While the corona vaccines for adults are a necessity, we cannot allow the regular immunisation of children to fall back either
That 23 million children worldwide missed out on the basic vaccines in 2020 is alarming to say the least. The figure, according to the World Health Organisation and UNICEF, is 3.7 million more than in 2019. The drop in childhood vaccination rates worldwide is, of course, attributed to the COVID-19 pandemic.
With all attention of governments in the developing world taken up in securing vaccines to control the coronavirus first, the immunisation of children for vaccine-preventable diseases (VPD) has been disrupted in many countries, what with the lockdowns and other measures in place to break the chain of corona infection. Even without the corona, millions of children living in conflict zones, remote, inaccessible areas and slums were already deprived of basic health and other social services, limiting their access to immunisation. According to the UN organisations, what is of particular concern is that among the 23 million children, 17 million likely did not receive a single vaccine in 2020. When children are unable to be immunised early on, the consequences can be ghastly for both the health of the individual and the well-being of the society and country at large.
There is a greater chance of a newborn getting the first dose of at least the BCG vaccine when women give birth in a clinic or a hospital, besides significantly reducing the maternal and neonatal mortality. The mothers are also likely to learn about the other vaccinations that a child must take over the weeks and months. In Nepal's case, there had been significant increase in the number of women giving birth in a health facility – by more than four times – since the year 2000 up until the start of the COV- ID-19 pandemic in 2020.
But, according to a new research published in the Lancet last year, decades of progress in maternal and newborn health is now in jeopardy because of the pandemic. With hospitals and other health facilities flooded with corona patients in critical condition, services for women had to be curtailed or shut down altogether. The immunisation drive also suffered because of the months-long lockdown last year and prohibitory orders this year, when people's movement was restricted.
The National Immunisation Programme has been a priority 1 programme of the Nepal government since its launch as the Expanded Programme on Immunisation in 1977/78. Previously, 11 antigens were provided through the national programme to eligible infants, children and mothers through 16,000 outreach sessions even in the remote and geographically-challenging terrain. The government has now added more antigens to control diarrhoea, a major killer of children in Nepal. Over the years, Nepal has been quite successful in immunising the children, and as a result it has scored a number of successes against vaccine-preventable diseases like polio, measles, rubella and Japanese encephalitis. Thus, a slackness in the immunisation programme could prove disastrous should there be an outbreak of VPDs at a time when the country is battling against the coronavirus pandemic. While the corona vaccines for adults are a necessity, we cannot allow the regular immunisation of children to fall back either.
Industrial village
The government's policies and programmes are hardly implemented as envisaged due to lack of a clear procedure, skilled human resources and technical support from the government. A case in point is the proposed model industrial village in Dhankuta, which has not come into operation despite its announcement four years ago. With a view to promoting cottage and small industries based on locally available raw materials, the government had set up an industrial village in Dhankuta five years ago.
The industrial village spread over 58 ropanis of land was set up at a cost of Rs 40 million and has 48 blocks, access road, walls, ditches and water facility.
Merely setting up an industrial village is not enough.
The villagers should be provided with the required skills and technical know-how to run a cottage and small industry. They must know how to collect the raw materials required for the production of finished goods. There are many factors that need to be considered before setting up an industry. The federal and provincial governments need to identify some select small-scale industries, which can easily get raw material from the neighbouring areas at a cheat rate so that these industries can make a profit out of them.
A version of this article appears in the print on July 22 2021, of The Himalayan Times.