Hepatitis B vaccine will become an integral part of our immunization program: PM

"India offers great potential for development of vaccines"

Vaccination is no longer seen as only an intervention to reduce infant and child mortality. It is also seen as a means to tackle diseases that occur in later life. The more common communicable diseases like malaria and rotavirus take a heavy toll on human lives. They also pose a serious challenge for developing countries and they emphasize the need for developing vaccines and for making them available at affordable prices.

The Universal Immunization Program in India has had a major impact on all sections of society. With the introduction of this program, the disease burden due to vaccine preventable diseases has shown marked decline over time. Since 1975, there has been a 72 percent decline in the incidence of diphtheria, a 91 percent decline in the incidence of whooping cough, and a 61 percent decline in the incidence of measles. We are also close to interrupting the transmission of poliovirus in the country. But I would be the last one to argue that we can be satisfied with the status quo. No, we cannot be and we cannot rest on our laurels. We must do more.

Even as we deal with old problems, new ones emerge. Japanese Encephalitis is pandemic in India and the Southeast Asian region, with high morbidity and unacceptable mortality. We face the growing challenge of HIV/AIDS. Here again, we need more investment in developing an AIDS vaccine. This is an important goal for medical research internationally, and for us in India as well.

Given the continental dimensions of our country and the vast climatic and geographical variation, there are several constraints in the implementation of the Immunization Program. A top-down, over-centralized model does not work. A decentralized model is more effective. But there is scope for experimentation. And we must learn from the experience of all those countries where the programs have had a greater incidence of success.

I do believe that we need to strengthen our public health systems, especially at the village level. We need also to place greater emphasis on preventive rather than curative solutions. Reaching 25 million infants and providing them the required vaccination in time remains the biggest challenge for our government.

The immunization sector in India has been using glass syringes and needles. To improve the vaccine safety and safe injection practices in immunization and to bring about efficiency in the program, Auto Disable (AD) Syringes were introduced in 2005 with the support of the Global Alliance for Vaccines and Immunization (GAVI). The government is committed to continue the use of AD syringes. The immunization program was expanded to include Hepatitis B vaccine in the year 2002, in 33 districts and 15 large cities with support from GAVI, as a pilot project. In the year 2004, in the pilot project, 1.2 million children were vaccinated; with three doses of Hepatitis B. Very soon this will be expanded to 11 states, covering 11 million new-borns each year. We expect to make it universal and Hepatitis B vaccine will become an integral part of our immunization program.

I do believe India offers great potential for the development of vaccines. We have some of the largest vaccine manufacturers in the world. India supplies more than 60 percent of world's requirement of basic vaccines, as procured by UNICEF. This is made possible due to our ability to produce quality vaccines at reasonable prices, affordable by many developing countries. Biotechnology is a rapidly developing sector in India. Our pharmaceutical companies have already helped in drastic reduction in prices of anti-retroviral drugs for the treatment of HIV patients. Production by Indian manufacturers was the key factor in reduction of price of Hepatitis B vaccine in the world about eight years back.
This paved the way for rapid introduction of low-cost vaccines in most countries of the world. This story is being rewritten with the production of combination vaccines by Indian manufacturers from this year. India can become the hub of vaccine production for the developing world.

Note: The above text has been extracted from the keynote address delivered by the Prime Minister, Dr Manmohan Singh at the Global Alliance for Vaccines and Immunisation (GAVI) Partners' Meeting in New Delhi on December 7, 2005.