Make EPI an ‘Essential Programme on Immunisation’

Context:

The year 2024 commemorates the 50th anniversary of the Expanded Programme on Immunization (EPI) initiated by the World Health Organization (WHO) in 1974.

Relevance:
GS-02 (Health)

Dimensions of the Article:

  • Background
  • What is the Issue
  • What is EPI
  • Its Significance
  • India’s Universal Immunization Programme (UIP)

Background:

  • Originally aimed at combating smallpox, the EPI has evolved into the Universal Immunization Programme (UIP) in India, catering to a broader spectrum of vaccine-preventable diseases
  • As India reflects on two decades since its last nationwide UIP evaluation, it presents an opportune moment to evaluate achievements and chart a path forward.

What is the Issue:

  • The success of immunization programs globally and in India is undeniable, with vaccines playing a pivotal role in preventing disease and saving lives.
  • Over the past five decades, the scope of immunization has expanded significantly, with vaccines now available for a wide array of diseases.
  • Despite this progress, challenges persist, as evidenced by recent declines in childhood immunization coverage and existing inequities in vaccine access.

What is EPI:

  • The Expanded Programme on Immunization (EPI), launched in 1974 by WHO, marked a turning point in global health efforts.
  • It is to ensure that all children, in all countries, benefited from life-saving vaccines.
  • By leveraging existing infrastructure and trained personnel, the EPI aimed to extend the benefits of vaccination to populations worldwide.
  • In India, the EPI evolved into the Universal Immunization Programme (UIP) in 1985, reflecting a commitment to providing comprehensive immunization coverage.
  • Over the years, the UIP has played a critical role in increasing vaccine uptake and reducing the burden of vaccine-preventable diseases.
  • Initially it focused on protection against six childhood vaccine-preventable diseases namely Bacillus Calmette-Guérin (BCG), diphtheria, pertussis, tetanus, polio, and measles.
  • Further, WHO included 7 more disease- Haemophilus influenzae type B (Hib), Hepatitis B (HepB), rubella, pneumococcal disease (PNC), rotavirus (Rota), human papillomavirus (HPV), and COVID-19 (for adults).

Its Significance:

  • The impact of immunization cannot be overstated, with vaccines saving millions of lives and preventing countless hospitalizations.
  • Economic analyses have underscored the cost-effectiveness of vaccination programs, highlighting their importance in promoting public health. Despite challenges, immunization remains one of the most successful public health interventions, enjoying widespread support and utilization, particularly in low- and middle-income countries.

India’s Universal Immunization Programme (UIP):

  • It originated as the Expanded Programme on Immunization (EPI) in 1978, later rebranded in 1985.
  • Objectives:
    • Accelerate immunization coverage.
    • Enhance service quality.
    • Establish a dependable cold chain system at health facilities.
    • Monitor performance.
    • Achieve self-reliance in vaccine production.
  • Eligibility:
    • Pregnant women and children can receive vaccinations at government/private health facilities or designated immunization session sites.
    • The UIP provides equal access to all sections of society nationwide, offering free vaccination against 12 preventable diseases.
    • Nationally covered diseases include Diphtheria, Pertussis, Tetanus, Polio, Measles, Rubella, severe Childhood Tuberculosis, Hepatitis B, and Meningitis & Pneumonia caused by Hemophilus Influenza type B.
    • Sub-national coverage includes Rotavirus diarrhoea, Pneumococcal Pneumonia, and Japanese Encephalitis, with ongoing expansion for Rotavirus and Pneumococcal Conjugate vaccines, and JE vaccine provided only in endemic areas.

Conclusion:

As India reflects on five decades of the EPI, it is imperative to envision the future of immunization efforts. By expanding coverage, addressing inequities, and embracing new strategies, India can further strengthen its immunization program and ensure the health and well-being of its population for generations to come.