India makes progress in child vaccination against diarrhoea, pneumonia amid pandemic: Report

India made significant progress in 2020 in ensuring children receive immunisation that provide protection against diarrhoea and pneumonia despite challenges caused by the Covid-19 pandemic, according to a new report from the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health.

According to the report released on the occasion of World Pneumonia Day on Friday, India's coverage of pneumococcal conjugate vaccine, which protects against the main cause of pneumonia, increased by six percentage points -- 15 per cent PCV coverage in 2019 expanded to 21 per cent in 2020.

In October 2021, a nationwide expansion of pneumococcal conjugate vaccine under the Universal Immunisation Programme was launched, making it available for the first time for universal use across India.

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India currently has the highest global burden of pneumonia and diarrhoea deaths among children under five, and accounts for an estimated 2,33,240 such deaths annually, the equivalent of 640 children per day, according to the report.

India's coverage of rotavirus vaccine, which protects against a leading cause of deadly diarrhoea in children worldwide, increased by 29 percentage points -- 53 per cent rotavirus coverage in 2019 expanded to 82 per cent in 2020 -- according to the report.

In 2019, India completed the “100-days agenda” -- an unprecedented national scale-up of rotavirus vaccine that will help protect 26 million children born each year against life-threatening cases of diarrhoea -- the report stated.

The annual Pneumonia and Diarrhoea Progress Report monitors trends in fighting childhood pneumonia and diarrhoea -- which collectively kill more children worldwide than any other infectious disease -- in the countries with the highest absolute number of deaths.

Of the 15 focus countries included in the report, India is one of just six countries that exceeded targets for exclusive breastfeeding (58 per cent exclusive breastfeeding rate).

Exclusive breastfeeding protects young children by making them healthier and less vulnerable to pneumonia and diarrhoea.

"We simply cannot afford to lose decades of hard-won progress for child health, and India's expansion of pneumococcal conjugate vaccine and rotavirus vaccine marks a major victory for equity in child health,” said William Moss, MD, MPH, executive director of IVAC and professor in the Department of International Health.

"India's successful national roll-out of life-saving vaccines that combat childhood pneumonia and diarrhoea is a considerable accomplishment that brings us closer to a world where no children die prematurely from these preventable diseases," Moss said.

Keith Klugman, Director of the Pneumonia programme at the Bill and Melinda Gates Foundation, said, "Pneumococcal conjugate vaccines are the most effective tools we have to prevent childhood pneumonia. It is heartening to see countries like India make momentous progress in rolling out this lifesaving vaccine, even amidst the challenges of the Covid-19 pandemic. It is vital that countries continue to push for expanded access to PCVs to protect future generations from this devastating disease."

Nearly every country included in the report lagged in access to treatments against pneumonia and diarrhoea and India didn't reach all four targets for treatment. ORS and zinc, especially when co-packaged, are proven to reduce deaths from diarrhoea in children.

The Covid-19 pandemic continues to put constraints on medical oxygen supply, which is used to treat both pneumonia and Covid-19 patients, for all countries and may impede efforts to tackle pneumonia. Although the efficient roll-out of new vaccines improved some of India's scores in the 2021 report, global trends find that progress in preventing child morbidity and mortality is lagging behind targets.

The report found that the 15 focus countries, including India, experienced on average a decrease of two percentage points across each of three key childhood vaccines -- diphtheria-tetanus-pertussis, measles-containing-vaccine, and Haemophilus influenzae type B vaccine.

The latest global immunisation coverage estimates show that 23 million children missed out on basic childhood vaccines through routine health services in 2020, the highest number since 2009 and 3.7 million more than in 2019.

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