Thursday, September 13, 2012

THE DROPPING IMMUNITY

State of immunisation in India is catastrophic

The child mortality rate of 5 deaths in every 4 minutes is something that should have ideally given nightmares to any sensible policymaker. But forget that, what is more shocking is that nothing concrete is done even when these deaths are mostly caused by preventable diseases. The blame squarely lies on the union and state governments as well as the public sector pharmaceutical companies. John Hopkins University estimates that over 3.71 lakh Indian infants perish from pneumonia every year. The picture is bleaker than sub-Saharan Africa, Pakistan and even Afghanistan. This breakneck expansion of the disease is because Indian government never cared to introduce newest generation of pneumonia vaccines that would have successfully shielded 23 common strains of the disease to proliferate.

The story repeats itself in polio immunization too. The officially declared immunization day, generally celebrated in January, had to be postponed to February 19 this year, because of shortages of polio vaccines! The immunization day was the host to vaccinate 17.5 crore children with 25 crore doses of requisite number that was supposed to be sent to the states fell short by 18 crore doses. It reflects the unease of the government who blamed it on the company where the order was placed, supposedly as early as January 2011!

There is a perennially short supply of Hepatitis B vaccine in Pune, extending for months, which has a demand of 17,000-18,000 doses per month. Meanwhile, vaccines of yellow fever are disappearing in many parts of the country too. There are reports that the vaccine is out of stock in Kolkata and in short supply at Government vaccination centres in Delhi. In December 2008, a team of Health Ministry visited 13 different states; and they were taken aback of what they found. There are no vaccines for diphtheria, whooping cough and tetanus in hospitals of Bihar, non-availability of measles vaccines in Assam, dearth of diphtheria and tetanus (DT) vaccines and tetanus toxoid (TT) in Kerala and an empty vault for DT and TT in Uttar Pradesh. Further, in Orissa, DT vaccine was unobtainable between April-December 2008 and DPT vaccine between August-September the same year. From the Health Ministry’s Data, 2008-09, in the period April-November, BCG vaccination plummeted by 7.9 percent in UP and 11.5 percent in Punjab, along with overall vaccination dropping by 29.5 percent in Orissa and 36.2 percent in West Bengal in the same period.

In stark contrast, the healthcare system focus in the developed nations, particularly in US and UK, is sharper and implementation impeccable. In the US, 95 percent of the school children are immunized and in England the figure stands at 89.1 percent (2010-11). In these countries, the occurrence of preventable diseases are at record low even if the number of the diseases has increased. It is a cycle of virtue created there that shaped the success story — research and development, a reliable manufacturing system, a highly competent and corruption free regulatory authority, a comprehensive immunization policy, immaculate implementation, and compensation for afew rare cases of adverse effect due to vaccination. On the contrary, the common man of India is frustrated with lack of accountability and corruption in the implementation of vaccination — that sets in the mess — and its ugly manifestation must be eroded quickly to save lives of innocent children.

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