Why every child needs access to immunisation
India’s Children’s Day is perhaps the most opportune time to reflect on both our country’s achievements and shortcomings on child health equity. Children’s Day honours the birthday of India’s first Prime Minister Jawaharlal Nehru, who prioritised the social and economic needs of India’s children. He considered children the real strength of India’s future and the very foundation of our society. As we Indians commemorate Children’s Day today, we must also reflect on child dignity and the right of every child to equitable access to quality health care.
Over the past 15 years, India has witnessed the most dramatic improvements in child health in its history. India’s under-five mortality rate has reduced by more than half in the past two decades, at a rate faster than global improvements in child mortality. In 1990, 3.3 million Indian children under the age of five died, compared to 1.34 million in 2013.
This has been possible only because of the combined efforts of the Indian government and our civil society. Since 2000, the Indian government has implemented cutting-edge child health schemes, such as the Balika Samriddhi Yojana programme, which provides grants to girls who delay giving birth at dangerously young ages. Civil society has also strengthened its voice in India’s child health equity movement. For instance, in 2013, activists across the nation rallied around their concerns related to the impact that the National Food Security Bill would have on the future of child nutrition and health in India.
Despite the pride I take in witnessing such sweeping improvements in our child health statistics, these numbers have fallen short because we do not yet have a firm commitment to our children’s right to quality health care.
Some of the most basic threats to India’s children are pneumonia and diarrhoea, which cause a quarter of child deaths in our country. Simple interventions such as access to clean water, sanitation, Oral Rehydration Solution, and timely immunisation can put an end to numerous deaths and suffering that these easily preventable diseases cause. One of the most effective ways to stop these childhood diseases from killing off India’s future is ensuring immunisation for all children as one of the key interventions towards upholding every born child’s right to health and survival.
Due to strong immunisation programmes in affluent countries, pneumonia and diarrhoea have little to no impact on the well-being of children in those pockets of the world. Although India produces 60 per cent of the world’s vaccines and is known as the world’s pharmacy, only three-fourths of India’s children are vaccinated.
Its even more tragic that while India’s rich and affluent have easy access to these vaccines through the private market, India’s most neglected child populations, from tribals to child labourers to urban slum dwellers, who are also the most vulnerable, rarely have equitable access to vaccines. The poor solely count on the government’s programmes and their outreach and if these immunisation interventions don’t reach them, their children are left unprotected and are victims to vaccine-preventable diseases. Subsequent hospital visits and medical expenses often entrap them into a vicious cycle of generational poverty. Immunisation is one of the most effective tools to not only fight pneumonia and diarrhoea, but to dismantle poverty and inequality among India’s children.
As a physician activist, I am saddened that something as simple and readily available as a vaccine is far from the reach of India’s children who need them the most. If children are to be seen as holders of rights, rather than objects of charity, we then must ensure all children are entitled to public health prevention tools such as vaccines.
A rights-based, participatory approach to vaccine delivery in India is not farfetched. A critical reason why polio was eradicated in India almost four years ago was due to local opinion leaders demanding for their communities the right to timely immunisation services. Innovative rights-based approaches such as these must be adapted so that India’s civil society can work with the government to strengthen the Universal Immunisation Programme, and in turn the health system itself.
We must stand in solidarity with India’s neglected children to ensure that their gender, caste, or place of birth does not dictate whether they receive critical health services such as immunisation. We must close the vaccine gap between India’s rich and poor children by shifting our mindset to view access to vaccines as both achievable and the just thing to do. I was full of hope and pride when our prime minister recently announced the introduction of four new vaccines into our Universal Immunisation Programme. Let us make this Children’s Day as our call to action, and most importantly our moral obligation, to ensure we do not take any steps backwards in ensuring health and survival for all our children, which I consider India’s greatest commitment to human rights to date.