On Dec. 4, 2018, Italy’s Minister of Health, physician Giulia Grillo, dismissed all 30 members of the Italian Ministry of Health’s health advisory board, the Consiglio Superiore di Sanità (CSS) or Higher Health Council. According to an article in Il Globo newspaper, “The CSS is the country’s most important committee of technical-scientific experts, who advise the government on health policy.”1 2 3 4 5
The current board members were appointed in 2014 and re-appointed last year. They were scheduled to remain in place until 2020. However, Minister Grillo will now select candidates to fill the vacant posts.2 3
Reportedly, the outgoing president of the board, physician Roberta Siliquini, a professor at the University of Turin, was not happy with Grillo’s decision to replace the board with new members. She was quoted as saying, “Given the quality of the members that make up the council, I don’t see any scientific reason at the base of the decision.”3
In explaining her decision, Minister Grillo wrote that it was “time to give space to the new.” She added, “We are the government of change and, as I have already done with the appointments of the various organs and committees of the ministry, I have chosen to open the door to other deserving personalities.”3 4 6 7
Grillo and the Five Star Movement political party, which now leads Italy’s coalition government, have faced criticism for their opposition to strict enforcement of mandatory policies for daycare and school children. Although voicing support for vaccination, Grillo specifically opposed legislation signed into law on July 28, 2017 by the previous Democratic Party-led government requiring children to receive multiple doses of Haemophilus influenzae type b, measles, mumps, rubella, varicella and pertussis (whooping cough) vaccines, in addition to already mandated diphtheria, tetanus, polio and hepatitis B vaccines.8 9
The 2017 law caused a firestorm of protest among many parents in Italy who opposed what they maintained was government overreach and a violation of their parental and medical informed consent rights. Thousands of Italians subsequently took to the streets in cities throughout the country in 2017 to protest the law, which was eventually repealed by the new government swept into power earlier this year. 9 10
Health Minister Grillo says that, while she supports vaccinations, she does not wish to force parents to seek certification from a doctor proving their children are vaccinated as a condition for attending school. She favors a less coercive policy of “flexible obligation” that emphasizes educating parents about vaccines and encourages mandatory vaccination only during limited periods when the coverage rate is too low. Grillo said this is the “most sensible idea.”1 10 11 12
1 Associated Press. Italy’s health minister sacks public health advisers. ABC News Dec. 4, 2018.
2 Dyer O. Italy’s health minister fires country’s top health board. The BMJ Dec. 5, 2018: 363.
3 Il Globo Editorial Team. Italy’s health minister sacks entire board of experts. Il Globo Dec. 5, 2018.
4 Giuffrida A. Sacking of Italy’s health experts raises political interference concerns. The Guardian Dec. 4, 2018.
5 Grillo azzera il Consiglio superiore di sanità: «Serve discontinuità, spazio al nuovo». Il Messaggero Dec. 3, 2018.
6 PROFILO/ Giulia Grillo, alla Sanità un medico. Giornale di Sicilia May 31, 2018.
7 Giulia Grillo. Wikipedia.
8 Burioni R, Odone A, Signorelli C. Lessons from Italy’s policy shift on immunization. Nature Feb. 21, 2018.
9 TVR Staff. Italy Passes Mandatory Vaccination Law. The Vaccine Reaction Aug. 9, 2017.
10 Fisher BL. Children in Italy Now Can Attend School Without Proof of Vaccination. The Vaccine Reaction July 6, 2018.
11 Fish Flexible vaccine obligation plan -Grillo. ANSA.it Aug. 9, 2018.
12 AFP. Vaccine row erupts in Italy as populist govt seeks to ease rules. TheLocal.it Aug. 11, 2018.