Editorial 1 : Make EPI an ‘Essential Programme on Immunisation’
Context:
In the 50 years of the Expanded Programme on Immunization, it is time for another expansion.
Expanded Programme on Immunization (EPI)
- The year 2024 commemorates 50 years since the launch of the Expanded Programme on Immunization (EPI) by the World Health Organization (WHO) in 1974.
- The EPI was introduced as the eradication of smallpox virus was on the horizon, and a need to leverage the then immunisation infrastructure and a trained workforce was recognised to expand the benefit of available vaccines.
- India launched the EPI in 1978, which was later renamed as the Universal Immunization Programme (UIP) in 1985.
- In India, this year is also two decades since the country conducted the last nationwide independent field evaluation of the UIP, in collaboration with international experts.
- Globally, and in India, there has been significant progress in terms of the impact of immunisation and vaccines.
A success story
- The children with three doses of DPT, a tracer indicator of coverage, has been rising over these years.
- In the early 1970s, around 5% of children in low- and middle-income countries had received three doses of DPT, which increased to 84% in 2022 at the global level.
- Smallpox has been eradicated, polio eliminated from all but two countries and many vaccine preventable diseases have nearly disappeared.
- In India, the coverage has increased every passing year and in 2019-21, 76% of children received the recommended vaccines.
- Moreover, in mixed health systems with both the public and private sector delivering services, immunisation often remains the only health intervention with greater utilisation from the government sector.
- For instance, in India, the share of the private sector in overall health services is nearly two thirds; however, nearly 85% to 90% of all vaccines are delivered from government facilities.
- It In early 2023, the UNICEF’s ‘The State of the World’s Children’ report revealed a concerning trend: for the first time in more than a decade, the childhood immunisation coverage had declined in 2021.
- But, over the years, the vaccination coverage in India has increased, both nationally and State-wise.
- However, there are persisting inequities in coverage by geography, socio-economic strata and other parameters, which demand urgent interventions.
From childhood focus to life course
- When it comes to vaccination, people often (and wrongly) believe that the vaccines are only for children only.
- But the first anti rabies vaccine, cholera, and typhoid vaccines developed between 1880s to mid 1890s were primarily for adults
- The first vaccine ever developed in any part of the world against plague (in 1897) was from India and meant for individuals across all age groups.
- This history clearly illustrates that vaccines have always been intended for individuals of all age groups.
- However, considering that children are most vulnerable from vaccine-preventable diseases, they have rightly been prioritised for vaccination.
To do’s for government
- It becomes imperative that government policies now focus on the vaccination of adults and the elderly, as well, as is happening in many countries.
- First, there are some initial policy and technical discussions regarding expanding immunisation coverage in additional populations. The recent announcement on HPV vaccines for teenage girls is a good start.
- Considering that vaccines are highly cost effective, once recommended by the National Technical Advisory Group on Immunization (NTAGI), vaccines for all age groups should be made available as free at the government facilities.
- Second, the NTAGI in India, which provides recommendations on the use of vaccines should start providing recommendations on the use of vaccines in adults and the elderly.
- Third, the prevailing myths and misconceptions about vaccines must be proactively addressed to tackle vaccine hesitancy.
- Fourth, various professional associations of doctors — community medicine experts, family physicians and paediatricians should work to increase awareness about vaccines among adults and the elderly.
- Fifth, medical colleges and research institutions should generate evidence on the burden of diseases in the adult population in India.
Way forward
- Expanding coverage of vaccines for adults and the elderly may result in improved coverage with childhood vaccines and reduced vaccine inequities.
- In the 50 years of the EPI, it is time for another expansion of the programme with focus on zero dose children, addressing inequities in vaccine coverage and offering vaccines to adults and the elderly.
- It is time to make EPI an ‘Essential Program on Immunization’.
Editorial 2 : Microbes, not fossil fuels, produced most new methane: study
Context
A modelling study has found methane emissions from fossil fuels declined between 1990 and the 2000s and have been stable since, whereas microbes have been producing more methane of late.
Evolving understanding
- Methane is the second most abundant anthropogenic greenhouse gas after carbon dioxide (CO2) but it warms the planet more.
- Over a century, methane has a global warming potential 28-times greater than CO2, and even higher over shorter periods like two decades.
- It wasn’t until recently that policymakers began to focus on methane vis-a-vis addressing global warming.
- At the U.N. climate talks in 2021, member countries launched the ‘Global Methane Pledge’ to cut the gas’s emissions and slow the planet’s warming. Yet our understanding of methane also continues to evolve.
- For instance, scientists have recently reported that microbes have been the biggest sources of methane in the atmosphere, not the burning of fossil fuels.
The sources of methane
- Scientists are increasingly recognising various sources of methane, most of which fit in two categories: biogenic and thermogenic.
- When fossil fuels such as natural gas or oil are extracted from deep within the earth’s crust, thermogenic methane is released.
- Biogenic methane comes from microbial action.
- The microbes that produce methane are archaea — single-celled microorganisms distinct from bacteria and eukaryotes — and are called methanogens.
- They thrive in oxygen-deficient environments, such as the digestive tracts of animals, wetlands, rice paddies, landfills, and the sediments of lakes and oceans.
- Methanogens play a crucial role in the global carbon cycle by converting organic matter into methane.
- While methane is a potent greenhouse gas, its production by methanogens is an essential part of natural ecosystems.
- But human activities like agriculture, dairy farming, and fossil fuel production have further increased methane emissions.
- Both biogenic and thermogenic activities produce different isotopes of methane.
Modelling with a supercomputer
- Tracking the isotopes is a way to track which sources are the most active and according to scientists, carbon-13 is key.
- If there are fewer carbon-13 atoms than a certain level in a group of 1,000 methane molecules, the methane is from a biological source.
- If the methane is from thermogenic sources, such as trapped fossil fuels or geological activities, there will be more carbon-13 atoms in 1,000 molecules.
- A team compared their own results with two emissions inventories, called EDGAR and GAINS, and found some discrepancies.
- EDGAR had reported that methane emissions from oil and natural gas exploration had increased between 1990 and 2020.
- GAINS had recorded a large “unconventional” rise in emissions since 2006. Their findings disagreed with both inventories.
Need for local data
- One possible reason could be an increase in cattle-rearing in Latin America and more emissions from waste in South and Southeast Asia, Latin America, and Africa. And number of wetlands worldwide had increased as well.
- Studies in the past have pointed to microbes like anaerobic archaea as potentially top contributors of atmospheric methane using satellite data.
- But according to scientists, Most studies that use satellites cannot measure the actual [changes over time] of methane.
- Satellite data is interpreted using models and thus are prone to uncertainties.” He said ground models are required to confirm these interpretations.
Conclusion
The only way is to reduce methane. For that, anthropogenic activity should be first controlled. Waste and landfills, rice fields, enteric fermentation, oil and gas are the majority of it.