Ankita has over 14 years of experience in sustainable development, digital inclusion and ESG advisory. An electronics and communications engineer, she started her career with research management in the telecom sector in New Delhi in 2008. Ankita is a 2013 alumna of the Indian School of Business. Ankita engaged in a conversation with India Pharma Outlook magazine in order to state the importance of last mile delivery of vaccines in India.
With the vastness and richness of diversity in India, it is necessary and challenging for every nook and corner of the country to have access to healthcare services, especially life-saving vaccines. Adequate distribution of vaccines, particularly across geographically and socio-economically disparate areas, is vital to averting outbreaks and avoiding the loss of lives caused by preventable diseases. In this article, we discuss the importance of last-mile vaccine delivery in India and underline its crucial role in public health management.
The "last mile" of vaccine delivery refers to the final leg of the vaccine's journey from the national storage facilities to remote and hard-to-reach communities. In other words, this is the most critical juncture, where problems such as the lack of infrastructure, health facilities, or logistics are traditionally the most chronic. Despite these, India has made substantial headway in improving last-mile vaccine delivery, as reflected in its achievements, such as eradicating Polio and a 90% reduction in maternal and neonatal tetanus.
The country's vast immunization coverage network has displayed a laudable performance. According to the Ministry of Health and Family Welfare, DPT (Diphtheria, Pertussis, and Tetanus) vaccine coverage has risen from 52% in 1992 to over 90% in recent times.
However, the systemic improvements and enhanced services are still unable to fill the gap to the last mile. This can be seen across different regions of India, including rural areas and a few states, where the National Family Health Survey (NFHS-5, 2019-2021) finds high variations in immunization coverage rates.
For example, in the case of vaccination, states like Kerala and Tamil Nadu have surpassed the national immunization rate, yet many fall below the national average in this respect, such as Uttar Pradesh and Madhya Pradesh.
Usually, marginal and remote communities end up being the most underserved groups when it comes to public health infrastructure - hence, ensuring that these groups have access to essential healthcare services becomes ever-important. As a part of equitable healthcare access, last-mile delivery ensures the vaccines reach the population to its last segment, irrespective of geography or socio-economic strata.
Last-mile delivery also assumes critical significance in more ways than only for disease eradication - it is an essential step to enable the healthcare authorities to take control of diseases and outbreaks. An example of India's success in this aspect is the Pulse Polio Immunization (PPI) program, which has seen the country free from Polio since 2014.
In addition to improved public health, proper immunization also creates a positive economic impact resulting from the saved health costs and avoided productivity losses, contributing to economic stabilization and growth. The socio-economic benefits of preventive healthcare underline the utmost importance of "last-mile delivery" for India.
The national immunization program in India provides immunization to 26 million new-borns and 29 million pregnant women every year, making it one of the most extensive immunization programs in the world, as per the World Health Organization (WHO).
However, the gigantic task of undertaking the last-mile delivery of vaccines in India is fraught with many geographical challenges. Some of these include the rugged terrains of the Himalayas, the remotest of islands in the Sundarbans, and the dense forests of Central India. In addition to the topographical diversity, other barriers to immunization coverage include vaccine hesitancy and cultural taboos among communities.
To address these challenges, India has implemented several innovative strategies ranging from improvements in the cold chain infrastructure that assure vaccine efficacy during transportation and storage to fostering collaborations with NGOs, international organizations, and the private sector to expand the reach of essential health services to all corners of the country.
Immunization programs increasingly integrate technologies, such as GPS tracking and data analytics, to optimize delivery routes and monitor vaccine stocks in real-time. In addition, community awareness campaigns and sensitization of community health workers to address vaccine hesitancy and cultural barriers will further strengthen the country's healthcare efforts.
While challenges remain, India's innovative approaches and commitment to improving last-mile vaccine access promise a healthier future for its people. The lessons learned, and successes posted by India offer valuable learning for countries and global health initiatives keen on ensuring no one is left behind in the war on preventable diseases.
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