Reflections 
The people of India are seeking positive change, and are increasingly more willing than ever before to act on every opportunity that enables and empowers them. In consonance with this yearning of the masses, the current government under the leadership of Sh Narendra Modi has shown unwavering commitment to take strong resolute stands on issues that matter, in favor of the people, and with a vision of a better future for its citizens. Good health is at the center of this future. Our honorable Prime Minister is fully committed to the ideal of ‘health for all’ and his commitment has pervaded every decision in our tenure. I’d like to focus today on the one health intervention that has proven to be the most effective at scale - immunization.
India’s Universal Immunization Programme (UIP) is the largest of its kind in the world, bringing the best of healthcare practices from around the globe, to save the lives of crores of children. However, in the two decades prior to the 2010 introduction of the pentavalent vaccine, no new vaccines had been introduced into the UIP nationally. What this meant was that the delay in introduction of new vaccines was potentially leading to massive loss of life, especially among infants and children. In the last two years, Modi government has brought a sea change in that situation, with the introduction of the Injectable Polio Vaccine (IPV), Rotavirus vaccine (RVV), and the Measles-Rubella (MR) vaccine and the scale up of the Japanese Encephalitis (JE) vaccine.
As an example, pneumonia and diarrhea have been among the leading causes of child death worldwide, together claiming the life of one child every two minutes in India, and causing widespread suffering including hospitalization, for many more. The challenge of pneumonia is currently being combatted by the Haemophilus influenzae type b (Hib) vaccine, part of the pentavalent vaccine. Soon the Pneumococcal Conjugate Vaccine (PCV) will join its ranks, targeting to prevent over a million cases of pneumococcal pneumonia and meningitis each year. Likewise, the RVV vaccine, which protects against rotavirus diarrhea, is also a success story for our government – both because it has the potential to save many close to 80,000 children from rotavirus diarrhea, and also because it presents a brilliant example of our “Make in India” philosophy. The rotavirus vaccine has been developed in India leveraging the country’s thriving research and development.
While introducing new vaccines, we are also ensuring that each and every child and all pregnant women have access to vaccines. To achieve this aim, Mission Indradhanush (MI) was conceived in 2014 with the aim to reach out to all those children who are un-immunised or partially immunized. Introduced in 2014, MI includes vaccines for 11 diseases and aims to reach more than 90% full immunisation coverage among children in the country by 2020. After three phases, 2.1 crore children and 55.9 lakh pregnant women have been vaccinated thus far. In some cases in several remote areas, this has led to communities having access to healthcare workers, and therefore better access to all health services, for the first time. Reflecting our priorities, 93% of the government’s immunization program is domestically funded.
The decisions to introduce these new vaccines have their basis in research and evidence. Multiple data sources such as Integrated Disease Surveillance Programme (IDSP), Central Bureau of Health Intelligence (CBHI), and similar surveys provide us with a disease burden of the country. The National Technical Advisory Group (NTAGI) thoroughly reviews this data in conjunction with all evidence on potential solution options, and then takes a decision to introduce a vaccine. NTAGI includes members from the national and state health departments, Indian Council of Medical Research (ICMR), National Institute of Health and Family Welfare (NIHFW), Indian Academy of Paediatrics (IAP), Indian Medical Association (IMA) and other representatives of government agencies such as the National Regulatory Authority, Department of Biotechnology and other independent experts. It is the varied expertise of these scientists, pediatricians, epidemiologists, and public health specialists that comes together to take critical evidence-based decisions on vaccine introductions. The NTAGI recommendations are passed onto the Mission Steering Group (MSG) before any health policy changes are carried out. It is through these informed, independent experts that the government makes its vaccine agenda, free from any external influence.
No child should be left behind, is the fundamental goal of the UIP. By leveraging partnerships with development partners like WHO, UNICEF, UNDP and GAVI, we are ensuring that our goals are achieved. Our partners bring a diverse range of knowledge and expertise, creating room for innovations in strengthening our health goals and outcomes. For example, many vaccines need to be kept at low temperatures, so we need a robust cold chain system throughout their journey. Our partners have helped us leverage tools and technologies to develop systems that allow a person sitting in Delhi to monitor the temperature of the cold chain across multiple remote locations. It is through the collaborative efforts of all these organizations, led by a government committed to children’s health that the best vaccines and healthcare innovations around the world, are today available to our children through the public health system in the country.
While there may be naysayers and people who doubt these efforts and cast aspersions on the government’s immunization program, fact is the vaccines save lives. And we are committed to enabling every child to get an opportunity to lead a healthy life. Through our work guided on science and innovation, keenly supported by evidence and insights, and led by vision and compassion, I am convinced that we will be able to provide better healthcare to all Indians.
(Jagat Prakash Nadda is an Indian politician. He is currently the Union Minister of Health and Family Welfare and member of Rajya Sabha from Himachal Pradesh and Parliamentary Board Secretary of Bharatiya Janata Party. Earlier, he was a Minister in Himachal Pradesh Government.)
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