Prime Minister of India - Dr. Manmohan Singh

PM's address at the global alliance for Vaccines & Immunization meeting

"It has been said many a time that in increasingly interdependent world that we live in peace and prosperity are indivisible. But so also is disaster. So also is disease. Therefore, I stand here to commend all of you for the efforts that you are making to reduce child, infant and maternal mortality. Yours is a noble adventure, in quest of promotion of human solidarity. And I salute all those men and women of courage, of vision, and of conviction who are contributing to this valiant effort to make this world safe for our children.

Therefore, it gives me great pleasure to welcome you all on behalf of the Government and the people of India to this very important mision. I am happy that our country is a co-host for this meeting of this Global Alliance for Vaccines & Immunisation - or in short, GAVI. This is a very important meeting, where you propose to formulate future strategies and directions for GAVI and the Vaccine Fund. I share your vision that vaccines are probably the most cost-effective health interventions available to humanity, particularly to save our children.

Vaccination is no longer seen as an intervention to reduce infant and child mortality, but also as a means to tackle diseases that occur in later life. The more common communicable diseases like malaria, rota virus etc. take a heavy toll on human lives. They also pose a serious challenge for developing countries and they emphasise the need for developing vaccines and for making them available at affordable prices.

I compliment the UNICEF, the World Health Organisation and other international agencies, the Gates Foundation, the Government and people of Norway and of Scandivanian countries for helping popularise and universalise vaccination. We are also very grateful to them all for their assistance in launching a programme of universal immunisation. A significant contribution has also been made in strengthening the cold chain systems of the countries and developing a system of vaccine storage in the peripheral parts of various countries. Our former Prime Minister, the Late Shri Rajiv Gandhi used to take keen interest in upscaling immunisation programmes and accorded it the status of a Technology Mission under the direct monitoring of the Prime Minister himself.

The Universal Immunisation Programme in India has had a major impact on all sections of society. With the introduction of this programme, the disease burden due to vaccine preventable diseases has shown marked decline over time. Since 1975, there has been a 72% decline in the incidence of diphtheria, a 91% decline in the incidence of whooping cough, and a 61% decline in the incidence of measles. We are also close to interrupting the transmission of polio virus in the country. But I would be the last one to argue that we can be satisfied with the status quo. No we cannot be and we cannot rest on our laurels. We must do more.

Even as we deal with old problems, new ones emerge. Japanese Encephalitis is pandemic in India and the South-East Asian region, with high morbidity and unacceptable mortality. We face the growing challenge of HIV/AIDS. Here again, we need more investment in developing an AIDS vaccine. This is an important goal for medical research internationally, and for us in India as well.

Given the continental dimensions of our country and the vast climatic and geographical variation, there are several constraints in the implementation of the Immunisation Programme. A top-down, over-centralised model does not work. A decentralised model is more effective. But there is scope for experimentation. And we must learn from the experience of all those countries where the programmes have had a greater incidence of success.

I do believe that we need to strengthen our public health systems, especially at the village level. We need also to place greater emphasis on preventive rather than curative solutions. Reaching 25 million infants and providing them the required vaccination in time remains the biggest challenge for our Government.

Our Government has launched very recently, a National Rural Health Mission, to improve the access of our people, especially rural people, poor women and children, to assured primary health care services. This Mission, with its focus on decentralised grassroot health planning and management will be the primary institutional mechanism for achieving a quantum leap in public health systems in our country. I do hope that immunisation and preventive action will form a core concern of this Health Mission. We need to back this up by generating low-cost, effective, easy-to-deliver vaccines, which can reach our vast hinterland. I believe India has the capability to take a leadership role in this activity, particularly when it comes to tropical diseases.

The Immunisation sector in India has been using glass syringes & needles. To improve the vaccine safety and safe injection practices in immunisation and to bring about efficiency in the programme, Auto Disable (AD) Syringes were introduced in 2005 with the support of GAVI. The government is committed to continue the use of AD syringes. The immunisation programme was expanded to include Hepatitis B vaccine in the year 2002, in 33 districts and 15 large cities with support from GAVI, as a pilot project. In the year 2004, in the pilot project, 1.2 million children were vaccinated, with three doses of Hepatitis B. Very soon this will be expanded to 11 States, covering 11 million new-borns each year. We expect to make it universal and Hepatitis B vaccine will become integral part of our immunisation programme.

I am happy that GAVI has drawn global attention to the need for improving immunisation coverage, introducing newer vaccines and conducting research into communicable and newly emerging diseases.

The philosophy and aims of GAVI have been impressive and highly beneficial. This has motivated philanthropists like Bill and Melinda Gates and countries like France, Sweden, Norway and the United Kingdom to pledge a large amount of funds to support GAVI's activities. We heard the Hon'ble Prime Minister of Norway for announcing a further expansion of Norway's efforts in this regard and I thank him profoundly for this gesture. What is more encouraging is that GAVI not only funds immunisation services in various parts of the world, but also helps countries in capacity-building and in promoting vaccine research.

I do believe India offers great potential for the development of vaccines. We have some of the largest vaccine manufacturers in the world. India supplies more than 60% of world's requirement of basic vaccines, as procured by UNICEF. This is made possible due to our ability to produce quality vaccines at reasonable prices, affordable by many developing countries. Biotechnology is a rapidly developing sector in India. Our pharmaceutical companies have already helped in drastic reduction in prices of anti-retroviral drugs for the treatment of HIV patients. Production by Indian manufacturers was the key factor in reduction of price of Hepatitis B vaccine in the world about eight years back.

This paved the way for rapid introduction of low-cost vaccines in most countries of the world. This story is being rewritten with the production of combination vaccines by Indian manufacturers from this year. India can become the hub of vaccine production for the developing world. I sincerely hope discussions during your meeting will accelerate these possibilities. I take this opportunity to give you my best wishes for the success of the noble task in which you are engaged".