The National Vaccine Policy, announced by the Union health ministry last year, has come in for severe criticism from experts. They have termed that the government has fallen trap to the same ‘global’ slogans of the World Bank that has pushed the world into recession and the aid politics of Gates Foundation, WHO and Global Alliance for Vaccines and Immunization (GAVI).
In an article in 'Current Science', Dr N Raghuram, associate professor, School of Biotechnology, GGS Indraprastha University, New Delhi and Dr Y Madhavi, NISTADS, Pusa, New Delhi have said that the government policy pays lip service to several important issues such as criteria for new vaccine introduction into UIP, including the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system, strengthening the surveillance of Vaccine Preventable Diseases (VPD) and Adverse Events Following Immunization (AEFI), operational efficiency, etc.
“Clearly, this vaccine policy is not designed to enhance national public capacities for public immunization programmes, but to justify spending public money on privately produced vaccines in the name of protection from diseases, whose incidence figures and public health statistics are dubious and industry-manufactured. In its eagerness to push vaccines, this policy completely missed the very idea of selective immunization and implies that all immunization is universal,” the article says.
Questioning the hurry in which the Policy was announced by the government, experts questioned about the hurry under which the entire drafting exercise done and intriguing secrecy, when the government has been having its way with the national immunization programmes all these decades despite the lack of a clearly articulated policy? Unlike the policy drafts for National Health Policy, National Health Research Policy, National Biotechnology Policy, etc., which were kept in the public domain for discussion among stakeholders, this vaccine policy draft was not kept in public domain.
The policy does not provide an uncompromising scientific basis on which a vaccine can be introduced in Indian UIP based on its proven ‘need’ (actual disease burden in relation to other diseases), suitability (for local strains and variants etc.), safety and efficacy, cost-benefit and risk benefit analyses based on evidences from India.
Thus, the policy is not only putting the cart before the horse, but also taking a philosophically or ideologically different approach; it is the difference between adopting suitable vaccines to control serious diseases and finding disease burden to suit available vaccines. In other words, it is the difference between finding solutions to problems and offering solutions to imaginary or insignificant problems.
Criticizing the PPP model adopted by the government for this policy, the article says that this circular model would collapse if any link is broken. The government’s fanatical adherence to PPP despite the recent history of dubious PPPs highlighted in the media, parliament and courts is another area of concern. The report of CAG on the Commonwealth Games 2010 noted that Suresh Kalmadi converted the government owned organizing committee into a body outside governmental control despite full funding from the government.
The new PPPs being envisaged for vaccines will be no different, except that now this is no longer the sleight of hand of a minister, but a matter of national policy of public spending and private profiteering! The policy rightly recommends expansion of NTAGI to include public health researchers, academicians, epidemiologists, etc. but does not say who will select them or how and for how long, or how to ensure a composition that prevents conflicts of interest and promotes rational decision-making.