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Could The Government Have Learnt From The Polio Vaccine Program? Yes. Did It? No

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This post is a part of YKA’s dedicated coverage of the novel coronavirus outbreak and aims to present factual, reliable information. Read more.

As the second wave of Coronavirus hits India hard, leaving citizens to scramble for beds, oxygen, and other resources as the preparation by the government for this wave was woefully inadequate (read: non-existent). As of now, nearly one in two COVID cases and one in four deaths worldwide are being reported from India. The only hope that remains for COVID to be successfully and sustainably held at bay is vaccinating most of the Indian adult population. 

Banquet Halls Converted Into Covid Care Centre In Delhi
Hospitals and COVID centres are quickly running out of beds. (Photo by Mohd Zakir/Hindustan Times via Getty Images)

The vaccination rate has slowed down in Phase 3, where those between 18-45 were supposed to be vaccinated beginning from May 1st. States such as Bihar, Madhya Pradesh, Uttarakhand, and Tamil Nadu don’t even know when they will be able to vaccinate people in this age group, and the demand far outpaces supply in every state. Adding onto this, the vaccines being produced mostly by private players such as Serum and the onus on the state to buy the vaccines, India’s COVID vaccination drive is far from ideal. 

Only 2.1% of India’s population has been fully vaccinated until now.

India’s Battle With Polio

As the government struggles to get COVID vaccinations off the ground, India’s war and eventual victory from Polio comes to mind. The current NDA government cannot shrug the responsibility from their shoulders, saying India did not have the resources or the framework for quick universal vaccination when the previous government managed to eradicate an epidemic that had plagued India since independence. India has led the world in eradicating smallpox and Polio.

Can We Even Compare The Two?

Before comparing the vaccination programs between Polio and Coronavirus, it is important to look at some arguments about differences in both the programs before comparing it. The first limited round of Polio Vaccines was introduced in 1964 in Mumbai and Vellore in 1965. WHO’s Expanded Programme On Immunisation (EPI) was implemented in 1979. However, cases only started coming down a decade later after pulse immunization was introduced, the first city to be polio-free was Vellore in 1983.

One can make the argument that Polio took many years to eradicate. While this may be true, a universal pulse polio vaccination program only came about in 2004 which also targeted marginalized communities and remote areas. Polio was eradicated in 2014, and the last known case of Polio came from Howrah, West Bengal in 2011. Therefore, the above argument against comparison does not hold so strong, as universal vaccination of Polio was a roaring success, and the government faced similar (if not more) logistical issues in vaccinating children in every corner of India.

The difference which can’t be refuted is the nature of the diseases themselves. Polio was hyperendemic in India, while Coronavirus is a global pandemic that came on suddenly. Coronavirus is also much more easily transmitted as it is airborne, while Poliovirus spread through food and water, and sometimes through saliva, and mostly in poor hygienic conditions.

While these differences are notable, they do not change the fact that Polio required universal vaccination too, much like Coronavirus and this vaccination policy was miles different from the one the government has employed for Coronavirus.

What The Government COULD Have Learnt From The Polio Vaccinations

Faced with vaccine hesitancy of enormous proportion, the problem of reaching remote areas, and a lack of distribution capabilities endemic to a developing nation the size and geographical diversity of India, the universal polio pulse vaccination program began in 2004. 

The Polio vaccination program consisted of 10 rounds made all over the country by healthcare workers, as well as Rotaract volunteers, who went house to house to administer the vaccine. Camps were also held to reduce vaccine hesitancy through awareness. 2 National Immunization Days were also held in a year, one in January and one on March 16th, National Vaccination Day.

Representational image

The Indian government’s failure to procure vaccines is coming back to haunt them.

According to the Global Polio Eradication Initiatives 2012 report in India, “ During each NID, nearly 2.3 million vaccinators under the direction of 155,000 supervisors visit 209 million houses to administer OPV to around 172 million children under 5 years of age across the country. To reach people on the move, mobile vaccination teams immunize children at railway stations, inside running trains, at bus stands, market places, construction sites, etc. Around 5 million children are immunized by transit and mobile teams during every round in UP, Bihar, and Mumbai alone.

Compare 172 million vaccinations per day where only 158 million have been vaccinated in total. What the government failed to see was that India had a broad base of Rotaract volunteers as well as a general public who had lived through a mass vaccination program. India’s current vaccination program had been completely centralized and slowed down, and once autonomy was given to the states, it also came with the financial burden of procuring vaccines. 

Polio vaccines were free for the people, procured by the centre, and distributed to the states. 

The State Of The COVID Vaccination Program

The current vaccination program is also not helped by the fact that the government didn’t pre-purchase vaccines, and didn’t buy enough once it was available. I have discussed this issue in another article I have written. The complete imbalance of demand and supply is also not helped by the fact that the Government isn’t using any of the more than 20 manufacturing facilities capable of producing vaccines, and the production is helmed mainly by private players like Serum and Bharat Biotech.

According to Immunologist Dr Chandrakant Lahariya who spoke on this topic to The Swaddle, India’s central vaccination distribution system was very strong, but this liberalization and shunting of responsibility to the states is a poor policy decision. 

They elaborate, “The childhood vaccines in India are delivered through a central-sponsored program: the central government procures the vaccine, they cover the cost of the vaccine, and the state government delivers.

While a similar approach has been followed for the target population of 45 years and older, the strategy for people between 18-44 years makes the entire drive confusing. This is also the first time state governments are expected to pay for and purchase the vaccines. The state governments have to compete to buy vaccines from the same pool from which the private sector will buy.

The other aspect is that most states have a really weak procurement system for medical supplies. All these put together, the biggest challenge is going to be the availability of the vaccine because the country definitely needs more vaccine doses than is currently available.

The current government of India has put barely any resources into reducing vaccine hesitancy, and with vaccines priced exorbitantly, this hesitancy will only increase. It has not used the community resources well such as ASHA workers, mistreating them and not paying their already minimal wages.

 In its typical “we know best/masterstroke” fashion, it has refused to learn anything from one of India’s crowning moments in healthcare and is currently busy financing research on Gayatri Mantra’s effects on COVID, and building the Central Vista instead of protecting its people.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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