In my years as a paediatrician, I have watched vaccines transform children’s lives. A child who would once have been paralysed by polio, or killed by measles, now grows up healthy. That transformation did not happen by accident. It happened as India decided, decades ago, to build one of the world’s most ambitious and resilient immunisation programmes, and then it kept building. What is less well known is that India now does the same for children far beyond its own borders. We are not just vaccinating India. We are vaccinating the world.
India is the world’s largest vaccine manufacturer by volume. It produces over 60 per cent of global vaccine supply. It meets 55-60 per cent of Unicef’s vaccine needs, 99 pc of WHO’s demand for DPT vaccines, and supplies over half the world’s BCG vaccines. These are not abstract statistics. Behind every dose is a child somewhere in Africa, Asia or Latin America who will not die of a preventable disease. Factories in Pune, Hyderabad and Chennai are producing vaccines that support public health systems across the world.
At home, the results are just as striking. Full immunisation coverage has increased to 93.5 pc nationally, a gain of nearly 30 percentage points in a decade. The programme reaches 2.6 crore infants and 2.9 crore pregnant women every year through over 1.3 crore immunisation sessions.
Children who were once entirely missed by the system, the so-called zero-dose children, now account for just 0.06 pc of the number of children born each year. The number of children born in India each year exceeds the entire population of New Zealand and Australia combined. Even a one per cent gap here is hundreds of thousands of unprotected children.
The numbers tell only part of the story. I think of the children I used to see in the clinic who no longer arrive with vaccine-preventable conditions that used to be routine. Neonatal death (within the first 27 days) has fallen from 26 to 19 per 1,000 live births since 2014. Under-five deaths have dropped from 45 to 31. India eliminated polio over 15 years ago and has eliminated maternal and neonatal tetanus too. These are not small achievements; but the result of an unbroken chain, including ASHA and district health workers who reach families in every corner of the country. Their work is the foundation on which everything else rests.
India is now looking ahead. It is advancing a malaria vaccine with the capacity to reach 100 million doses a year, priced under $4 a dose, specifically to make it accessible to poorest countries. An indigenous dengue vaccine is in Phase 3 trials. These are not just domestic health priorities. They are part of India’s broader role as the “pharmacy of the world”, producing affordable vaccines. For a paediatrician, this is the most exciting development of our generation: the country that once struggled to vaccinate its own children is now designing vaccines for children everywhere.
Nothing demonstrated this more vividly than the Covid-19 pandemic. When the world desperately needed vaccines, it turned to India. The Serum Institute scaled up Covishield at breathtaking speed. Bharat Biotech developed Covaxin, the first indigenously-designed Covid vaccine, through domestic science developed by the Indian Council of Medical Research (ICMR). As India was vaccinating over a billion of its own people, it still managed to export more than 300 million doses globally. Of these, 52 million doses went through the COVAX alliance to low-income countries, and 15 million were gifted to neighbouring nations under the Vaccine Maitri initiative. India did not step back when the world needed it most. It stepped up. That is what “India for the world” looks like in practice.
What often goes unrecognised is the quiet infrastructure that makes all of this possible. Vaccine manufacturing at India’s scale doesn’t happen through improvisation. It rests on decades of investment in scientific institutions, skilled workforces, and regulatory frameworks. The Central Drugs Standard Control Organisation has steadily strengthened its oversight capacity, allowing Indian-made vaccines to meet international quality benchmarks. Training programmes for virologists, immunologists and bioprocess engineers have created a talent pipeline that sustains innovations across generations. This is the less visible side of India’s vaccine story, not the headline numbers, but the institutional depth that makes those numbers commendable. It’s that depth which made India indispensable to global public health.
This global role also brings with it a responsibility that extends beyond manufacturing volumes. As demand for vaccines grows across low- and middle-income (LMIC) countries, the need is not only for supply but for reliability, affordability and trust. India’s comparative advantage has been its ability to deliver all three at scale, often under tight timelines and cost constraints. But sustaining this position will require continued investment in research and development, regulatory systems that can keep pace with innovation, and stronger partnerships with global health agencies to ensure predictable demand and financing. It will also require continued focus on last-mile delivery, both within India and in partner countries, where health system constraints can limit the impact of even the most effective vaccines. At a time when misinformation can undermine decades of progress, protecting public confidence in vaccines is as critical as producing them. India’s credibility in this space has been built over decades and is one of its most important contributions to global health.
The 2030 goal of universal immunisation is within reach, but only if the world’s vaccine manufacturing backbone holds. That backbone is India. The challenge ahead is to close the final gaps in coverage, to keep vaccine confidence strong in a world awash in misinformation, and to continue supplying the world with affordable, quality vaccines while our own children benefit too.
What India has built is not just a national achievement. It is a global one.
Dr Naveen Thacker is executive director of the International Paediatric Association (IPA), and was the first paediatrician from India to serve as IPA’s president (2023-2025)
