An Enterprise Approach to Reducing Inequities

Equal vaccine distribution has long been a challenge. According to Gavi, approximately 1.5 million people are still dying from vaccine-preventable diseases each year, while 22.7 million children do not receive basic vaccines. Low-resource countries in particular experience persistent challenges that impede the needed operations and decision making to deliver vaccines equitably and at scale. These include insufficient communication across stakeholders, limited availability of quality data and skilled human resources, and hampered ability to effectively reach all geographies. Unfortunately, this inequity has extended to combatting the COVID-19 pandemic.

Investments are being made to correct for this, such as the COVID-19 Vaccines Global Access (COVAX) initiative which delivered its 1 billionth dose earlier this year. But how do countries set themselves up for success to address challenges while reducing inequities quickly and effectively in the future? The answer lies in making upfront investments now. India provides such an example. Over the last decade, long before masks were commonplace, the Indian government set up the Aadhaar national identification system, laying a foundation in its national ID system. Despite issues around such a centralized system (e.g., data security, privacy, access) it enabled the country—in mere months—to establish a COVID-19 vaccine certification system for its population of nearly 1.4B individuals. The country’s investment in shared digital platforms through an enterprise architecture approach positioned India to face the challenge of COVAX distribution in an ambitious, accelerated, and holistic way.**

Despite criticism and a number of issues being addressed, India’s COVID-19 vaccination program exemplifies the importance of early investment and continued focus on shared digital platforms for resilience and responsiveness to national and global crises. Setting expectations, building strategies and operational plans, and allocating resources now and into the future—pre- and post-pandemic—requires upfront investment and a holistic view of service delivery. Key actors in India exhibited a notable focus and drive (read: stick-with-it-ness) to invest at this level early on, setting the stage for its rapid response to the pandemic. Perhaps most importantly for the near-term, is to increase awareness, application, and coordination of a shared digital platform approach amongst global donors, national governments, and the digital development community. When the next disaster strikes—be it climate change, war, or another pandemic—systems, organizations, and governments will be better prepared to respond quickly, efficiently, cost effectively, and equitably.

**Enterprise architecture is “a blueprint of business processes, data, systems, and technologies used to help key stakeholders design increasingly complex systems to support the workflow and roles of people in a large enterprise, such as a health system .” (WHO, 2020)

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