The Introduction of New Health

Technologies in India
India’s experiences in adopting other health technologies can help to guide planning for broad access and rapid
uptake of an AIDS vaccine.

With an estimated 5.2 million people living with HIV/AIDS, India has one of the highest numbers of
infections in the world. While the Government of India (GOI) has implemented a number of prevention and
treatment strategies, much more remains to be done. The development of a vaccine is recognised as the best
long-term hope to end the AIDS pandemic, but it may be many years before the goal of developing an
effective AIDS vaccine is realized. However, steps can be taken today to implement mechanisms to maximize
the benefits of an AIDS vaccine once it becomes available.

To address the question of what it would take to Figure 1. Factors influencing introduction of new technologies
adopt and implement AIDS vaccines in India, IAVI
reviewed the experience of other health technologies:
hepatitis B vaccine, the Universal Immunisation
Programme (UIP), no scalpel vasectomy (NSV),
voluntary counselling and testing (VCT), and
antiretroviral treatment (ART). These were chosen
because they offer valuable lessons that could be
applied to AIDS vaccines in India. The analysis relied
on data from literature reviews, national datasets,
international health agency reports, and interviews
with field experts.

Key issues in the introduction of new health

technologies

Key issues in the introduction of new health

technologies include the formal decision by the
government to approve a product of service and the
process implementing that decision. Prior health
technology experience has helped identify specific
factors influencing those decisions and processes.
Figure 1 outlines some of the social, political, and
economic factors that influence the process of health
technology adoption, implementation, and uptake.

Introducing an AIDS vaccine in India

India’s healthcare system faces a number of

challenges that may impede the introduction of new
health technologies: the size of the country, limited
financial resources, differences in health status across
states, inadequate surveillance systems, and gaps in manpower and infrastructure. Introduction of an AIDS
vaccine may pose additional challenges. These include stigma and discrimination that will affect both
political decisions and programme implementation, the potential disinhibition effect of partially effective
vaccines, the marginalization of key target groups, making them difficult to reach, and the need for delivery
systems that are separate from traditional childhood immunisation programmes.
Despite the potential challenges to introducing AIDS vaccines in India the past experiences of other health
technologies suggest that steps can be taken now to facilitate the adoption/implementation process. These
actions include:

ƒ Improving data and information available for decision-making and generating political and financial
support. This can be done through research on incidence and prevalence, expected impact of a vaccine,
social science research and cost-effectiveness analyses of the vaccine and its delivery mechanisms.

ƒ Clarifying roles of stakeholders and partners. This should include the private sectors along with central,
state and local governments. Both NGO and commercial sectors have demonstrated their capacity to reach
those not covered by government services for AIDS-related products and programs, and plans to include
them in an overall vaccination strategy should be developed as early as possible, especially if an AIDS
vaccine is directed at marginalized groups. Experience with other technologies demonstrated that mapping
out roles and responsibilities of different government layers could also be beneficial.

ƒ Assessing infrastructure needs for delivering an AIDS vaccine in advance. There may be opportunities to
leverage existing networks to capture significant synergies in HIV/AIDS services, including the current
network of VCT and ART centres.

ƒ Securing political and financial commitment to implement an AIDS vaccine program. Ensuring the
availability of national and international financing is important, as is the government’s ability to negotiate
affordable prices. It will also be critical to find national champions to provide leadership and political
support for such a program.

Several factors provide a positive outlook for the future adoption of an AIDS vaccine in India. There is
strong political support for AIDS vaccine research, and growing awareness of the threat of HIV/AIDS and the
benefit of prevention measures. A vibrant civil society sector has demonstrated its capacity to reach many
marginalized groups and to appropriately address sensitive health and social issues. There is also increasing
awareness of health care issues and growing expectations among the population about products and services
to be made available, particularly by the public sector. All of these can contribute to the successful adoption,
implementation, and uptake of an AIDS vaccine in India. Given the magnitude of the epidemic in India, and
indeed, across the globe, it is critical that all possible steps be taken today to ensure that an AIDS vaccine, our
best hope for ending the epidemic, can be adopted and implemented as quickly and successfully as possible.

This summary is drawn from IAVI Policy Research Working

Paper #12, The Introduction of New Health Technologies in
India. This and other IAVI policy research publications are
accessible online at www.iavi.org.

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