Ending Endemics: My Learnings from Eradicating Polio from India

PHF Medal
PHF Medal

Background

The rumors, fake news and experts comments around Covid Vaccination has pitched. In China, the mass sentiment is that their Covid vaccine is not effective and is just a placebo. While in India there are concerns on the efficacy of the vaccines under development and their safety. As a result our Hon. Prime Minister, Narendra Modi has to address the nation around this issue. There was a similar safety concerns around the pulse polio program in Tamil Nadu and Karnataka back in 2010 which was being organized by Rotary International. A few kids has some effects from the polio drops in the adjoining district of Bangalore, Hosur in Tamil Nadu. I was part of the Rotary which was planning the campaign for polio to ensure that there was a maximum turn out. The rumours and fears of the people in Hosur would have an impact on the turn out in the bordering districts of Tamil Nadu near Bangalore.

Our Strategy and Learnings

Back then the power of social media such as Facebook, WhatsApp was not effective medium to reach to the rural masses. Our challenge was to communicate effectively with every household which had children in immunization age in our state on the safety, benefits and turning out for the polio drops. As Rotary was a not for profit organization supporting this initiative, we had limited budgets for the campaign. The jugaad we used was SMS to every mobile subscribers in the state. Airtel, Vodafone, Idea, Tata Docomo, Spice Telecom, Reliance Mobile Circle CEOs were reached out to provide pro bono three broadcast SMS, free of costs to support the Rotary Polio initiative. All the mobile operators except Reliance Mobile agreed to support the campaign. Through the broadcast SMS, we communicated with the masses on informing the safety and need for polio drops for the children; it was free of cost; inform on the date of the polio program; reminder on the polio program one day before and on the date of the program. The result of this SMS campaign was over 99% coverage and turnout in Karnataka for the polio drops for the children. While Tamil Nadu had around 80% turnout.

Armed with this information, I visited Planning Commission office in New Delhi on one of my visits and met with Dr. Salma Hamied and Dr. Jagendra Haldea. I urged them to make free broadcast SMS mandatory for polio program for all states of India through the mobile operators. This request was accepted and sent to the Ministry of Telecom and actioned immediately. Through this process, India was declared Polio free on 27 March 2014 by World Health Organisation. I was honored by Rotary International with Paul Harris Fellow Medal for organizing and pushing the campaign.

Ending Endemics of Covid in India: Getting the Covid Vaccination Program Logistics in Place

The Numbers

As per my estimate, on the demand side, around 800 million Indians will be covered in the Covid immunization program. I am assuming that there will be a boster dose also. Hence we would require around 1.6 billion in two phases along with the allied materials such as gauge, syringes, swabs, etc to be provided for distribution to every nook and crany of India. Unlike the polio drop which the Rotary volunteers could easily deliver, this program will required trained volunteers in delivering injectables. My estimate is that we would require any where between 50 million trained volunteers in injecting the vaccines throughout India. These need not be medical professionals. On the supply side of the four key vaccines under development for India, Serum Institute, Cadila, Bharat Biotech and a few others would be able to deliver around 1 billion doses through their ramped up manufacturing facilities. The issue is the last mile linkages and cold chain required to reach the masses. Around 10 key states have ready excellent cold chain and warehousing and reefer facilities. These constitute around 68% of India’s eligible population for Covid immunization by April of 2021. The challenge will be for the other states which would need to be ready by April 2021 in the cold chain logistics.  

Busting the Myths: Communication Mediums

During Covid, we have implemented Covid Bots on the National Health Mission’s program through WhatsApp. It was a struggle to get the policy change in WhatsApp as there was no such policy in WhatsApp in March 2020 at the beginning of the pandemic. India was the first country in the world to get the approval to go ahead from WhatsApp headquarters to implement such Covid Bots. I would like to personally thank WhatsApp India and Facebook India Government Affairs teams to be able to push this with their global headquarters to get a policy out and obtain such approvals for roll out of such CovidBots. These Bots can be upgraded to answers queries on the Covid Vaccine program to be rolled out in March 2021 rather than the operators replying to the queries on the normal 104 helpline. We already have the policy in place for the mandatory SMS in place. This would give us reach and coverage to around 800 million eligible population of India for the Covid immunization.   

For more details on Covid Vaccine Race and More: Please visit the Podcast Ending Endemics: The Future of Healthcare QuoteUnQuote with KK – Kapil Khandelwal (KK)

Palu Harris Fellow Medal
Palu Harris Fellow Medal

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