This World Immunisation Week (April 24-30), countries around the world will celebrate one of the most transformative health interventions in the history of public health - vaccines. For India, this should also be a time to take stock of a three-decade-long national immunisation programme and reflect on the challenges that prevent even the world's largest government-led immunisation scheme from reaching all its citizens. At present around 89 lakh children - one in every three children - don't receive all the vaccines available in the programme.
Last month, the government launched the ambitious Mission Indradhanush Campaign that aims to ensure all Indian children are fully immunised by 2020. The campaign is focusing on improving vaccination coverage in over 400 high-priority districts - home to the largest number of unimmunised children across the country. It will also provide vaccines against pneumonia and adult Japanese encephalitis in select districts.
This is great news because in India, it is the children who are most vulnerable to disease who are not yet being reached. For example, according to an Indradhanush survey, in Uttar Pradesh, a state that usually ranks low on socio-economic indicators, more than 900 unvaccinated children die every day. Many of these children have poor immunity, are malnourished, live in crowded and unhygienic conditions and don't have access to clean water -- all of which increase their risk of infection. What's more, these same children also don't have access to timely treatment when they do fall sick.
"[C]ommunicating about vaccines poses a unique challenge: unlike drugs that are prescribed to treat an illness, vaccines are given to healthy children and the protection they provide a child is invisible to a parent."
Another positive step the government has taken to address the issue of child survival and health is to expand India's immunisation programme to include a rotavirus vaccine, which can protect children against one of the most severe types of diarrhoea - a disease which kills more than 300 children every day. The rotavirus vaccine will go a long way in preventing many of these deaths and allowing India's children to have a healthy future.
For all these efforts to be successful, we will need to work together to make the parents of these children recognise the benefits of immunisation. So far, progress has been slow and this is apparent from our low immunisation coverage: between 2009 and 2013 India's full immunisation coverage increased from 61% to 65% with only a 1% increase in coverage every year. India's is also lagging behind in the introduction of new lifesaving vaccines -- there has been no country-wide roll-out of new vaccines under the government's immunisation programme in the last 20 years.
The power of vaccines has been well documented over the last two centuries. But communicating about vaccines poses a unique challenge: unlike drugs that are prescribed to treat an illness, vaccines are given to healthy children and the protection they provide a child is invisible to a parent. According to a recent Mission Indradhanush survey, close to 30% of people in India don't feel the need to get their children vaccinated; 26% don't know about vaccines; and around 9% find vaccinations to be an inconvenience.
"Research shows us that immunised children are well nourished, able-bodied individuals with relatively advanced cognitive capacities as compared to unvaccinated children."
Here's what these parents need to know: vaccines not only prevent deaths, but give children the best shot at developing into healthy, productive adults. Research shows us that immunised children are well nourished, able-bodied individuals with relatively advanced cognitive capacities as compared to unvaccinated children. They are also more likely to be more productive in school and have an increased chance of earning a higher income than their unvaccinated classmates.
With a collaborative and focused approach, India was able to overcome these challenges in its fight against polio. In 2009, India accounted for more than half the world's polio cases and today that number is down to zero. Communicating the benefits of vaccines was a key part of these efforts. Health workers targeted the most vulnerable sections of the population including families at bus stations, in trains, at construction sites and the remotest corners of the country. Community Mobilization Coordinators visited the families of expectant mothers to educate them on the benefits of the polio vaccine and dispel misconceptions that may have prevented them from vaccinating their children - there were rumours of the Oral Polio Vaccine (OPV) causing sterility, HIV/AIDS and even death. These efforts, involving civil society organizations, local government bodies, community leaders and the media, encouraged communities to voice their demand for the polio vaccine.
India's success with polio will be remembered in the history of public health for generations to come. We can repeat this success with other vaccines against life-threatening and crippling diseases if we once again work together - NGOs, governments, health workers and the media - to empower parents with the knowledge to protect their children.