Immunise Against Policy
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