Former Prime Minister of India - Shri Atal Bihari Vajpayee

Speech by Prime Minister Shri Atal Bihari Vajpayee at Inauguration of Hepatitis B Pilot Vaccination Project

It gives me great pleasure to be with all of you this morning. We have gathered here to launch a programme that promises to soon become a major national initiative in healthcare.

With the inauguration of the pilot project on Hepatitis B today, we once again

· demonstrate our commitment to promotion of public health;

· confirm our faith in the efficacy of universal immunisation programmes; and, above all,

· reaffirm our priority to care for our children, whose health is the wealth of our nation, and whose wellbeing is our duty towards the future of humanity.

In my Independence Day speech last year, I had said that, after our phenomenal success in the nationwide drive for polio immunisation, we shall soon replicate such mass campaigns in respect of other challenges in public health.

I must, therefore, congratulate the Ministry of Health and Family Welfare for preparing this pilot project on Hepatitis B immunisation.

I must also sincerely thank the Global Alliance for Vaccines and Immunizations, the international partnership jointly created by WHO, UNICEF, and global charities like the Bill and Melinda Gates Foundation, for their financial assistance and technical advice.

This pilot project is yet another fine example of global partnership to address challenges in human development.

And what can be a greater challenge — national as well as global — than that of ensuring the survival and wellbeing of our children?

I am told that every year, out of 260 lakh infants born in this country, as many as 19 lakhs do not live to see their first birthday.

This is completely unacceptable. It is particularly unacceptable, because in this 21st century, we have all the technical means to prevent these deaths.

And many of these technical means, such as universal immunization, are also highly cost-effective.

It is, of course, true that our country has made significant progress in reduction of infant and child mortality since independence.

Still, we have a long distance to cover. We have to reduce it substantially to a much lower level comparable to the countries in South-East Asia and Sri Lanka.

It is our national determination to make India a nation of healthy people. This is the overriding objective of the National Health Policy that we have adopted recently.

The Policy underscores our commitment, especially, to address the healthcare needs of our poor.

For it is the poor who are the most vulnerable to infectious and contagious diseases.

We have seen it in the case of tuberculosis and malaria.

We have seen it in the case of HIV/AIDS.

The same is also true for Hepatitis B.

We know that Hepatitis B is many times more infectious than HIV/AIDS and is the main cause of liver cancer.

Even when it does not kill, it causes chronic liver problems, which severely impacts the quality of life.

I am, therefore, happy that the Ministry of Health has started a universal immunization programme for Hepatitis B. Although this is a pilot project, I am confident that the Ministry, with the cooperation of the State Governments, will succeed in its goal to cover the entire country during the Tenth Plan period.

I urge them especially to reach out in the shortest possible time frame to all the vulnerable sections of the population in rural as well as urban areas.

Support of civil society and involvement of voluntary organizations is crucial for the success of this, as of any other national health programme.

A good example is India’s pulse polio campaign. It is today universally recognized as one of the most successful and largest ever mass mobilizations in the world to tackle a public health challenge.

India is now on the verge of becoming completely polio-free.

This is thanks to the exemplary partnership between the Central and State Governments, municipal and panchayat bodies, the medical community, voluntary organizations, and other institutions of civil society.

Indeed, the outreach achieved through the immunisation programme for polio, as well as for tetanus for pregnant women, and six basic vaccines for infants, has now become a useful vehicle for delivery of a whole range of public health services.

Nevertheless, it is a matter of concern that nearly 45 percent of our children are not yet immunized with all the six basic vaccines. As many as 14 percent of our children still receive no vaccination at all.

Therefore, our experience of public-private partnership in immunisation needs to be further institutionalized. It should also be used for further improving the delivery of services for maternal and child health, family planning, sanitation, provision of clean drinking water, and basic health education of all our citizens.

In this context, I look forward to the early adoption of the national strategy for social franchising of reproductive and child health care services.

I especially urge all those engaged in planning and executing our health programmes to also effectively address inter-State imbalances. I am told that while Tamil Nadu, Himachal Pradesh, Maharashtra, Kerala, and Karnataka usually achieve 80 percent coverage of child vaccination, it is as low as 20 to 10 percent in States like Assam, Rajasthan, and Bihar.

Along with regional imbalances, we must also resolve to eliminate social imbalances in healthcare. Our first concern should be for children belonging to the scheduled tribes and castes, who are still the most neglected in public as well as private delivery of health services.

If I may say so, pilot projects like this one should be considered successful only when they quickly lead to national public health programmes running on auto-pilot, and automatically reaching out to the poor and neglected.

Friends, our public health programmes have benefited immensely from scientific research in both India and abroad. Nevertheless, we continue to look to medical R&D for more benefits.

For example, besides the six basic vaccine preventable diseases, vaccines are also now available for a large number of other diseases. But several of these vaccines are still very expensive. We need to make them affordable for universal coverage.

There is another challenge. We know that unsafe injections are a major source of infections, including Hepatitis B, in most developing countries. We want to expand the use of auto-destruct syringes and needles in all our public health programmes during the Tenth Plan period. We need technology to reduce their cost.

Before I conclude, let me share an observation and a hope with all of you. Last week, I visited Almaty in Kazakhstan where we discussed ways to promote peace, security and development in Asia. Alma-Ata, as the city was earlier called, rings a bell in all those interested in public health. It was there that, in 1978, the World Health Organisation adopted the famous Alma-Ata Declaration “Health For All by 2000”

That goal is still elusive. But it is not difficult to achieve.

Funds are not the main problem in achieving this objective. The problem is getting our delivery mechanisms right.

We should vastly expand the scope of public-private partnership, especially for primary health care, reproductive and child health, and public health services.

We need to look at practical models that have worked in our own country and elsewhere and take steps to replicate them on a large scale.

Today, as we inaugurate this important pilot project, let us rededicate ourselves to achieving the goals set in the National Health Policy 2002 to secure the basic healthcare needs of all our people.

Thank you.