Sustaining Access to Vaccination in India (SAVI)

Challenge

Historically, new vaccine introduction in India’s Universal Immunization Programme (UIP) was not prioritized and there was little public engagement. However, the UIP has recently seen unprecedented momentum in new vaccine introductions, with a focus on improving coverage and strengthening immunization systems. In 2015, India completed its phased rollout of Hib-containing pentavalent vaccine and launched inactivated polio vaccine, followed by the introduction of rotavirus vaccine (RVV) in 2016 and both measles-rubella and pneumococcal conjugate vaccines (PCV) in 2017. Many vaccines that were initially introduced sub-nationally are now being expanded. In a significant shift from the previous approach where vaccine introduction was prioritized in settings with strong systems, the government has also prioritized the introduction of some new vaccines in high child mortality settings. On top of this, the Government of India has committed to reaching 90% full immunization coverage by December 2018 and the conversation has shifted from focus on vaccine controversies to one that touts the value of immunization and benefit to families, communities, and the economy.

Despite these important positive developments, several challenges—shifts in the political and economic landscape, India’s upcoming transition from Gavi new vaccine introduction support in 2021, and a resurgence of anti-vaccine voices in India and faltering public confidence in vaccination in some small pockets—present a potential risk to India’s immunization gains and program sustainability. Strong, independent institutions in India that can systematically synthesize evidence, analyze policies, and present data to inform evidence-based, equity-driven vaccine introduction and scale-up can help ensure momentum and increase the probability of success.

Approach 

Since 2010, IVAC has partnered with Global Health Strategies to build and sustain an enabling environment for immunization in India. Our work focused on advancing the case for Hib/pentavalent vaccine, PCV, and RVV introduction by synthesizing evidence and building technical and advocacy capacity amongst key stakeholders, engaging champions to communicate the value of vaccines; and supporting efforts to ensure sustainable immunization financing.

In 2017, we began a new multi-year phase of this initiative which aims to:

  • support the scale-up of recently introduced vaccines (RVV, PCV) and build a conducive environment for evidence-based decision-making for and introduction of other new vaccines
  • strengthen and institutionalize the technical capacity within India to support evidence-based decision-making and timely, financially sustainable, and equitable vaccine rollout in India
  • develop and implement strategies to address misinformation around vaccines, promote vaccine equity, and build vaccine confidence across different stakeholders
  • facilitate the development of policies and guidelines for financial sustainability for the immunization program at the center and in select states