More than a pinprick

Government failures lead to vaccine shortages

The management of vaccine supply in India is in a mess. There are regular shortages of crucial vaccines, thanks to disrupted domestic production or imports. One is happening right now: yellow fever vaccines, mandatory for travel to African and South American countries, are impossible to find. Rabies vaccines for dogs and rabies immunoglobulin for human beings are also in short supply. In many cases, the cause is government mishandling. The sole public sector plant that used to manufacture vaccines against yellow fever, at Kasauli in Himachal Pradesh, has been out of commission for nearly two years - it met 40 per cent of total requirements. Thus, stocks at the government-authorised yellow fever vaccination centres have dried up. Meanwhile, procedural snags have held up imports. In any case, vaccines administered at private centres are deemed invalid unless verified and certified by the government centres.

This is predictably an enormous inconvenience for business visitors travelling to Africa or South America; many have been forced to abandon their plans. Indeed, this is a significant barrier to the prospect of meeting India's target of increasing its bilateral trade with Africa by $30 billion to $100 billion by 2015. And, of course, corruption thrives: fake vaccination certificates are becoming common, which pose the danger of importing yellow fever infection into India through unvaccinated travellers. Yellow fever, it may be noted, is caused by a mosquito-borne virus similar to the one that causes dengue fever, but it is far more deadly. India has, luckily, remained free of it, and an outbreak would be a major public health crisis.

There are questions the government needs to answer. Why are its rules so outdated and inflexible that the Kasauli vaccine plant can't be repaired (due to procurement hassles), or that vaccines can't be imported? Why has it not expanded domestic infrastructure for manufacturing this vaccine, as the demand grows? Remember that India has been home to the evolution of the world's first vaccines against major epidemics - rabies, plague, smallpox and cholera. The country has also put in place a vaccine regulatory system duly approved by the World Health Organisation. Yet, the domestic vaccine industry has failed to keep pace with soaring demand. A major reason for this is the want of adequate emphasis on the augmentation of vaccine output capacity in the health policies followed in recent decades, including the National Vaccine Policy, 2011. Much of the existing vaccine production infrastructure has remained confined to making common vaccines meant for routine immunisation, such as DPT (diphtheria, pertussis and tetanus) and BCG (bacillusguerin) vaccine. A more favourable policy environment is needed to induce new investment and revive old capacity. Otherwise, a public health crisis is around the corner.