A moment to savour for India’s public health system

A year after the launch of the COVID vaccination drive, a look at the challenges that were overcome

January 16, 2022 12:42 pm | Updated 12:57 pm IST

Students pose for photographs after COVID 19 vaccination at a school in Kochi.

Students pose for photographs after COVID 19 vaccination at a school in Kochi.

One year, 156 crore vaccinations — this is the extraordinary achievement of “Team Health India” in the face of many challenges.

Ahead of the launch of the world’s largest vaccination drive on January 16, 2021, there had been several questions: Will the vaccines be available as per the needs of the country? Is there adequate transport and storage capacity? Can the required manpower be trained in time? How will vaccine hesitancy be addressed? How will the vaccines reach far flung regions?

However, “Team Health India” had on its side years of experience running the National Immunization Programme, particularly the more than 25 years of administering polio drops to almost 10 crore infants within a short span of time during Pulse Polio campaigns. The experience of storing vaccines at more than 29,000 cold chain points and reaching them to far flung areas with consistency also came to the team’s aid, as did the experience of implementing ‘Mission Indradhanush’ strategies to mop-up and vaccinate left-out children and expectant mothers. India had also successful implemented monitoring of storage and distribution of vaccines as per prescribed standards through e-Vin (Electronic Vaccine Intelligence Network). This, and Prime Minister Narendra Modi’s backing, became the greatest strengths of “Team Health India”.

To resolve the issues facing the vaccination drive, the Ministry of Health & Family Welfare in the Government of India, the Health Departments of the States and Union Territories, the non-government organisations working in the health sector, international organisations, among others, participated in marathon meetings, not only ideating and consulting on various aspects of the vaccination drive, but also forming strategies and guidelines.

Ahead of the launch of the world’s largest vaccination drive on January 16, the basic guidelines and training for the vaccination campaign had been completed. The operational guidelines for COVID vaccination were ready, as was manpower for carrying out the vaccination. The systems for reaching the vaccines safely to the vaccination centres and extra storage capacities were in place, along with a communication strategy to address vaccine hesitancy. The CoWIN platform to collect vaccination details in a digitised system was another key factor in place. A ‘dry run’ was also carried out in all States and Union Territories to ensure readiness.

Personally, I recall the experience of the night of January 15. It was a tense one, with CoWIN teams in thousands of COVID vaccination centres across all States and Union Territories and teams stationed in State and Central headquarters awake the entire night. There was a technical issue to be resolved for which everybody had to be on vigil. There was anxious anticipation and a deep sense of satisfaction as the glitch was resolved and CoWIN kicked off on time.

This was just the beginning. In the first phase, vaccine availability was limited and expectations were high. Rationalised distribution of the limited number of vaccines posed a big challenge not only for the Centre, but also at the level of States and districts. In such circumstances, criticism was inevitable. To overcome this, there were virtual meetings for hours on end every day with vaccine manufacturers, vaccine transport agencies, storage centres, cold chain points and COVID Vaccination Centres. The aim was the use of every drop of the available vaccines as optimally as possible.

Getting the vaccines to the far-flung areas of the country and administering them required some Indian ingenuity. Where there was no road, cycles were used; in the desert regions camels came to the rescue; in the hills, the vaccine were carried on backs. People were invited for vaccination with offers of turmeric rice. For those hesitant to take the vaccination, ‘Har Ghar Dastak’, or door-to-door calls, was done. The team kept learning and adapting from the experiences gathered from the field, improving the programme much like ‘building the ship while sailing’.

“Team Health India” members often had to put their personal lives on hold and suffer the loss of dear ones to COVID-19. Despite that, there is great pride in having served the nation in a moment of crisis. What I write here is but the tip of the iceberg; for “Team Health India”, there are countless moments of struggle and satisfaction, examples of humanitarianism, and experiences that impart a deep sense of gratitude and hope.

To conclude, I would like to remind that health is considered a ‘public good’ and in the story of the COVID vaccination drive in India, the role of the government machinery in delivering this has been further embellished.

(Dr. Manohar Agnani is Additional Secretary in the Ministry of Health and Family Welfare and the nodal officer for the COVID-19 vaccination drive. The views expressed here are personal. )

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