More than a Pinprick: The Risk to India’s Newborns

By Vijay Simha, Tehelka



BABIES, THEY say, are a nice way to start people. They are also, it would appear, a nice way to start profit. If the babies are Indian, there’s added allure to the profit because there are so many of them every year. In the days to come, as the denouement of a series of extraordinary events, the Indian government is expected to make a fresh decision on the number of vaccines Indian infants are to be given soon after birth. Much rests on the decision for Indian families and, oddly, the World Health Organisation (WHO), which has made a bizarre push for new vaccines it wants Indian newborns to be given in the country’s public health programme.

A decision one way could risk the lives of the country’s babies, because there are doubts on the quality of vaccines the WHO is pitching for; it could push the government into financial commitments it is in no position to meet; it could empty the pockets of people who seek private medical help, and put the nation’s health sector more firmly under the control of agencies outside India. A decision the other way could force units formerly run by the Indian government to resume full work and make homegrown vaccines; and thrust more expenses on a feeble state wallet, which will need to fund more R&D.

This vaccine soup has been stirred by the WHO, which is in the midst of several controversies of late for creating medical scares and then backing drugs to fight them. In the first week of June, the WHO admitted it had failed to disclose conflict of interest for scientists who advised it on the H1N1 influenza pandemic. The response came after a British media report said the WHO had announced a fake pandemic to boost sales for pharmaceutical companies that manufacture antiviral drugs and the H1N1 vaccine. Now, there appear to be the makings of a similar controversy over what may be taking the shape of an Indian vaccine scam.

The Vaccines 

India does not have a well-defined vaccine policy. It has a National Immunisation Programme, under which it conducts an Expanded Programme of Immunisation (EPI). Twenty-five million children are born every year in India. That is a vast vaccine market, far bigger than many countries put together. Only about 53 percent of the children born in India are vaccinated. This means about 11 million children in India, almost wholly from poor families in the hinterlands, still need to be vaccinated every year.

Also, only about 40 percent of the children are born in medical institutions. Here, there is a process laid down for vaccination. A whopping 60 percent of annual Indian births, or 15 million, are in homes or anywhere else. Most of them, in the villages and backwaters of India, are not likely to get vaccinated. Eighty-five percent of all vaccination in India is done by the government. The private sector accounts for the other 15 percent.

India’s EPI covers six primary vaccines: BCG, Bacillus Calmette-Guérin, a vaccine for tuberculosis; DPT, also called the trivalent vaccine, for diphtheria, pertussis (whooping cough) and tetanus; DT, a diphtheria and tetanus vaccine given to children with adverse reactions to pertussis or where there is a family history of seizures or brain disease; TT, tetanus vaccine normally given as DPT or also separately; measles; and polio.

For millions of parents, this is a moment of absolute helplessness. They have created a life and will take no chances with its protection. They will do anything for the newborn. They are like fodder. Those who can afford the private clinics end up paying far more than they should. The private clinics run their own vaccination programme that may differ from the national immunisation policy. For instance, many clinics offer hepatitis B and Hib (Haemophilus influenzae Type B) shots though they are not part of the national programme. This package can cost between Rs 1,500 and Rs 4,000. Doctors in the know say the profit margin is huge. The pharma companies send the pentavalent vaccine to the doctors at, say, Rs 1,000. The MRP might show, say, Rs 525, or even Rs 2,200 depending on the manufacturer. The doctor adds consultation fee, nurse costs, syringe costs and so on.

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