Unity of purpose between political and religious leaders and nations against an enemy of the entire humanity is the only way to end and recover from a pandemic.
On 23 March 2020, World Health Organisation (WHO) director, Dr Michael J. Ryan said that India has tremendous capacities and had previously led the world in eradicating two killers, smallpox and polio. He expected India to show the way again and India did not disappoint. The enormity of India’s vaccination success is obvious from the sheer magnitude of the Indian population and geography covered, the R&D, logistical, and numerous other challenges overcome to provide vaccines free of charge, even to the beneficiary’s doorstep at remote locations. Drones were used to supply vaccines and healthcare workers utilized bicycles, boats, and camels. The “Har Ghar Dastak” (house-to-house) campaign reached out to all missed-out or dropped-out eligible beneficiaries. India achieved several unprecedented global milestones, including administering over 100 crore doses in less than nine months, administering 2.51 crore doses in a single day, and several times administering one crore doses in a day. The current population of India is 1.4 billion and constitutes 17.5% of the world’s 8 billion population. Till now a total of 2,206,624,273 vaccine doses have been administered in India, of 13,340,343,269 vaccine doses administered globally. 90% of eligible beneficiaries in India have received both doses. Globally, there have been 0.76 billion confirmed cases of COVID-19 and 6.89 million deaths reported to WHO. These confirmed cases include 0.1 billion cases in the US in a population of 0.3 billion (33%), 0.09 billion cases in China in a population of 1.4 billion (6.4%), and 0.04 billion cases in India (2.85%). India also shared precious vaccines under the “vaccine maitri” program with more than 100 nations, unlike many that hoarded stocks until they expired. India’s success provides many major lessons to the world and to those mandated to manage global health, especially the WHO.
WORLD’S LARGEST VACCINATION DRIVE: India’s first vaccine, and vaccination, was for smallpox in 1802. India has had a strategy of Universal Immunization Programme (UIP) for 11 diseases. Visionary leadership, with the combined effort of the government and the private sectors, genome sequenced, developed, tested and provided in one year instead of the usual 10 years, multiple vaccines against Covid-19 that were compatible with existing cold chain logistics. A simultaneous increase in local manufacturing and funding of medical disposables, cold storage chain, and vaccines enabled this massive drive. In January 2021, India launched the world’s largest universal immunization program, and in a time-bound manner through the Co-WIN (Covid Vaccine Intelligence Network) app, a comprehensive cloud-based scalable IT solution for planning, implementing, monitoring, and evaluating Covid-19 vaccination. It provided real-time stock tracking at the national, state, and district levels and plugged the wastage of Covid-19 vaccines. It also enabled registering beneficiaries in 12 regional languages and issuing digitally verifiable certificates as per WHO guidelines to enable international travel. To enable those having limited access either due to age, disability, or lack of identity proof, special provisions were made such as “Workplace Covid Vaccination Centres” and “Near to Home Covid Vaccination Centres”. Prime Minister Narendra Modi publicly took shots of the Indian Covaxin to endorse its efficacy and safety. His good communication skills and the combined effort of healthcare experts, the media, telecommunication networks, and social and behavioral communication campaigns helped overcome vaccine hesitancy without compulsion. India has one of the lowest vaccine hesitancies in the world.
LESSONS LEARNT: This pandemic has pushed the health of the nations to the geopolitical centre stage and health workers into frontline warriors. Protecting healthcare workers is important to prevent the healthcare system from becoming overwhelmed as happened in Italy. Refusal to share patents on vaccines and their constituents and profiteering by big pharma companies during a pandemic are major problems that need to be sorted out. Trustworthy credible public policy, protocols, or guidelines based on scientific facts and data in a transparent way by credible unbiased experts and effective communication by leaders, experts, and media to the public and health workers is required to win public confidence, trust, and credibility in the authorities and agencies managing a pandemic and the vaccination drive. Celebrities, influencers, and leaders of all kinds political, religious, social; and health insurance companies should be roped into the promotion of vaccination. Unity of purpose between political and religious leaders and nations against an enemy of the entire humanity is the only way to end and recover from a pandemic. There should be universal consensus on managing pandemics, vaccines, and certification. Global resilient supply chains and disaster management facilities are necessary.
*Dr P.S. Venkatesh Rao is Consultant Endocrine, Breast & Laparoscopic Surgeon, Bengaluru.