'5 Lakh Children Die Every Year In India Due To Vaccine Preventable Diseases'

In spite of the advent of technology in intelligent vaccine management, India has only succeeded in achieving 65 percent coverage in basic immunization. According to WHO, these rates are significantly low with countries with similar or lower per capita GDP.

Dr. Davinder Gill CEO, Hilleman Laboratories, talks to BW Businessworld about the ‘Role of technology and innovation to boost immunization coverage’.

How will technology aid in better preservation and vaccine outreach?

We need to build our existing capacity of our technical staff to handle complex vaccine environment and familiarize them with best practices in supply chain management. Along with that, vaccines under all conditions, need to be carefully temperature managed so they don’t lose their potency. At the heart of a robust delivery system is the cold chain infrastructure which will help preserve vaccines at prescribed temperatures and maintain product-specific environmental parameters including air quality levels. We also need efficient collection of reliable data for informed decision-making in planning for vaccine distribution, improving supply chains and introducing newer vaccines in the future.

Technology and innovation together can bridge the gap between academia and product development by establishing proof-of-concepts for promising vaccines. 

How to deal with immunization of unregistered births? 

Nearly 10 million children around the globe do not have their existence formally registered. Recognising this global challenge, the United Nations’ Sustainable Development Goals (SDGs) has an indicator for the same to ensure that everyone has a legal entity by 2030. This is crucial especially for those living in remote or vulnerable areas. Unregistered births are a big deterrent to achieving the SDG which is aimed at ending preventable deaths for children below the age of five years by giving them access to affordable vaccines. 

Technology has enabled and equipped millions around the world with a digital presence. These innovations could also help in aiding the public-health community in vaccinating every child. For example, Khushi Baby is a digital platform that helps in providing health records through a necklace worn by the infant which carries a unique identification number on a communication chip. The community health workers can access this chip through a mobile phone for updating the child’s digital record. 

What are the barriers in achieving 100% immunization and how to overcome them?

Every year, five lakh children die in India due to vaccine preventable diseases and another 89 lakh remain at risk due to partial or no immunization.

One of the key challenges is that children are still being missed from the immunization coverage. Government data shows that in percentage terms, the number of children and mothers who are missed, has not dropped drastically, despite the gains of the four phases of ‘Mission Indradhanush’ both in urban and rural areas, and the goal of 90 percent vaccination is not being achieved. Few of the possible reasons could be due to parents often thinking that vaccines are unnecessary because their children appear healthy or that children may fall sick but may recover. The service gap may occur due to several reasons, one being that the health workers may not have visited some families or vaccines may not have been delivered. The government has been doing community-monitoring to study what are the barriers to immunization and from the data we have, it is important that we have to keep continuing interpersonal education and awareness on this so that beneficiaries come forward.

What has the government been doing to help achieve immunization across the country?

With a view to immunize every child in the country, the government of India launched the Universal Immunization Program (UIP) in 1985. India records 5 lakh child deaths annually due to vaccine preventable diseases. 

Being operational for over 30 years, UIP has been able to fully immunize 65 percent children in the first year of their life. The increase in coverage has stagnated in the past 5 years to an average of 1 percent every year. To strengthen and invigorate the program and achieve full immunization coverage (FIC) for all children at a rapid pace, the Government of India launched Mission Indradhanush in December 2014.

Mission Indradhanush aimed to fully immunize more than 90 percent children by 2020 through innovative and planned approaches. Under the mission, all the vaccines provided under Universal Immunization Program were administered to children and pregnant women. A total of 528 districts were covered during the four phases of Mission Indradhanush. The goal of 90 percent FIC has now been advanced to December 2018.

What role are Artificial Intelligence (AI) and data playing in achieving 100% immunization? How have they helped outreach and delivery of vaccines?

The Ministry of Health and Family Welfare in partnership with The United Nations Development Program (UNDP) is implementing the eVIN (Electronic Vaccine Intelligence Network) as a step towards enhancing immunization coverage. This technology is an indigenously developed system that digitizes vaccine stocks and monitors the temperature of the cold chain through a smartphone application. The EVIN aims to strengthen the evidence base for improved policy-making in vaccine delivery, procurement and planning for new antigens. This will be a powerful proposition in the days to come for strengthening health systems through easy and timely availability of vaccines to all children. The future of vaccines in India lies in collaboration, innovative technological solutions and intelligent delivery designs.