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Conversations with the Director: Stephen Cochi

January 31, 2013

Dr. Frieden and Dr. Cochi.

Photo by Jessica Podlaski

Building a Legacy around Eradicating Vaccine-Preventable Diseases: A Conversation with Dr. Stephen Cochi of CDC’s Global Immunization Division

What started out as a two-year stint as an Epidemic Intelligence Service officer for Centers for Disease Control and Prevention (CDC) in the early 1980s, has turned into a long and rewarding career with the agency for Stephen Cochi, MD, MPH. “It was very professionally rewarding coming here – and here we are 30 years later,” Dr. Cochi said with a smile to CDC Director Thomas Frieden, MD, MPH, during their Conversations with the Director talk.

Over the years, Dr. Cochi has held several senior positions in immunization work at CDC. Currently, he is senior advisor to the director of the Global Immunization Division (GID) in the Center for Global Health. Within GID, his team works on vaccine-preventable disease (VPD) eradication and elimination and on strengthening immunization systems and introducing new vaccines around the globe.

Strengthening Public Health & Immunization Systems

During their hour-long conversation, Dr. Frieden was particularly interested to learn more about GID’s Strengthening Immunization Systems Branch (SISB). “It’s hard to know the best way for public health to help guide clinical systems to get maximum population impact,” Dr. Frieden said of the challenge. “CDC’s immunization programs are a best practice for how to work with clinicians, health departments, and advocates. There’s so many ways immunization gets it right.”

Dr. Cochi explained how his group is looking into how to best integrate immunization delivery with other primary care services to create synergies for both. “The branch has done studies in different countries to answer the question, ‘Under what conditions do you get synergy and when does integration become burdensome or problematic?’”

By distributing mosquito nets to caregivers at the end of a child’s primary vaccination series, SISB researchers found increases in both immunization coverage and net use among young children in Malawi and Indonesia. In Kenya, the researchers found improvements in both young children’s access to safe drinking water and hand hygiene among their caregivers through the distribution of hygiene kits during the children’s immunization visits. These are just a few of many examples of success.

Building a Legacy around Eradicating Vaccine-Preventable Diseases

Dr. Cochi has seen CDC’s global immunization initiatives grow in size and scope over his two-and-a-half decades at CDC. When he led the agency’s first polio eradication activity in the early 1990s, he had a budget of $3 million and a staff of six people. By the end of the decade, the program had a budget of $150 million, more than 100 staff members, and an agenda that covered not just polio, but also measles and other vaccine preventable diseases. “Maybe that’s my legacy at CDC,” Dr. Cochi told Dr. Frieden. “To have helped turn GID, which started with modest roots, into a division that has had a positive impact on child survival globally and on the diseases it’s trying to eradicate or control.”

Polio eradication remains a priority for GID and CDC. In December 2011, Dr. Frieden activated CDC’s Emergency Operations Center to strengthen the agency’s partnership engagement though the Global Polio Eradication Initiative, which is committed to completing the eradication of polio. In 2012, 222 polio cases were reported in five countries – the lowest annual number of cases ever recorded.

As their discussion came to an end, Dr. Cochi told Dr. Frieden about one his most enduring professional memories. It was 2000 and he was in Pakistan, on the Khyber Pass looking out towards Afghanistan. “As I witnessed thousands of Afghans streaming into Pakistan, I noticed a polio vaccination station off to the side,” he said. “It gave me such joy to see government officials steering families with kids who looked less than five years old over to that station. It left an indelible imprint on my brain.”

This Snapshot by Jessica Podlaski.