When you
have good
leadership,
you ensure
that different
partners are
on the same
wavelength,
and you
realize that
in a matter of
months you
can perfectly
organize a
campaign.”
—Jean-Luc Poncelet, MD,
Pan American Health
Organization, Port-au-Prince, Haiti
have to mobilize the population in a massive way,”
Dr. Poncelet says. “It’s a complex operation.” Project management skills proved especially valuable in
three areas, he adds: procurement and distribution,
stakeholder management and evaluation.
Procurement and distribution: The global supply of cholera vaccines is extremely limited, making
resource acquisition a major challenge facing the
PAHO project team. To claim its share of vaccines,
the team detailed the urgency of Haiti’s cholera crisis
to vaccine producers and leveraged relationships
within WHO and other organizations to bring additional pressure to bear. “You have to plead your case
to the producer to release the vaccine, and you have
to make sure you don’t get pushed aside because of
competing interests in other countries where cholera
exists,” Dr. Poncelet says.
Along with procuring the vaccine, the project
team also had to determine the optimal way to distribute it. The Ministry of Public Health and Population and the team identified the most vulnerable
communities and then the team recruited, trained
and deployed vaccination teams of appropriate
sizes. “Locality by locality, you must detail how
many people are part of the team, who will bring
the cold box with the vaccine, who is going to make
connections with the local authority and who is
going to make the population aware of what is being
done,” Dr. Poncelet says.
Stakeholder management: Although Haiti’s
government directs all anti-cholera efforts, it part-
ners with numerous nongovernmental organiza-
tions to execute projects. “It’s a very fragmented
way of working,” Dr. Poncelet says. “You have
many different entities working with different
views on what must be done, and you have to get
them all to agree on a time frame and on what
resources should be invested where.”
With so many stakeholders involved, success
hinges on strong executive sponsorship—one voice
in the crowd rising above the rest. “When you have
good leadership, you ensure that different partners
are on the same wavelength, and you realize that
in a matter of months you can perfectly organize
a campaign,” Dr. Poncelet says. “The government’s
leadership made the difference.”
Evaluation: Public health projects, like those
in every other sector, must stay on schedule and
within budget. When the goal is containing or
eradicating a disease, however, the project must
also achieve health outcomes. After the project’s
vaccination phase ends, detail-oriented project
managers prove their value by collecting and
analyzing data.
“Ensuring the campaign’s scientific quality and
impact is a big challenge,” Dr. Poncelet says. “In the
long term, the objective is to eradicate cholera. In
the short term, though, you first have to eliminate
transmission.” That means carefully tracking infection patterns to understand the changing dynamics
of an outbreak. Since the completion of PAHO’s
vaccination project and the implementation of
sanitation measures in affected areas, he adds, “the
number of cholera cases has started to decrease, so
we are controlling the epidemic.”