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'The Change Equation' - Key Drivers and Influencers of New Vaccine Implementation

Updated: Jul 22, 2020

14 January 2016

Written by Bruce Langoulant

Asia Pacific Leader, CoMO

Ever wanted to change something that you and others believed needed to be changed?

Would it be helpful if there was a formula, an equation to guide you?

Our experience is that you can implement an organised approach, a Change Equation (CE) to guide you and to involve others in change.

Our task was to work with others we were yet to meet to have the Australian Government add an important lifesaving vaccine for children to the national immunisation plan.

As an active parent advocate for our infant daughter who suffered significant lifelong disabilities from pneumococcal meningitis we were approached to contribute our experience ‘our story’ to the efforts of others. We did and after a period of three years of concerted campaigning we achieved our goal. Today and for the past 11 years, all children receive the vaccine at no cost and the incidence of deaths and disabilities has dropped significantly.

The Change Equation comprises three key segments- policy makers and opinion leaders, patient advocates and their stories, and health experts. The formula also assists to identify the relevant key participants in each component using our successful campaign as the example. What made our project successful were the clear roles of the contributors, the concerted efforts of all the groups, the single focus outcome, persistence and the oversight of a campaign director.

One of the great learnings from the campaign was the power of the parent and patient survivor stories. In the mix with scientific and medical professional evidence, the stories had the ability to attract the attention of key opinion leaders – politicians, commentators and news teams across all forms of media. Remove the stories, the real life outcomes and the pictures that capture the devastation and the equation is dramatically weakened.

The Change Equation invites a mutual approach.

It has the ability to harvest powerful personal experiences told well from across the population – the grass roots. They arm the educated and necessary conversations and arguments of the physicians and researchers so as to draw the attention of key opinion leaders including the media who in turn inform the public – the constituents of our political representatives.

This was best represented in 2003/4 when after 3 years of campaigning our efforts drew a meeting in federal parliament house with the Health Minister of the day, Tony Abbott. We had developed significant momentum over the years. This was achieved through many stories and news items being reported and persistent and varied events to enlighten politicians and the public of the issue and the most appropriate way forward for all. Our work with and alongside many health professionals added to their voices and their purpose in driving home the best outcome – add the vaccine to the schedule.

An important learning here was that you should not assume the man at the top understands your cause better than the other causes being considered for funding. Until a good decision is made the battle is alive and needs due attention. For us the media made a significant impact in the latter stages. A federal election was approaching and we upped the effort. As more parents came out with their disabled young children, the reality of the disease and devastating after-effects on kids drew strong media support. The powerful stories of loss and the impact of the pictures captured the attention of all.

We worked with the opposition and their health spokesperson of the time, Julia Gillard, and with a local senator who was compassionate towards our fight. This added another edge to the campaign, with the opposition party pledging to add the vaccine to their funded election promises.

As the mid-year 2004 election date drew nearer the Government met the opposition’s promise and agreed to fund the inclusion of the vaccine within a package of $178 million, which included a recommended catch up programme for children and a plan for the over 65 year olds who were another vulnerable cohort. The programme was implemented in January 2005.

A fantastic outcome and the Change Equation in action!Subsequent to this outcome we took this story of success overseas in September 2004 to a conference of meningitis organisations in Surrey, UK. We demonstrated how this approach engaged others to our cause. CoMO was born at this event.

In more recent times we adopted the CoMO Change Equation as a tool for our members to utilise. As many are still growing and the efforts in their countries are similar to ours in the early 2001/04 period. Most notably has been the support for it in Malaysia and the Philippines. The Malaysian experience though has had some classic successes to date.

We ran an advocacy workshop in Kuala Lumpur in late 2010. To do this we worked with representatives of a vaccine manufacturer on the ground there. Our purpose was to establish a member organisation in KL and this was the starting point. At the same time we participated in some media activities as overseas experts and met some influential paediatricians there. Very important and busy people – well connected.

We had a successful meeting and agreed with a few lay people to grow the effort in KL according to the Change Equation principles. This needed us to involve the busy paediatricians who we identified as key targets and potential allies. Assisting this endeavour was the support of the Philippines CoMO member. They were conference leaders in the region. We were invited to speak at a number of high level regional conferences such as ASAP, APAP, ACIP. We told our stories and met face to face with many key paediatricians, including our Malaysian allies.

Today they are with us and we are with them on our journey in Malaysia to have the pneumococcal vaccine added to their country’s national immunisation plan. We share the stage with them at regional conferences as we promote the CE and our Malaysian member has presented at their conferences. Many Malaysian doctors have now joined the cause and are collecting petition signatures via their clinics. They understand and support the importance of us all working together for better outcomes!

And so it continues.

The CoMO Change Equation has enormous potential in all markets as it creates guide posts and direction and encourages a collaborative approach. Parents and patients have been the sufferers and their sad stories tell of the pain and loss to remind us of our purpose but ahead they stand to be the greatest beneficiaries. To include them is essential for a future with no sad stories!! They are integral to the success of the CoMO Change equation.

Significant progress has been made since 2004.

Create your own!


Bruce is the leader of CoMO’s Asia Pacific region and the Chairman of The Meningitis Centre in Perth, Australia. Bruce’s passion for meningitis awareness comes from caring for his daughter Ashleigh, who contracted pneumococcal meningitis in 1989 at just six months of age. Read Bruce and Jenni’s story.

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