Vaccines have been used to protect millions from disease since the time of Edward Jenner. While it is true that smallpox is the only disease to have been eradicated, there are many more which have been markedly reduced. For example, after the measles vaccine was introduced, measles deaths decreased worldwide by almost 40 per cent between 1999 and 2003. No polio case has been reported in India for the past two years due to the intensive polio immunization drive. Today India’s polio success has inspired a global Scientific Declaration on Polio Eradication, which outlines how global polio eradication is possible.
Hundreds of scientists — including Nobel laureates, successful smallpox eradicators and heads of public health institutions and universities — from 80 countries, have come together to launch the declaration and pledge to end polio and create a public health legacy. Unlike other public health interventions, vaccines are unique in the fact that they also confer indirect benefits to the unimmunised — by reducing the number of potentially infective people. These include infants and elderly too. When vaccines are used to prevent illness and death, the push to expand their usage and implementation also delivers major economic and societal benefits to families and the Government.
Communicable diseases, many of which are vaccine preventable, account for 77 per cent of the mortality gap between the world’s poorest and richest 20 per cent. They also disproportionately affect the poorest fifth of the population, the quintile that suffers from lack of clean drinking water and proper sanitation facilities as well. As in India, the urban-rural divide in other developing countries is also quite significant, both in access to vaccines as well as clean water and sanitation.
Vaccines are critical but must be deployed with interventions that have a broad application and can be integrated into existing health programmes. For example, exclusive breastfeeding for the first six months of a child’s life could considerably reduce cases of pneumonia and diarrhoea — two of the leading causes of child morbidity and mortality in India. Other preventive interventions include hand washing, improved living environment, and access to appropriate disease management therapy. Clean water and sanitation initiatives should be continued unabated irrespective of the hurdles, both foreseen and unforeseen. The effort to clean the environment will also aid preventive health in the long run. On the other hand, it will be criminal to deprive a population of the benefits of interventions available as a result of advances in the field of medicine and technology, particularly those that have been used effectively elsewhere in the world and have reduced deaths due to infectious diseases considerably.
All the new vaccines are available in private sector, but decisions to include them in the public programme on a pan-India scale are pending. Thus, they remain out of reach for a majority of those who are in need and rely on the programme. For India, which has made enormous progress on the economic front, it is ignominious to be contributing to one in five child deaths occurring in the world every year despite effective vaccines against these diseases. It is about time that India pledges to put an end to the its children dying of diseases that can be easily prevented by ensuring that access to life saving vaccines is given to all.
(The writer is president, Jawaharlal Institute for Post Graduate Medical Education and Research, Pudducherry)