The highest attainable standard of health for all people of all countries. Reliable data are vital for assessing whether we are making progress towards that vision, for highlighting areas of progress and for exposing where we need to change course. Health trends are constantly evolving, and so are health systems. No health system is perfect, and all countries have people who are left behind. It is therefore important to accurately document the state of global health and how it is changing.

India has made rapid strides in the health sector since independence. However, various eye opening data from NFHS clearly indicate that access to healthcare still remains a challenge.

While the health statistics of rural India continue to be poor, the health status and access to health for the poor in urban slum dwellers has surfaced to be equally deplorable and have less than 4% of government primary healthcare facilities.

Urban slum dwellers suffer from adverse health conditions owing to mainly two reasons –first the lack of education and thus lack of awareness; and second the unwillingness to lose a day’s wage in order to reach the nearest medical facility. Healthcare for underprivileged, which is a desperate need, thus remains unaddressed.

In its 2019 new year message, WHO has named vaccine hesitancy as one of the world’s top 10 global health threats, alongside air pollution and climate change, non-communicable diseases, global influenza pandemic, fragile and vulnerable settings, antimicrobial resistance, Ebola and other high-threat pathogens, weak primary health care, Dengue and HIV.

When you look at the list, vaccine hesitancy is directly related to most of them, with available vaccines for flu, Ebola (albeit still not registered), Dengue (with all its struggles), and HIV (in trials). The threats of fragile and vulnerable settings and weak primary health care both affect hesitancy given low confidence in the system or anxieties in conflict settings. And, as for antimicrobial resistance, we need vaccines more than ever as we are faced with antibiotics that no longer work.

While it is a stretch to relate vaccine hesitancy to air pollution and climate change, climate change will be changing disease vectors and vaccine needs, so vaccine confidence will again matter to mitigate hesitancy.