Vaccine Nation: Uncovering the fascinating story behind lifesaving jabs

A little jab that protects us from some of the deadliest diseases has a fascinating backstory. Ameer Shahul does an admirable job of uncovering compelling ones in his book

Vaccine Nation: How Immunization India Shaped

by Ameer Shahul

Published by Pan Macmillan

485 pages ₹699   

Vaccines have been central to India’s public health outcomes — and indeed those of the world-saving millions of lives, reducing child mortality, and extending life expectancy. But when did it all begin? Vaccine Nation is a fascinating portrait of a journey that has so far remained largely untold and overlooked.

 

India’s vaccine ecosystem came more starkly into public focus during the Covid-19 crisis. During the second wave of the pandemic, environmentalist, author and public policy professional Ameer Shahul turned his attention to how the industry developed in India and how the country became a global vaccine powerhouse. A little jab to protect us from some of the deadliest diseases has fascinating backstories — and Mr Shahul does an admirable job of uncovering compelling ones.

 

The result is a sprawling historical saga that travels back to colonial-era science, India’s post-Independence ambitions and initiatives, and the complex, eventful transition to the global stage. When colonial-era patent laws were replaced by the 1970 Patents Act, it marked a turning point in India’s pharma and vaccine industry. Indian companies could now reverse-engineer patented vaccines using different methods, making medicines and vaccines affordable and accessible. As a domestic pharma market rose, it enabled the large-scale production of low-cost generics by home-grown companies, pushing India towards its ambition of becoming the “pharmacy of the developing world.” Its vaccine-building capability, too, multiplied manifold.

 

By the time India launched the Expanded Programme on Immunisation in 1978, a vaccine strategy and institutional capacity were already taking shape. Mr Shahul notes that, unlike most developing countries at the time, India was less reliant on imports, with state-run production hubs in Coonoor, Kasauli and elsewhere ramping up manufacturing.

 

The 1980s were a period of “consolidation”, when India doubled down on cold chain logistics, training for health workers, and disease surveillance. By the following decade, immunisation coverage was substantial but still uneven. Nevertheless, these efforts laid the foundation for India’s immunisation programme.

 

Beyond institutions and infrastructure, the book tells the story of the individuals — scientists, doctors and entrepreneurs — who drove this transformation. Vaccine Nation is, in many ways, a tribute to their work. It also traces how Indian firms moved from being “backroom suppliers to frontline partners in global health,” eventually operating independently alongside multinational players and altering the economics of vaccines worldwide. The narrative comes full circle, from India’s entry into the global patent regime in 2005 to the emergence of a mixed ecosystem of public and private organisations working on cutting-edge biotechnologies.

 

Mr Shahul successfully sets up these broader contexts while mining minute details, digging deep into historical events, shifts in science and medicine, and key policy changes across the book’s five well-defined sections. For a weighty subject, the author keeps readers engaged with suspenseful anecdotes. Tighter editing could have made it crisper.

 

In Early Days (1875–1930), he begins with a fatal snakebite at businessman Cyrus Poonawalla’s stud farm in Pune — a tragedy that turned into a groundbreaking business opportunity and gave rise to one of India’s best-known vaccine manufacturing facilities, the Serum Institute of India.

 

The foundations, however, had been laid much earlier by French–Russian bacteriologist Waldemar Haffkine, who established the Haffkine Institute and led pioneering cholera and plague vaccination campaigns in India, not without controversy, as vaccine politics began to take root in colonial India.

 

Other important figures such as Sahib Singh Sokhey — a medical officer involved in the development of anti-venom to treat venomous snake bites at the Haffkine Institute — took India’s vaccine story forward. More recently, there’s Alka Dwivedi, a young scientist whose team is behind India’s first cutting-edge, affordable CAR-T cancer therapy in recent years, yet who has largely missed the mainstream spotlight.

 

The book brings to light many such individuals who played key roles in shaping India’s vaccine ecosystem. The author also examines India’s major public health challenges, including smallpox, typhoid, tuberculosis, polio, measles, through the lens of vaccine innovation and the political, medical and economic contexts in which they unfolded.

 

Importantly, it draws attention to the darker side of unethical clinical trials, often led by Western pharma companies, urging a rethink as India moves quickly up the global clinical trial ladder, surpassing the United States. The book reminds us of issues around consent, ethical oversight and accountability in our pursuit of vaccines.

 

The book leans heavily on a historical framing of vaccine development in India, with a lighter focus on contemporary geopolitical tensions, profit-driven vaccine markets, philanthropy in the Global South, vaccine nationalism and corporate lobbying that have played a big role. This epic account of exciting achievements and innovation has much to offer — and it is a story that is still unfolding.    The reviewer is an independent journalist and author who reports on global health, development and culture