Im­mu­nise Against Pol­icy

The Economic Times - - The Edit Page - Adar Poon­awalla

Why is In­dia not tak­ing its best shot? Ac­cord­ing to a re­cently pub­lished Na­tional Fam­ily Health Sur­vey (NFHS) IV, as many as 72.5% of Indian chil­dren sur­veyed in the age group of 12 to 23 months, con­sid­ered a cru­cial pe­riod in a child’s de­vel­op­ment and im­mu­nity build­ing, were not get­ting im­mu­nised in time. While we have made huge steps in health­care, the first step, im­mu­ni­sa­tion, clearly lacks in the coun­try. The co-re­lat­ing fig­ure in China is just about 1% of their chil­dren. We can­not af­ford to let our fu­ture cit­i­zens face such ad­ver­sity in ba­sic health­care.

To ad­dress this gap, we must bring mean­ing­ful re­forms to the im­mu­ni­sa­tion and vac­ci­na­tion setup/pub­lic health­care sys­tem in the coun­try and en­sure a much smoother func­tion­ing ecosys­tem.

De­spite hav­ing the re­quired state-ofthe-art prod­uct, tech­nol­ogy, a ma­jor is­sue that Indian vac­cine man­u­fac­tur­ers face is the lack of ad­e­quate stor­age fa­cil­ity and proper modes of trans­porta­tion. It’s un­for­tu­nate that close to 25% of vac­cines are be­ing wasted ev­ery year due to se­vere short­age of cold stor­age ca­pac­ity.

Unat­tended tem­per­a­ture con­trols, non-func­tional equip­ment, dis­rup­tions in ser­vice de­liv­ery and an in­ef­fi­cient use of hu­man labour are some of the in­fras­truc­tural is­sues that plague Indian vac­cine man­u­fac­tur­ers. Im­prov­ing cold-chain sys­tems and the skillset of hu­man re­sources will in­crease the reach of ef­fec­tive im­mu­ni­sa­tion cov­er­age.

The lengthy pro­cesses and per­mis­sions to be granted for the sec­tor hin­der its func­tion­ing. While the health min­istry and bu­reau­crats en­sure that ap­provals are granted swiftly, our man­ner of op­er­a­tions and ef­fi­ciency can surely go a notch higher. This will re­sult in the sec­tor wit­ness­ing op­er­a­tions be­ing ac­cel­er­ated with rel­a­tive ease, and also re­duce the ad­min­is­tra­tive work­load.

In­dia is home to the largest im­mu­ni­sa­tion programme in the world. But lack of ad­e­quate gov­ern­ment sup­port and scanty Bud­get al­lo­ca­tion to rou­tine im­mu­ni­sa­tion has ren­dered Indian vac­cine man­u­fac­tur­ers in a help­less state com­pared to their for­eign coun­ter­parts. A for­eign man­u­fac­turer can eas­ily en­ter the Indian mar­ket and sell its vac­cines with­out much scru­tiny, qual­ity checks and for­mal­i­ties. But Indian man­u­fac­tur­ers are only able to ex­port their vac­cines to China if they en­ter into a 50-50 part­ner­ship with a lo­cal man­u­fac­turer and share the tech­nol­ogy with it.

This has put Indian man­u­fac­tur­ers at a loss. A change in pol­icy is war­ranted so that there is a bal­ance be­tween the way both Indian and Chi­nese vac­cine man­u­fac­tur­ers op­er­ate.

By keep­ing stricter qual­ity checks on the im­ported vac­cines, in­ci­dents of sub­stan­dard vac­cines en­ter­ing the coun­try can be re­duced. With In­dia stop­ping the im­port of faulty Chi­nese vac­cines this month, it is be­ing en­sured that only vac­cines of the high­est qual­ity will be man­u­fac­tured and dis­trib­uted re­gard­less of where they come from.

China and South Korea’s use of ag­gres­sive mar­ket­ing strat­egy and ad­van­tage in price bar­gain­ing due to pro- cure­ment pol­icy of vac­cines chang­ing from yearly to quar­terly has put Indian man­u­fac­tur­ers on the back foot.

In­dus­try own­ers must have a dis­cus­sion with the gov­ern­ment and en­sure the poli­cies and pric­ing are made trans­par­ent so that In­dia is in a po­si­tion to take on China and South Korea in the in­ter­na­tional mar­ket.

While Indian vac­cine man­u­fac­tur­ers face re­stric­tions on sell­ing vac­cines in the coun­try, hav­ing poli­cies that al­low eas­ier ac­cess to for­eign mar­kets will en­sure that th­ese man­u­fac­tur­ers in­vest in R&D to de­velop new vac­cines for the Indian mar­ket.

Lastly, we speak about an is­sue that can only be tack­led once the coun­try has an ef­fi­cient in­fra­struc­ture and suit­able poli­cies in place: the pub­lic. One of the ma­jor rea­sons why In­dia’s gen­eral pub­lic ab­stains from the use of vac­cines is be­cause of the lack of aware­ness about the ben­e­fits and the ac­cep­tance to use th­ese vac­cines to pre­vent the dis­ease. This is known as vac­cine hes­i­tancy.

An in­ter­per­sonal con­nec­tion with th­ese peo­ple from those be­long­ing to the med­i­cal sec­tor will help raise aware­ness.

The Indian vac­cine in­dus­try has over­come af­ford­abil­ity bar­ri­ers, ad­dressed tech­nol­ogy chal­lenges and earned the recog­ni­tion and rep­u­ta­tion of hav­ing the largest global ca­pac­ity for WHO pre­qual­i­fied vac­cine man­u­fac­tur­ing. While the sec­tor seems poised well to con­tinue its dom­i­nant po­si­tion as a vac­cine man­u­fac­tur­ing hub, it also needs to im­prove im­mu­ni­sa­tion cov­er­age. The in­dus­try is po­si­tioned well to strengthen its global im­pact in line with the gov­ern­ment’s Make-in-In­dia programme.

How­ever, to ac­com­plish this, it is im­por­tant that the pol­icy and reg­u­la­tory chal­lenges are ad­dressed. All stake­hold­ers, in­clud­ing pol­i­cy­mak­ers and reg­u­la­tors, should main­tain the mo­men­tum in this ef­fort and work col­lec­tively to help In­dia win over the next set of pub­lic health chal­lenges.

The writer is CEO, Serum In­sti­tute of In­dia

Let’s give it our best shot

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