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On vaccines and their critical role

There was a compelling article on the critical role of vaccines by Prof. N K Arora in the dna India  two days ago. Prof. Arora is the Executive Director of the International Clinical Epidemiology Network (INCLEN) Trust. He writes that “research has long established that tools such as vaccines are a vital component of early childhood interventions that, in addition to preventing the onset of infections among children, can help improve education, health and economic outcomes. However, Indian children most vulnerable to diseases are unable to access these vaccines because they are not on the national programme and only available on the private market at prohibitive prices”.


A fascinating fact he mentions is that a study estimated that by introducing and scaling up coverage of just three vaccines—Hib, PCV, and rotavirus—India could realise Rs. 3621.4 crore each year in economic benefits and avert a large number of needless child deaths!

In July 2014, the government announced its plans to expand the national immunisation programme to introduce four new vaccines. including one against rotavirus diarrhoea. However, no timetable was given and no orders placed. As far back as 2012, a group of eminent Indian researchers reported that, “introduction of vaccination into the national immunization program would be a cost-effective step toward control of the rotavirus diarrhea-related morbidity and mortality in India.”  As yet, there are not even any pilots. The rotavirus vaccines used in the rest of the world and funded by Gavi are licensed and available in India but only in the private sector. The only indigenous rotavirus vaccine was licensed in early 2015 but requires a special, extra cold storage system and can only be administered 20 minutes after a child has been given an acid-neutralising buffer. Many experts think it is, therefore, not suitable for broad use in the community.

India, in the context of immunisation has been faring poorly in comparison to some of  its neighbours. For example, Nepal has demonstrated significant progress in the last 10 years in achieving MDG targets in maternal and child health care despite of difficult topography. The Nepal Comprehensive Multi-Year Plan 2011-2016 describes its National Immunization Program (NIP) which is the government’s high priority program . Currently, the NIP provides vaccination against 9 major killer diseases  which includes BCG ,OPV, DPT, HepB, Hib, Measles, TT and JE. The government supplies all vaccines under the NIP free of cost . It is however, working to improve its vaccination coverage which for for the last three years remains below the target of 90% and is not uniform across the district and below level.

As mentioned by Prof. Arora in the article, “good immunisation coverage rate is a critical indicator of a robust healthcare infrastructure and also helps indicate results for equity, human rights and child survival.Given the enormity of India’s development task and its proclaimed reliance on its demography, it is in India’s best interests to ensure that a comprehensive preventive approach, which includes new vaccines against both, pneumonia and diarrhoea—the largest killers of India’s children under the age of five—is judiciously adopted”.


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