Are immunization policies sustainable in the Indian context? Insights into wastage and inefficiencies

Immunization programs globally have played a pivotal role in reducing mortality rates. However, the effectiveness of these programs often falls short of the intended coverage targets, primarily due to challenges within the supply chain, storage facilities, and distribution processes. Notably, a substantial percentage of vaccine wastage has been observed in numerous countries, thereby imposing a significant financial burden on immunization initiatives, and presenting a formidable challenge to policymakers. This paper undertakes a comprehensive study of the financial dynamics inherent in an immunization program within the context of India. Employing a systems perspective, we scrutinize the intricate interactions among various cost factors. Through a five-year system dynamics simulation, we derive insights into the amplified financial constraints resulting from vaccine wastage and the inefficiencies associated with shared personnel. Furthermore, our analysis extends to evaluate the impact of an additional investment aimed at enhancing the quality of the cold chain infrastructure and health worker proficiency on the overall funds of the immunization program. This research contributes to a nuanced understanding of the financial intricacies of immunization programs, offering valuable insights for policymakers and stakeholders seeking to optimize program efficiency and resource allocation.