Prime Minister Modi’s recently announced introduction of the newer, more expensive vaccines into the Universal Immunisation Programme (UIP) meant that the budget allocation for vaccine procurement would have to go up six times by over Rs 5,200 crore in the forthcoming budget. The TOI article argued that developing countries such as Thailand and Rwanda are making remarkable progress in reducing child mortality by spending on strengthening primary health care through hiring and training thousands of health workers and not by pouring money into increasing the number of vaccines. We absolutely agree that strengthening the primary health care network and system is an urgent need and will go a long way towards reducing child and maternal mortality. But in response to the main question “can India afford costly vaccines?”,we felt otherwise- can India afford not to include them?
A recent opinion piece in Business World Magazine “can India afford to not vaccinate?” talks about the urgent need to invest in vaccines to rescue lakhs of children from death, disability and illnesses. The author is Prof. Ramanan Laxminarayan, the Vice President of Public Health Foundation of India. He writes that India has recently taken giant leaps forward for improving the state of public health in the country but the most significant announcement was when the Prime Minister announced the introduction of three new vaccines in the country’s Universal Immunisation Programmes.”He presents some interesting facts in support of this step and mentioned the health benefits of introducing these vaccines. But even more interesting are his arguments for the “ detractors worried about the increase in expenditure on immunisation” as he puts it.
Here are some facts to think about as mentioned in his article:
- India accounts for nearly a fifth of the global disease burden and loses about 6 per cent of its GDP to premature deaths and preventable illnesses.
- Hospitalisations remain a major cause for indebtedness, pushing 2.2 per cent of the population below the poverty line every year on account of out-of-pocket expenditure. Yet, public expenditure on health comprises only 1.4 per cent of the GDP and public expenditure on vaccines an even more miniscule 0.03 per cent.
- For perspective, India ranks 171st out of 175 countries in public expenditure on health care, lagging behind many resource strapped countries in sub-Saharan Africa. In contrast, India ranks third in out-of-pocket expenditure on health.
- Governments in the four other BRICS countries spend, per citizen, nine to twenty-seven times more and vaccinate their children against more illnesses than India.
- Even Rwanda provides vaccines against more diseases in its immunisation programme than India. In terms of budget allocation, the Ministry of Health and Family Welfare ranks 9th, with a total allocation of Rs. 35,163 crore. Out of this, nearly 21,912 crore have been allocated to the National Health Mission.
- According to the Comprehensive Multi Year Plan for 2013-2018, the projected cost of procurement of these vaccines and injection supplies (including the cost of pentavalent vaccine, which is provided free of cost till 2015 by GAVI) will not exceed Rs 2,800 crore in 2016. That is, even with these four new vaccines, the cost of procurement for both vaccines and injection supplies will comprise 13 per cent of the National Health Mission budget.
- More importantly, the introduction of these new vaccines will increase the total expenditure on immunisation from 0.03 per cent to 0.07 per cent of GDP. This means, by spending 0.04 per cent more of its GDP the country is set to rescue lakhs of children from death, disability and illnesses. The question then again to be asked is: can India, the country home to the greatest burden of maternal and child deaths in the world, afford not to vaccinate? To read his entire article , please click here.