported that international disease experts gave them a better understanding of the potential impact of the rotavirus vaccine on its population. Respondents in Mexico also indicated that these experts’ international stature helped accelerate the decision to introduce the vaccine (Exhibit 1).</p> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-inline-module-container mck-o-md-center"><div class="mck-c-content-header"><div class="ContentHeader_mck-c-content-header__eyebrow__cBTe_"></div></div><div class="mck-u-inline-module-border-bottom"><picture data-component="mdc-c-picture" class="Exhibit_mck-c-exhibit__image__pyIDm"><source media="(min-width: 768px)" srcSet="/~/media/mckinsey/industries/public%20and%20social%20sector/our%20insights/a%20better%20way%20to%20speed%20the%20adoption%20of%20vaccines/svgz_ex1.svgz?cq=50&cpy=Center"/><img alt="Engaging experts" src="/~/media/mckinsey/industries/public%20and%20social%20sector/our%20insights/a%20better%20way%20to%20speed%20the%20adoption%20of%20vaccines/svgz_ex1.svgz?cq=50&cpy=Center" loading="lazy"/></picture></div><div class="mck-u-sr-only"></div></div> <p>We found as well that in all four countries, finance representatives either had no role in the process of deciding whether and when to introduce vaccines or were peripheral to it—and usually brought in near its end. When Zambia, for example, decided to introduce a new vaccine, representatives from the Ministry of Finance had relatively little contact with other decision makers (Exhibit 2). Given the importance of financing vaccine programs sustainably, especially in countries such as Egypt and Mexico, which renegotiate funding every year, these conclusions are troubling. Health ministries and other leading national stakeholders should look for ways to involve senior Finance Ministry colleagues earlier in the process and include them in regular meetings about potential vaccine programs.</p> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-inline-module-container mck-o-md-center"><div class="mck-c-content-header"><div class="ContentHeader_mck-c-content-header__eyebrow__cBTe_"></div></div><div class="mck-u-inline-module-border-bottom"><picture data-component="mdc-c-picture" class="Exhibit_mck-c-exhibit__image__pyIDm"><source media="(min-width: 768px)" srcSet="/~/media/mckinsey/industries/public%20and%20social%20sector/our%20insights/a%20better%20way%20to%20speed%20the%20adoption%20of%20vaccines/svgz_ex2.svgz?cq=50&cpy=Center"/><img alt="Few interactions with finance" src="/~/media/mckinsey/industries/public%20and%20social%20sector/our%20insights/a%20better%20way%20to%20speed%20the%20adoption%20of%20vaccines/svgz_ex2.svgz?cq=50&cpy=Center" loading="lazy"/></picture></div><div class="mck-u-sr-only"></div></div> <p>Finally, our research showed that global institutions, such as WHO and UNICEF, play a pivotal role in decisions to introduce vaccines; all respondents, for example, said that WHO guidelines are important. We found, however, that surprisingly few stakeholders mentioned cross-country gatherings, such as regional meetings of WHO’s Expanded Program on Immunization (EPI), as important inputs. This finding appears to reflect a broader failure to share information across countries—something we also observed in other aspects of our study. International organizations should therefore look for new ways to promote the sharing of best practices and relevant technical knowledge (such as disease burden data) among countries afflicted by similar maladies.</p> <div data-component="mdc-c-module-wrapper" data-module-theme="default" data-module-background="transparent" data-module-category="" class="mck-c-disruptor1up mck-o-md-center mck-u-inline-module-border-top mck-u-inline-module-border-bottom mck-u-screen-only" data-layer-region="disruptor-1up"><div class="mdc-u-grid mdc-u-grid-gutter-md mdc-u-grid-col-lg-12 mdc-u-grid-col-md-12 "><div class="mdc-u-grid-col-lg-span-4 mdc-u-grid-col-md-span-5 Disruptor1Up_mck-c-disruptor1up__image___2Gc4"><picture data-component="mdc-c-picture"><img alt="Eradicating polio in Nigeria" src="/~/media/mckinsey/industries/public%20and%20social%20sector/our%20insights/eradicating%20polio%20in%20nigeria/eradicating-polio-in-nigeria_156731127_1536x1536.jpg?cq=50&mh=145&car=16:9&cpy=Center" loading="lazy"/></picture></div><div class="mdc-u-grid-col-lg-span-8 mdc-u-grid-col-md-span-7"><header data-component="mdc-c-header" class="mdc-c-header"><div class="mdc-c-header__block___i1Lg-_8032924"><h3 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_8032924"><div>Eradicating polio in Nigeria</div></h3></div></header><div data-component="mdc-c-link-container" class="mdc-c-link-container___xefGu_8032924 mdc-c-link-container--display-column___X0HDD_8032924 mck-c-disruptor1up__content Disruptor1Up_mck-c-disruptor1up__content--links__VV4lE mdc-u-grid-gutter-md"><a data-component="mdc-c-link" href="/industries/healthcare/our-insights/eradicating-polio-in-nigeria" class="mdc-c-link-cta___NBQVi_8032924"><span class="mdc-c-link__label___Pfqtd_8032924">Read the article</span><span data-component="mdc-c-icon" class="mdc-c-icon___oi7ef_8032924 mck-link-arrow-right-icon"></span></a></div></div></div></div> <p>Ours was a small-scale research effort. But it not only highlights issues that if addressed could speed future vaccine introductions, it also shows the value of network analysis as a tool to explore their dynamics in developing economies.</p> <p>Our study was guided by an advisory board with experts from the Bill & Melinda Gates Foundation, the Pneumococcal Vaccines Accelerated Development and Introduction Plan (PneumoADIP), the Johns Hopkins Bloomberg School of Public Health, and the Program for Appropriate Technology in Health (PATH).</p></div><div class="container-placeholder"></div></div></div><div class="mdc-u-grid mdc-u-grid-gutter-xl"><section role="contentinfo" data-layer-region="article-about-authors" class="mdc-u-grid mdc-u-grid-col-md-12 AboutAuthor_mck-c-about-author__nRJzu"><div class="mdc-u-grid-col-md-start-2 mdc-u-grid-col-md-end-12 mdc-u-grid-col-lg-start-3 mdc-u-grid-col-lg-end-11"><h5 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_8032924 mdc-c-heading--title___5qyOB_8032924 mdc-c-heading--border___K8dj3_8032924 mdc-u-align-center"></h5><div data-component="mdc-c-description" class="mdc-c-description___SrnQP_8032924 mdc-u-ts-8 mck-u-links-inline mck-u-links-inline--secondary mdc-u-mt-5"><div><p><strong>Michael Conway</strong> is a director in McKinsey’s Philadelphia office, <strong>Carlo Rizzuto</strong> is an associate principal in the London office, and <strong>Leigh Weiss</strong> is an associate principal in the Boston office.</p></div></div></div></section><section class="mdc-u-grid mdc-u-grid-col-md-12 mck-u-screen-only"><div class="mdc-u-grid-col-md-start-2 mdc-u-grid-col-md-end-12 mdc-u-grid-col-lg-start-5 mdc-u-grid-col-lg-end-9"><h5 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_8032924 mdc-c-heading--title___5qyOB_8032924 mdc-c-heading--border___K8dj3_8032924 mdc-u-align-center">Explore a career with us</h5><div data-component="mdc-c-link-container" class="mdc-c-link-container___xefGu_8032924 mdc-c-link-container--align-center___ar3mu_8032924"><a data-component="mdc-c-link" href="/careers/search-jobs" class="mdc-c-button___U4iY2_8032924 mdc-c-button--secondary___Boipq_8032924 mdc-c-button--size-large___jwpUy_8032924" aria-label="Search Openings" data-layer-event-prefix="CTA Link" data-layer-action="click" data-layer-category="careers" data-layer-subcategory="search" data-layer-text="Search Openings"><span class="mdc-c-link__label___Pfqtd_8032924">Search Openings</span></a></div></div></section></div></main></div><div data-component="mdc-c-module-wrapper" data-module-theme="light" data-module-background="lightest-grey" data-module-category="StandalonePromo" class="RelatedArticle_mck-c-article-related__GGA76 mck-u-screen-only" data-layer-region="related-articles"><div class="mdc-o-container__wrapper is-wrapped mdc-u-spaced-mobile"><h5 data-component="mdc-c-heading" class="mdc-c-heading___0fM1W_8032924 mdc-c-heading--title___5qyOB_8032924 mdc-u-align-center">Related 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mdc-c-link___lBbY1_8032924"><div>Cutting costs: The great healthcare challenge of the century</div></a></h6></div></div></div></div></div></div></div></main></div><script id="__NEXT_DATA__" type="application/json">{"props":{"pageProps":{"locale":"en","dictionary":{},"sitecoreContext":{"route":{"name":"A better way to speed the adoption of vaccines","displayName":"A better way to speed the adoption of vaccines","fields":null,"databaseName":"web","deviceId":"fe5d7fdf-89c0-4d99-9aa3-b5fbd009c9f3","itemId":"fbb1ecb9-2cad-4a85-8e86-ab738ce6e6a7","itemLanguage":"en","itemVersion":1,"layoutId":"ae753eb4-a035-40b4-83bf-4b4438df6742","templateId":"683910db-02ba-40ba-92e7-726c880160a9","templateName":"ArticleJSS","placeholders":{"jss-main":[{"uid":"232bb7e9-289f-492d-a916-2b6185e44a84","componentName":"ArticleTemplate","dataSource":"","fields":{"data":{"articleTemplate":{"title":{"jsonValue":{"value":"A better way to speed the adoption of vaccines"}},"sEOTitle":{"value":""},"description":{"jsonValue":{"value":"Nearly 11 million children die every year due to a lack of vaccination programs. McKinsey research suggests that network analysis, a business-improvement technique, could change this."}},"sEODescription":{"value":""},"displayDate":{"jsonValue":{"value":"2008-08-01T00:00:00Z"}},"body":{"value":"[[DownloadsSidebar]] \u003cp\u003e\u003cstrong\u003eVaccines eradicated smallpox\u003c/strong\u003e in the 1970s and reduced the number of deaths from measles by nearly 40 percent from 1999 to 2003. Yet many vaccines are implemented slowly, particularly in developing countries, and nearly 11 million children die every year due to a lack of vaccinations. McKinsey research suggests that network analysis, which companies use to improve business outcomes by analyzing information flows and personal relationships, could speed their adoption. Specifically, these techniques can shed light on the complicated processes and interactions that underpin (and often slow down) the introduction of vaccines.\u003c/p\u003e\n\u003cp\u003eThe process of introducing vaccines varies from country to country and involves the influence of many stakeholders\u0026mdash;ministries of health and finance, international agencies such as the United Nations Children\u0026rsquo;s Fund (UNICEF) and the World Health Organization (WHO), nongovernmental organizations (NGOs), community leaders, experts on disease, and funders, to name just some of the players. Defining roles, decision rights, and data requirements for this constellation of participants is difficult. The resulting confusion slows decision making and compounds chronic problems, such as poor infrastructure and limited public-health budgets. Delays, sometimes as long as 15 to 20 years, between the\nintroduction of a vaccine in developed countries and its adoption in developing ones are the result.\u003c/p\u003e\n\u003cp\u003eTo understand the decision-making processes involved, we analyzed recent or ongoing vaccine introductions in Egypt, Mauritania, Mexico, and Zambia. These countries gave us a well-rounded picture because they vary substantially by\npopulation size, per capita income, per capita healthcare expenditures, and disease burden\u0026mdash;a health problem\u0026rsquo;s impact in a geographical area (for example, mortality, morbidity, and financial costs). In each country, we interviewed up to 30 decision makers and stakeholders, including health ministry officials and key NGO representatives. We also used confidential surveys to collect data on how frequently participants exchanged information, with whom they exchanged it, the value they ascribed to those interactions, and the types of information they exchanged. Finally, we asked participants about the role of documents (such as WHO\u0026rsquo;s vaccine introduction guidelines) and of national and international meetings on vaccines in their decision making.\u003c/p\u003e\n[[Disruptor1UP dis1]]\n\u003cp\u003eThe survey findings allowed us to construct network maps\u0026mdash;illustrations that identify relationships and knowledge flows among individuals and groups. We hoped that the maps would show us how national and international roles are\nconnected and which roles are central and valuable. In this way, the maps might help stakeholders understand how to improve decision-making processes and thus hasten the introduction of vaccines.\u003c/p\u003e\n\u003cp\u003eOur analysis showed that decision makers in Egypt, Mauritania, and Zambia didn\u0026rsquo;t actively engage global experts on the specific diseases these countries were targeting. The experts who participated in the decision to introduce the hepatitis B vaccine in Mauritania, for example, were all local medical and research specialists, primarily in its National Central Hospital. By contrast, stakeholders in the fourth country\u0026mdash;Mexico\u0026mdash;reported that international disease experts gave them a better understanding of the potential impact of the rotavirus vaccine on its population. Respondents in Mexico also indicated that these experts\u0026rsquo; international stature helped accelerate the decision to introduce the vaccine (Exhibit 1).\u003c/p\u003e\n[[exhibit 1]]\n\u003cp\u003eWe found as well that in all four countries, finance representatives either had no role in the process of deciding whether and when to introduce vaccines or were peripheral to it\u0026mdash;and usually brought in near its end. When Zambia, for example, decided to introduce a new vaccine, representatives from the Ministry of Finance had relatively little contact with other decision makers (Exhibit 2). Given the importance of financing vaccine programs sustainably, especially in countries such as Egypt and Mexico, which renegotiate funding every year, these conclusions are troubling. Health ministries and other leading national stakeholders should look for ways to involve senior Finance Ministry colleagues earlier in the process and include them in regular meetings about potential vaccine programs.\u003c/p\u003e\n[[exhibit 2]]\n\u003cp\u003eFinally, our research showed that global institutions, such as WHO and UNICEF, play a pivotal role in decisions to introduce vaccines; all respondents, for example, said that WHO guidelines are important. We found, however, that surprisingly few stakeholders mentioned cross-country gatherings, such as regional meetings of WHO\u0026rsquo;s Expanded Program on Immunization (EPI), as important inputs. This finding appears to reflect a broader failure to share information across countries\u0026mdash;something we also observed in other aspects of our study. International organizations should therefore look for new ways to promote the sharing of best practices and relevant technical knowledge (such as disease burden data) among countries afflicted by similar maladies.\u003c/p\u003e\n[[Disruptor1UP dis2]]\n\u003cp\u003eOurs was a small-scale research effort. But it not only highlights issues that if addressed could speed future vaccine introductions, it also shows the value of network analysis as a tool to explore their dynamics in developing economies.\u003c/p\u003e\n\u003cp\u003eOur study was guided by an advisory board with experts from the Bill \u0026amp; Melinda Gates Foundation, the Pneumococcal Vaccines Accelerated Development and Introduction Plan (PneumoADIP), the Johns Hopkins Bloomberg School of Public Health, and the Program for Appropriate Technology in Health (PATH).\u003c/p\u003e"},"isFullScreenInteractive":{"boolValue":false},"hideStickySocialShareBar":{"boolValue":false},"desktopID":{"value":""},"mobileID":{"value":""},"desktopURL":{"value":""},"mobileURL":{"value":""},"desktopPaddingPercentage":{"value":""},"mobilePaddingPercentage":{"value":""},"desktopOverrideHeight":{"value":""},"mobileOverrideHeight":{"value":""},"cerosOembedURL":{"value":""},"cerosRenderMode":{"targetItem":null},"cerosBackgroundColor":{"targetItem":null},"hideByLine":{"boolValue":false},"tableOfContentsTitle":{"value":"TABLE OF CONTENTS"},"accessStatus":{"targetItem":{"key":{"value":"RegisteredUsers"},"value":{"value":"Registered Users"}}},"articleType":{"targetItem":{"displayName":"Article"}},"hasSpecialReport":{"boolValue":false},"contentType":{"targetItem":{"displayName":"Article"}},"sourcePublication":{"targetItem":null},"externalPublication":{"value":""},"excludeFromClientLink":{"boolValue":false},"originalPublishDate":{"jsonValue":{"value":"2008-08-01T02:00:00Z"}},"footnotes":{"value":""},"contributoryPractice":{"targetItems":[]},"aboutTheAuthors":{"value":"\u003cp\u003e\u003cstrong\u003eMichael Conway\u003c/strong\u003e is a director in McKinsey\u0026rsquo;s Philadelphia office, \u003cstrong\u003eCarlo Rizzuto\u003c/strong\u003e is an associate principal in the London office, and \u003cstrong\u003eLeigh Weiss\u003c/strong\u003e is an associate principal in the Boston office.\u003c/p\u003e"},"authors":{"targetItems":[{"template":{"id":"3FBABDB63A094F68B1F8E1BBE1BA124E","name":"Author"},"id":"23BCF8F52CFD4A8CB7A0EAB869D01A79","name":"Michael Conway","authorTitle":{"value":"Michael Conway"},"description":{"value":""},"thumbnailImage":{"alt":"","src":null},"profile":{"targetItems":[{"standardImage":{"src":"/~/media/mckinsey/our people/michael conway/michael_conway_standard_profile2_1536x1152.jpg","alt":"Michael Conway"},"emailLinks":{"value":"Michael_Conway@mckinsey.com"},"linkedInUrl":{"value":"https://www.linkedin.com/pub/michael-d-conway/0/a24/290"},"description":{"value":"Leads our global work in international development, public health, and biopharmaceuticals, helping leading organizations in public, social, and private sectors to address strategic, organizational, and operational challenges"},"locations":{"targetItems":[{"name":"Philadelphia","displayName":"Philadelphia"}]},"firmTitle":{"value":"Senior Partner"},"thumbnailImage":{"alt":"Michael Conway","src":"/~/media/mckinsey/our people/michael 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