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Trust the process! Using evaluation to drive strategic, evidence-based progress [1]
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Date: 2024-12
Laurence Cibrelus, WHO Lead of the Eliminate Yellow Fever Epidemics (EYE) Strategy Secretariat, discusses how evaluation is an essential strategic tool for advancing the global effort to eliminate yellow fever epidemics.
Q: What is the EYE Strategy, and what are its main goals?
The EYE strategy was developed in response to the 2016 yellow fever crises in Angola and the Democratic Republic of Congo, where two linked outbreaks affected the capital cities. These incidents highlighted the growing risk of urban outbreaks and international spread of yellow fever. In response, more than 30 million people were vaccinated, depleting the global yellow fever vaccine stockpile. Soon after, in 2017-2018, Brazil experienced the largest yellow fever outbreak in the Americas in over 50 years, with active yellow fever virus circulation in coastal areas around major urban centres.
These events, alongside lessons from past programmes, informed the creation of the EYE Strategy. The strategy is focused on three main objectives: protecting at-risk populations, preventing international spread, and rapidly containing outbreaks. It is supported by five key enablers, or "competencies for success": strong political commitment, robust governance through long-term partnerships, affordable and sustained vaccine supply, synergies with other programmes, and continued research and development for better tools and practices.
Achieving these ambitious goals requires collaboration among over 50 partners, each contributing to the effort. The leadership of Gavi, UNICEF, and WHO forms the core of this partnership, with governance structured around two main bodies, the leadership group and programme management group, seven implementation groups (three regional offices and four working groups), and a coordination and steering body that leads the active implementation of the strategy, the EYE Secretariat.
Q: Why did the EYE partnership commission a mid-term evaluation, and why in 2022?
From the beginning, we recognized the value of a mid-term evaluation as a critical component of the strategy. It was always part of our commitment to remain adaptable and responsive to the changing landscape of global health. Reflecting on past programmes, we wanted to ensure that the EYE strategy could be flexible enough to incorporate emerging challenges, such as the impact of the COVID-19 pandemic.
The decision to conduct the evaluation in 2022 came at a key moment: we had made significant progress, but enough time remained to make the necessary adjustments before the end of the 10-year strategy. The timing also allowed us to reflect on the lessons from COVID-19 and incorporate them into our approach. Ultimately, this evaluation demonstrated the strength of the partnership's governance mechanisms and its ongoing commitment to accountability and improvement.
Q: What insights did the evaluation provide and how were they used?
The evaluation offered several crucial insights that have shaped our response moving forward. One key finding was the resurgence of yellow fever in countries that had previously conducted large-scale vaccination campaigns but still faced significant gaps in coverage among children and vulnerable communities. This highlighted the need for more targeted strategies in regions, especially urban areas, and an enhanced focus on routine immunizations to prevent future outbreaks.
In response to these findings, the EYE partnership developed a robust management response. A three-year action plan for 2024–2026 was created, which prioritizes several key actions: enhancing urban readiness, addressing the risks associated with climate change, and tackling vaccine hesitancy. Additionally, we are focusing on the protection of mobile and vulnerable populations, engaging civil society and humanitarian organizations to support these efforts.
Q: What are some notable changes to the EYE Strategy following the evaluation?
The evaluation has prompted several notable changes to the EYE Strategy, with an emphasis on urban readiness and targeted prevention efforts. One of the most significant adjustments is the focus on risk communication and community engagement in densely populated urban areas. These areas face unique vulnerabilities, and we need tailored approaches to mitigate the spread of yellow fever.
The strategy has also expanded its work on the mosquito vector element of yellow fever, aligning it with global arboviral strategies to address the root causes of yellow fever transmission, especially in urban settings. Another important shift is the prioritization of mobile and underserved populations. Through partnerships with civil society and humanitarian organizations, we aim to ensure comprehensive vaccine coverage and provide bundled health services to those most in need. These adjustments reflect our commitment to adapting and accelerating progress toward our 2026 goals.
Q: What advice would you give programme managers looking to conduct an evaluation?
For programme managers, my main advice is to view the evaluation as a proactive and constructive opportunity rather than just an assessment of performance. It's incredibly valuable to bring in an external, independent perspective to look at progress. This will help identify gaps and prioritize areas for improvement.
Start by embedding the evaluation into the programme’s design from the beginning. Ensure that the evaluation aligns with the long-term goals and incorporates lessons learned from other similar initiatives. It is essential to engage stakeholders throughout the process to maintain transparency and incorporate their insights into actionable recommendations.
Treat the evaluation findings as a blueprint for change. Develop a clear, multi-year action plan based on the recommendations to implement necessary adjustments. This ensures that the evaluation becomes a tool for continuous improvement, building trust and accountability. And above all, trust the process.
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[1] Url:
https://www.who.int/news/item/16-12-2024-trust-the-process!-using-evaluation-to-drive-strategic--evidence-based-progress
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