Slack immunisation means loss of lives

It is a matter of concern that India’s immunisation efforts have flagged in the post-Covid-19 period, and the levels are yet to go back to the pre-pandemic levels. According to a WHO-Unicef report, the national immunisation programme missed 1.6 million children for diphtheria, tetanus, and pertussis (DTP) and measles shots in 2023, eroding the gains made in 2022. India has the world's biggest birth cohort, with 26 million babies born every year, but remains one of the world's worst when it comes to administering the basic vaccines to babies, though there have been improvements compared to what the situation was two decades ago. The underperformance is not just the case with India---the report says the global vaccine coverage has yet to return to pre-Covid-19 levels. More than half of the world’s zero-dose children live in 10 countries, including Nigeria, Sudan, Yemen, Pakistan, Afghanistan, and India.

India had a fairly efficient and stable immunisation programme that took decades to put in place. The pandemic disrupted it, as it did in other countries. Though there were signs of recovery in 2021 and 2022, last year saw a regression. Immunisation is the basic requirement of primary health care, and the first line of defence against many diseases that babies and children are prone to. It is accepted as a human right and the government is bound to provide it to every child. It is an investment in health. Even when the immunisation programme was doing well, many children were left out of it for various reasons. The government has no excuse to allow the programme to dwindle. The other poorly performing countries in the WHO-Unicef list are failed or failing states, or countries torn by war and strife. India has a functioning government and an immunisation programme that ran well for decades. Failure of the programme even by a small percentage in India would mean fatalities or disabilities for millions of children because the country has the world’s largest newly-born children’s population. 

The report also says India is among the 52 countries which did not include HPV vaccination in the immunisation package even though cervical cancer remains the second biggest cause of cancer among women, accounting for nearly 18 per cent of cancers in females. A relatively cheap Indian vaccine has been developed, but HPV vaccination has not received the attention it deserves. A pilot project is underway, but the programme needs to be integrated into the universal vaccination scheme. Programmes such as Mission Indradhanush, intended to extend vaccination to all children, need to be further reactivated. The government must ensure that a robust and universal immunisation programme is put back in place because it involves the lives and health of future generations.