Editorial Simplified: A Shot in the Arm | GS – II

Relevance: GS Paper II (Development & Welfare)

Theme of the article

The under-five mortality rates have declined considerably from 126/1000 live births in 1990 to 39/1000 in 2017, much faster than the global rates. Much of this can be attributed to the successful immunisation programme in India.


Mission Indradhanush (MI), one of the largest public health programmes in the world, and one of the greatest health-related accomplishments of India , was launched in 2014.

The importance of vaccines in India

  • Around 27 million children are born every year in India.
  • India also has the largest burden of under-five mortality, more than what prevails in some of the poorest countries in the world. Nearly 39 children under the age of five years die for every 1,000 live births each year — pneumonia and diarrhoea are the leading killers.
  • Approximately 0.1 million children die due to rotavirus-induced diarrhoea alone, which is around 50 per cent of all deaths attributed to diarrhoea.
  • Unimmunised and partially-immunised children are most vulnerable to diseases and disability, and are at three to six times higher risk of death than fully immunised children.
  • A large percentage of under-five mortality in India can be averted through vaccination.

Challenges to vaccination programme

India faces a threefold challenge:

  • Low full immunisation coverage (65 per cent),
  • limited basket of vaccines and,
  • issues regarding quality and logistics of vaccine management for such a vast and diverse country.

Mission Indradhanush

  • India’s full immunisation coverage (FIC), which used to be 61 per cent in 2009, improved to 65 per cent in 2013 at a meagre increase rate of 1 per cent per year.
  • To hasten the full coverage to at least 90 per cent till 2020, the Ministry of Health & Family Welfare launched Mission Indradhanush in 2014.
  • Under this, seven vaccines would be given to all those children and pregnant women who have missed out or are left out under the routine immunisation rounds. It would cover all far-flung areas.
  • To bring sharper focus onto the least vaccinated areas, MI has been transformed into “Intensified Mission Indradhanush” (IMI) that aims to reach those rural and urban slums that have under-performed during MI. One hundred and ninety high-focus districts and urban areas across 24 states have been selected for such intensified efforts.
  • There is a sharper focus on surveillance activities and to create partnerships with states, community-level departments and ministries for grass roots implementation and monitoring.
  • Mission Indradhanush has led to an impressive increase of close to 7 per cent in full immunisation coverage in one year as compared to 1 percent increase per year in the past. This is apart from the Universal Immunisation Programme (UIP) which targets to vaccinate about 27 million children against 12 deadly diseases every year, more children than any other similar programme in the world through more than nine million immunisation sessions conducted annually.
  • It now aims to achieve 90 per cent immunisation by December 2018.
  • On a global scale, MI/IMI is meant to reduce India’s contribution to the global burden of disease, including deaths in children under five, thereby achieving SDG-3 by 2030.
  • The journey of Universal Immunisation Programme (UIP), which India embarked upon in 1985, has been further bolstered by Mission Indradhanush/Intensified Mission Indradhanush.


An immunisation programme, anywhere in the world, is the most cost-effective public health intervention. It is the basic and foremost right of children across the globe, that they receive a safe and effective “shot in the arm” in a timely manner. This is the minimum which any country must deliver to save their children from vaccine preventable diseases.