UPSC EDITORIAL ANALYSIS : Make EPI an ‘Essential Programme on Immunization’
Kartavya Desk Staff
Source: The Hindu, WHO
• Prelims: Current events of national importance, WHO, NCDs, G20, age tax, mortality, fertility rate, AI, robotic surgery etc
• Mains GS Paper I & II: Development and management of social sectors/services related to Health and education etc
ARTICLE HIGHLIGHTS
• The year 2024 commemorates 50 years since the launch of the Expanded Programme on Immunization (EPI) by the World Health Organization (WHO) in 1974
INSIGHTS ON THE ISSUE
Context
Health:(WHO)
• A certain totality of health to the realms of mental and social well-being and happiness beyond physical fitness, and an absence of disease and disability.
• We cannot achieve health in its wider definition without addressing health determinants.
Expanded Programme on Immunization (EPI):
• EPI was launched in 1974 to ensure that all children, in all countries, benefited from life-saving vaccines
• EPI was introduced as the eradication of smallpox virus was on the horizon.
• There are now 13 vaccines (antigens) recommended by WHO for the EPI programme: Bacillus Calmette-Guérin (BCG) diphtheria pertussis tetanus Haemophilus influenzae type B (Hib) Hepatitis B (HepB) polio measles rubella pneumococcal disease (PNC) rotavirus (Rota) human papillomavirus (HPV) COVID-19(for adults).
• Bacillus Calmette-Guérin (BCG)
• diphtheria
• Haemophilus influenzae type B (Hib)
• Hepatitis B (HepB)
• pneumococcal disease (PNC)
• rotavirus (Rota)
• human papillomavirus (HPV)
• COVID-19(for adults).
• India launched the EPI in 1978, which was later renamed as the Universal Immunization Programme (UIP) in 1985.
Progress in immunization and vaccines:
• In 1974, there were vaccines to prevent six diseases. There are vaccines against 13 diseases which are universally recommended Vaccines against 17 additional diseases are recommended for a context-specific situation.
• There are vaccines against 13 diseases which are universally recommended
• Vaccines against 17 additional diseases are recommended for a context-specific situation.
• There is research in progress to develop vaccines against nearly 125 pathogens.
#### India’s success story:
#### ● The children with three doses of DPT, a tracer indicator of coverage, has been rising over these years.
#### ● In the early 1970s, around 5% of children in low- and middle-income countries had received three doses of DPT.
#### ○ Which increased to 84% in 2022 at the global level.
#### ● Smallpox has been eradicated
#### ○ Polio eliminated from all but two countries and many vaccine preventable diseases have nearly disappeared.
#### ● In India, the coverage has increased every passing year and in 2019-21,
#### ○ 76% of children received the recommended vaccines.
Impact of EPI:
• Studies have shown that vaccines have saved millions of lives and prevented billions of hospital visits and hospitalisations.
• Economic analyses have estimated that vaccines are highly cost-effective interventions, with every single dollar (or rupee) of expenditure on vaccination programmes ensuring a seven to 11-fold return.
• In nearly all low- and middle-income countries, including India, the immunization programme remains a success among all government initiatives.
• In mixed health systems with both the public and private sector delivering services Immunization remains the only health intervention with greater utilization from the government sector. In India, the share of the private sector in overall health services is nearly two thirds; Nearly 85% to 90% of all vaccines are delivered from government facilities.
• Immunization remains the only health intervention with greater utilization from the government sector.
• In India, the share of the private sector in overall health services is nearly two thirds; Nearly 85% to 90% of all vaccines are delivered from government facilities.
• Nearly 85% to 90% of all vaccines are delivered from government facilities.
UNICEF’s ‘The State of the World’s Children’ report(2023):
• The childhood immunization coverage had declined in 2021.
• In 2022, globally, an estimated 3 million children were zero dose (did not receive any recommended vaccine) Another 6.2 million children were partially immunized.
• Another 6.2 million children were partially immunized.
• Over the years, the vaccination coverage in India has increased, both nationally and State-wise.
• There are persisting inequities in coverage by geography, socio-economic strata and other parameters, which demand urgent interventions.
Background of Vaccine development:
• The first available vaccine was against smallpox in 1798
• The first anti rabies vaccine, cholera, and typhoid vaccines developed between 1880s to mid 1890s were primarily for adults.
• The first vaccine ever developed in any part of the world against plague (in 1897) was from India and meant for individuals across all age groups.
• The BCG vaccine (against tuberculosis) was first introduced in a nationwide campaign in 1951. It was administered to the adult population.
• It was administered to the adult population.
• Influenza vaccines have been administered to adults and children alike.
What steps need to be taken?
• Expanding immunization coverage in additional populations: The recent announcement on HPV vaccines for teenage girls is a good start. The Indian government needs to consider providing recommended vaccines for a wider section of the adult and elderly population.
• The Indian government needs to consider providing recommended vaccines for a wider section of the adult and elderly population.
• Considering that vaccines are highly cost effective, once recommended by the National Technical Advisory Group on Immunization (NTAGI). Vaccines for all age groups should be made available as free at the government facilities.
• Vaccines for all age groups should be made available as free at the government facilities.
• NTAGI should start providing recommendations on the use of vaccines in adults and the elderly. Once a vaccine is recommended by the government body, the coverage is likely to be far greater than if the vaccines are not recommended by the government.
• Once a vaccine is recommended by the government body, the coverage is likely to be far greater than if the vaccines are not recommended by the government.
• Prevailing myths and misconceptions about vaccines must be proactively addressed to tackle vaccine hesitancy.
• The government must consider the help of professional communication agencies to dispel myths (and in a layperson’s language and with the use of social media). This requires citizens to learn and educate themselves about these vaccines from reliable sources.
• This requires citizens to learn and educate themselves about these vaccines from reliable sources.
• Various professional associations of doctors — community medicine experts, family physicians and pediatricians should work to increase awareness about vaccines among adults and the elderly.
• Physicians treating patients with any disease should use the opportunity to make them aware of vaccines.
• Medical colleges and research institutions should generate evidence on the burden of diseases in the adult population in India.
Way Forward
• With increased vaccine coverage, children are better protected. Diseases that are preventable with vaccines are increasingly becoming common in the adult population. Therefore, it becomes imperative that government policies now focus on the vaccination of adults and the elderly. For better coverage of adult vaccines, learn from the past and five decades of the EPI.
• Diseases that are preventable with vaccines are increasingly becoming common in the adult population.
• Therefore, it becomes imperative that government policies now focus on the vaccination of adults and the elderly.
• For better coverage of adult vaccines, learn from the past and five decades of the EPI.
• The introduction of new vaccines in national programmes contributes to increased coverage of all existing vaccines. Expanding coverage of vaccines for adults and the elderly may result in improved coverage with childhood vaccines and reduced vaccine inequities.
• Expanding coverage of vaccines for adults and the elderly may result in improved coverage with childhood vaccines and reduced vaccine inequities.
• India’s EPI has made major progress and it is time for another independent national level review of the UIP in India, engaging key partners and international experts.
• In late 2023, India launched a pilot initiative of adult BCG vaccination as part of efforts to ‘end TB’ from India.
• The COVID-19 vaccination of the adult population has made the public sensitized to the need for and the benefits of adult vaccination.
• In the 50 years of the EPI, it is time for another expansion of the programme with focus on zero dose children, addressing inequities in vaccine coverage and offering vaccines to adults and the elderly. Make EPI an ‘Essential Program on Immunization’.
• Make EPI an ‘Essential Program on Immunization’.
QUESTION FOR PRACTICE
Besides being a moral imperative of the Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyze.(UPSC 2021) (200 WORDS, 10 MARKS)
Editorial Analysis – 1 May 2024