India currently holds the highest burden of child deaths due to pneumonia in the world. Pneumonia kills more children under five years old in India than any other disease. This accounts for 20 percent of child mortalities globally. In India, this amounts to around 944,000 child deaths a year (based on data from 2015). The disease is however entirely preventable, yet until recently there was no government programme to ensure that all available vaccinations were in place to attempt to reduce infant mortality.
Pneumococcal conjugate vaccine (PCV) was added to the Universal Immunisation Programme (UIP) as of May 13th. J P Nadda, Union Minister for Health and Family Welfare said on the matter “No child should die in the country from Vaccine-Preventable Diseases“.
Nadda adds that this vaccination has been available in the private sector in India for years. While this has meant that the vaccine was potentially accessible, it was off limits to those who could not afford it. He goes on to say “by making them available under the UIP, the government is ensuring equitable access to those who need them the most, the underprivileged and underserved,”
The question is, why has India been so slow. PCV is already available in many African countries that are far poorer than India. How can Burkina Faso and the Central African Republic manage something that India cannot? Some suspect that the Government has been tempted to wait by promises from Indian manufacturers that they would soon have rival PCV vaccines. Despite the promises, and large chunks of Gates funding none have yet succeeded.
Current plans for the first phase of the belated rollout of the vaccine involve the distribution to 21 lakh children (2.1 million) in Himachal Pradesh and parts of Bihar and Uttar Pradesh. In 2018 the aim is to expand the programme to Madhya Pradesh and Rajasthan, followed by implementation of the plan at a national level in a phase by phase manner.
The vaccine itself, the 13-valent pneumococcal conjugate vaccine (PCV-13), produced by Pfizer, is the most widely used pneumococcal vaccine in the world. Aside from pneumonia, the vaccination protects against pneumococcal bacteremia as well as the potentially lethal pneumococcal meningitis.
The vaccine has been shown in studies to be highly effective, with a coverage rate following vaccination of 86 percent after a single dose. Multiple doses were shown to be more effective, raising the effectiveness to 91 percent.
India takes the highest place in terms of child deaths due to pneumonia, followed by Nigeria, Pakistan, Democratic Republic of Congo and Angola. It is hoped that with the UIP programme taking effect, as well as gradually implementing more vaccines into the programme India will steer away from its track record of child mortality.
Despite the currently grave situation, progress is positive. The number of vaccinations counted as part of the programme has grown since it was introduced, and the focus seems to be on ensuring a healthy younger generation. Naddu commented “Strengthening routine immunisation is an essential investment in India’s children and will ensure a healthy future of the country.”