India Committed to Complete Polio Eradication 2012: Year of Intensification for Routine Immunization in South East Asia Region
The Union Health & Family Welfare Minister Shri Ghulam Nabi Azad has said that several new initiatives have helped India achieve improved coverage and quality of immunization. Shri Azad was addressing the High Level Ministerial Meeting of South East Asia Region on Increasing and Sustaining Immunization Coverage in New Delhi today. Health Ministers from Bangladesh, Bhutan, Sri Lanka, Maldives, Myanmar and Nepal are attending the two-day Conference. The World Health Organization has declared 2012 as the Year of Intensification for Routine Immunization in the South East Asia Region.
The text of the speech of Sh. Ghulam Nabi Azad is as follows:
"At the outset, I would like to extend a very warm welcome to my colleague Ministers from the South-East Asia Region of WHO and other distinguished participants to New Delhi. I am glad that New Delhi has been chosen for holding this historic regional meeting on immunization, particularly when a number of new initiatives have been launched in India to build upon the recent achievements in this extremely important area. India strongly believes that vaccination is one of the most cost effective public health interventions since it provides direct and effective protection against preventable morbidity and mortality. Therefore, we remain committed to increasing and sustaining quality immunization coverage.
Excellencies, Ladies & Gentlemen!
India runs one of the world's largest Immunization Programmes. You can estimate the scale and size of India's immunization programme from the fact that around 26 million children are born every year. There is no denying that we face a number of challenges to cover this large birth cohort in a vast country.
Besides the challenge of reaching out to a very large population size, in so far as improving the accessibility and affordability of health services is concerned, we face a number of unique challenges:
Geographical: From snow bound areas where temperatures reach 30-40 degrees Celsius below zero to deserts with temperatures of 45 degrees plus, we have hilly areas, tropical forests, remote island territories, riverine deltas and plateaus.
Cultural: We are a diverse nation with many religions, languages, traditions, varied customs, beliefs and practices.
Infrastructural: While the pace of infrastructure improvement and human resource augmentation, particularly at the sub-centre and primary health centre levels, has been impressive in the last 5-6 years, we still need to focus on the difficult, inaccessible and remote areas in the country.
Political: India is a vibrant and largest democracy of the world, where opinions of all shades find expression in debates, discussions and demonstrations, both informed and uninformed, quickly highlighted by an over vigilant media, besides the various fora provided to the elected representatives from the village to the national level. Being a federal polity, where health is a state subject, coordinating the implementation of national programs is a big challenge. The Universal Immunization Program is a program where the national government provides the vaccines and meets the operational costs of administering them but is dependent on the state governments for its implementation. With improved technologies and faster communications, the coordination between the centre and the states is now much better. With cooperation of my colleague health ministers in the states, we hope to further improve the increasing coverage and achieve the goals set under the National Rural Health Mission.
Launch of the Mission in 2005 saw considerable enhancement in the funding to the States for strengthening the health care delivery systems. Under the National Rural Health Mission (NRHM), our endeavour is to re-vitalize the primary health care systems for the benefit of the people living in rural areas, particularly in difficult, inaccessible and remote parts of the country. Since the launch of NRHM in 2005, more than 15 billion dollars have been provided to the States in addition to their budgets, for strengthening health systems and infrastructure with key focus on reproductive and child health, including immunization. Augmentation of human resource has been a priority area, due to which more than 1.5 lakh medical and paramedical service providers have been added all over the country. This includes 67,000 Auxiliary Nurse Midwives (ANMs) to strengthen RCH services, particularly immunization. Other than these, over 800,000 Accredited Social Health Activists (ASHAs) are actively functioning as community mobilizers to improve health demand, including for immunization services, in rural areas.
Excellencies, Ladies and Gentlemen!
Here, I would like to mention the several new initiatives that India has embarked upon to improve both coverage and quality of immunization. We have introduced vaccine for Japanese Encephalitis in 111 districts in 15 States having a high disease burden. Hepatitis B vaccine, earlier introduced in 10 States, is now being extended to the entire country. Introduction of the second dose of measles as part of routine immunization is yet another major initiative. We are also introducing Pentavalent vaccine containing Hib, initially in two states of Tamil Nadu and Kerala and aim to scale it up. 11 centres across the country have been identified for laboratory supported surveillance for vaccine preventable diseases with special reference to potential vaccines in collaboration with the Indian Council of Medical Research. In a very recent initiative, we have introduced name & telephone based tracking of pregnant mothers and children through a web enabled system. The initiative intends to make sure that all pregnant mothers and children receive full continuum of care including complete vaccination. This system will enable us to track each and every child and monitor the provision of timely immunization services, thereby verifying and improving service outreach throughout the country.
To overcome the paucity of human resource, which is critical in last mile service delivery, the National Government has taken the lead in providing financial assistance to set up 265 schools for General and Auxiliary Nurse Midwives in those districts which are backward, remote and inaccessible or where there is not even a single GNM or ANM school.
I am happy to state that this will add another 20,000 nurse midwives annually to the current one lakh nine thousand nurses passing out every year to carry the immunization program forward. Another major step has been the framing of the National Vaccine Policy. This policy will now guide the Immunization program in the country in achieving its goals and objectives. The immunization program has benefited from the multi-year plan for immunization for the period 2005 to 2010. We are now in the process of finalizing the second multi-year plan that covers the period up-to 2017. Steps have also been taken to improve surveillance and case management for Adverse Events Following Immunization (AEFI). AEFI has been strengthened and new reporting guidelines have been published and widely disseminated. We are now closely monitoring AEFI cases to enhance public confidence in our Immunization Program. India has also joined the global post marketing surveillance network for new vaccines and Maharashtra is the participating State. These initiatives are a glimpse of our resolve to improve both the spread and quality of our immunization coverage.
Excellencies, Ladies and Gentlemen!
A very important reflection of our resolve is seen in the progress that India has made towards containing Polio. India introduced Bivalent polio vaccine in January 2010 which has given us significant success.
We have had only one wild Polio case since January this year, till date as compared to 240 cases in the corresponding period in 2009 and 30 cases in 2010. However, we are maintaining extreme vigil and have further intensified our efforts to sustain this progress. We have put in place an emergency preparedness and response plan and any case of wild polio would be treated as a public health emergency.
States have identified high risk areas, mobile and migrant populations and pockets of low routine immunization coverage. State-wise detailed micro plans have been prepared to strengthen routine immunization and to ensure that no geographical area or population remains un-reached. You may be aware that India's Pulse Polio programme is domestically funded and we have all along ensured that this programme should not suffer on account of financial resources. I take this opportunity to re-affirm India's commitment to complete polio eradication.
Excellencies, Ladies and Gentlemen!
I have highlighted our challenges and our initiatives. The task of reaching 100% full immunization coverage is enormous. In this endeavour, effective communication, at national, regional and local levels, will be a key area.
My Ministry has always worked in close collaboration and coordination with the World Health Organization(WHO), UNICEF, GAVI and other partners like the Bill and Melinda Gates Foundation, USAID, DFID, KFW and many others. The country has benefited from their support and I would like to take this opportunity to thank them for their continued and strong partnership for strengthening our immunization program and other health initiatives. India supports the initiative of WHO/SEARO towards intensification of the immunization efforts in the region and I would like to assure that the Government of India will do all that it can to intensify and sustain immunization coverage in the country.
Excellencies, Ladies and Gentlemen!
Before I conclude, I would like to once again welcome all of you to the beautiful city of Delhi and hope that all of you are comfortable.
I look forward to welcoming colleague health Ministers of the region again in a month's time."