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Why India Lags Behind Afghanistan and Pakistan?

Persistent socioeconomic hurdles and geographical differences impede immunization efforts, having considerable impacts on global health.

In 2023, India had 1.6 million zero-dose children, according to the World Health Organization (WHO) and United Nations Children’s Fund (Unicef) estimate of national immunization coverage (WUENIC). The country ranks among the ten worst countries for mass immunization, alongside Nigeria, Ethiopia, Congo, Sudan, Yemen, Indonesia, Angola, Pakistan, and Afghanistan.

Nigeria leads the list, with 2.1 million unvaccinated children by 2023. The situation in India’s neighbourhood is improving slightly. During this time, Pakistan had approximately 3,96,000 unvaccinated children, whereas Afghanistan had 4,67,000 in the same group.
According to WHO, zero-dose children are those who do not have access to or never receive routine immunization services.  

The global number of entirely unvaccinated, “zero-dose” children is 14.5 million, up 1.7 million from 2019.

This suggests no significant change in coverage since 2022, when the world was dealing with the aftermath of the Covid-19 pandemic. Performance has not yet been returned to the 2019 levels, which serve as the baseline for the Immunisation Agenda 2030.Unvaccinated children in crisis contexts.

The fact that zero-dose children are predominantly from fragile, conflict-affected, and vulnerable (FCV) countries and territories is concerning.
Around 55% of unvaccinated children live in 31 countries with FCV settings, despite these nations accounting for only 28% of the worldwide birth cohort. 

  Many of these countries have also seen alarming reductions in immunization rates since 2019. The bubbles’ size is proportionate to the number of unvaccinated youngsters in each country.Measles vaccination gaps

Furthermore, 55 percent of youngsters in ten nations did not receive a measles vaccine. Three of these also rank among the ten countries with the lowest MCV1 coverage.
In India, almost 1.6 million people have not received a single dose of measles vaccine. Only two nations, Nigeria and the Democratic Republic of the Congo, have more than two million children who have not received the measles vaccine, after India. Pakistan and Afghanistan rank higher on the list, with 1.1 million and 6,37,000 “measles zero dose children” respectively.HPV vaccination coverage surges

The HPV vaccine coverage, however, does not follow the same pattern. Its coverage has nearly returned to pre-pandemic levels in some countries, with approximately 37 countries beginning to use a single-dose regimen, both in higher and lower socioeconomic settings.
Global HPV coverage among girls has increased, owing primarily to new launches and programme extension, as well as hopeful signs of recovery in current programmes.
High dropout rate remains.

According to the survey, almost 13% of children do not complete the full prescribed timetable, resulting in a high dropout rate.

The Americas is the only territory that outperformed the end-of-year targets. All other regions have zero-dose youngsters who exceed their intended trajectory.The Immunization Agenda 2030 encourages all nations to reduce the number of zero-dose children in 2019 by half by 2030.

However, it is critical for countries to recognise that a single-minded concentration on zero dose (DTP1) does not guarantee complete immunization. The individual may still be susceptible to other antigens, necessitating a strong immunization push.   

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Source: Business Standard

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