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India not taking advantage of its own vaccines?

A community health worker administers a vaccination in Odisha. Image credit: By DFID – UK Department for International Development [CC BY-SA 2.0 (], via Wikimedia Commons
India is a leading producer of vaccines. It has enjoyed numerous vaccination campaign successes in the past. Despite this, around 60,000 Indian children under five die of vaccine-preventable diseases every year.

India has demonstrated its capacity for successful vaccination campaigns in the past. On March 27, 2014, the World Health Organization (WHO) declared India polio-free. Due to sustained vaccination drives, India has remained polio free ever since.

The polio campaign encompassed some of the most effective elements of making a vaccination campaign effective. The Centre worked with UNICEF, the WHO, rural community health workers (Accredited Social Health Activists, or ASHAs), and local leaders and religious elders in rural communities. The coordination between government and grassroots campaigns was bolstered by media support, involving appearances from numerous celebrities.

Such vigour is absent in current vaccination drives. This is reflected in dismal immunisation figures. According to Nijika Shrivastwa — lead author of a study conducted at the University of Michigan’s School of Public Health, Ann Arbor — just eighteen percent of Indian children receive the full three-dose course of the vaccine against diphtheria, pertussis and tetanus (DPT).

Around a third of children were found to have received the full course of the measles, mumps and rubella (MMR) vaccination by the age of ten months. Experts state that, in order to control outbreaks of a disease, more than 95 percent of a population should be vaccinated. India falls far short of this. As a result, many are left exposed to disease outbreaks.

“The WHO has recognised universal immunisation campaigns as the “most cost-effective investment” a country can make”

The Indian vaccine market is worth Rs 69 billion (approximately one billion USD) as of 2017, having grown eighteen percent since 2010. Of the total amount of vaccines produced, around two thirds are exported. The remaining third is used domestically.

Despite a large portion of the vaccine market remaining in India, vaccination coverage remains low. Some claim this can be partially explained by complacency.

Young parents will never have seen a case of polio in their lives. As a result they may be ignorant to the devastating disabilities that result from it. Likewise, they may never have seen a child affected by other conditions such as diphtheria or whooping cough. Without seeing the effects firsthand, a sense of urgency is lost. The disease gradually becomes a non-issue or a thing of the past to many — as it has in Europe and North America. This mindset is dangerous as the resultant neglect of vaccinations leaves communities prone to recurrent outbreaks.

The WHO has recognised universal immunisation campaigns as the “most cost-effective investment” a country can make. Many Indians are reliant upon healthcare providers in the private sector, as opposed to government-run hospitals and services. By not preventing these diseases from occurring, these Indians may be facing vast out-of-pocket expenditure coping with possible future infections and the complications that can arise. Public hospitals – already underfunded and overextended in many cases – will also feel the strain.

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