India's public healthcare stands to benefit with rotavirus vaccine

It is in the very nature of enterprises to be driven to achieve success. Success often depends on the impact of the tools and strategies being deployed. Public health in India too maybe viewed as an enterprise striving for success.

The latest public health tool being deployed is the rotavirus vaccine. It stands to make an enormous impact given that diarrhoea claims more than 130,000 Indian lives under the age of five every year.

By introducing a rotavirus vaccine, not only does India's public health "enterprise" stand to avert crores of rupees in treatment costs and lost productivity, it will minimise the harmful impact of diarrhea on child growth and development and will reduce susceptibility to other diseases. Nonetheless, the success of this move hinges on the vaccine reaching those who need it the most.

In most instances it is the poor that rely on the public health "enterprise" to provide them with critical life-saving services such as immunisation; unlike the rich, who are able to protect themselves from disease at any price.

Studies have shown that a single hospitalisation for rotavirus diarrhoea can cost a family anywhere between 2,000 to 8,400 rupees depending on the kind of hospital, a cost that may be negligible for say, the car owner, but one that could easily push the driver's family into irremediable poverty.

Including an intervention previously only available in the private sector into a public health programme certainly marks a symbolic move towards health equity. Each year, approximately 27 million children are born in India and each of them requires protection from several diseases - an enormous challenge.

The inclusion of the rotavirus vaccine to India's routine immunisation schedule stands to offer the beneficiary reliant on the public health "enterprise" a more comprehensive protection against preventable diseases.

However, to actually produce an impact, the vaccine in supply needs to be demanded by the targeted beneficiary. This necessitates a simultaneous delivery of both awareness and vaccines, affording both the car owner's child and the driver's child a chance at equal protection.

Of note here is India's polio programme - it saw an unprecedented mobilisation of resources, innovation,communications, and people for almost two decades till both the message and the vaccine was driven home.

With infrastructure available from our polio effort, we have learned that each and every child can be reached and protected. To generate the desired impact against diarrhoea, the addition of a rotavirus vaccine into the routine immunisation programme will have to be accompanied by a strong audio-visual campaign to help learn new behaviour and recall key messages as was done with polio.

The dissemination at high priority districts identified for Mission Indradhanush will bode especially well to obtain the anticipated increase on immunisation coverage and curtailing diarrhoea deaths.

Furthermore, the campaign accompanying the rotavirus vaccine will need to squarely emphasise that essential as it may be, a rotavirus vaccine is insufficient alone. Although, the vaccine will prevent severe and potentially fatal episodes of rotavirus infection from occurring in the first place, it warrants a comprehensive approach.

This comprises establishing good health practices from birth, including exclusive breastfeeding for six months, followed by adequate complimentary feeding, Vitamin A supplementation, and promoting the use of safe water, hand washing and sanitation.

Concurrent policies and initiatives such as the Swachh Bharat Abhiyan and the Mission Indradhanush are aiding the fight against preventable diseases. Recent moves prioritising preventative health such as the launch of new vaccines including the rotavirus vaccine into the Universal Immunization Programme highlights the ingenuity with which the public health "enterprise" is seeking to generate impact.

However, it is a timely nation-wide scale up of a comprehensive rotavirus vaccine campaign which will be hailed as a success.