In the Changlang district of Arunachal Pradesh, a state in northeastern India, a unique collaboration is taking place between the health and wildlife departments. They are using elephants to carry vaccinators and lifesaving vaccines to protect human children living in hard-to-reach hamlets across the Noa-Dihing river. The river is often flooded during the monsoon season, making it difficult for health workers to access the remote villages.

The initiative is part of the alternative vaccine delivery microplanning for routine immunization in the district, which also uses rowboats and drones to transport vaccines. The aim is to ensure that no child is left behind and that everyone, everywhere, at every age, fully benefits from vaccines to improve health and well-being.

A global vision for immunization

The elephant vaccine delivery is aligned with the Immunization Agenda 2030 (IA2030), a global vision and strategy for vaccines and immunization for the decade 2021–2030. The IA2030 was endorsed by the World Health Assembly, with the support of countries and partners, to address the challenges posed by infectious diseases and capitalize on the opportunities to meet them.

The IA2030 envisions a world where everyone, everywhere, at every age, fully benefits from vaccines to improve health and well-being. It aims to maintain hard-won gains in immunization, recover from the disruptions caused by COVID-19, and achieve even more – by leaving no one behind, in any situation or at any stage of life.

The IA2030 has seven strategic priorities, such as strengthening immunization programmes for primary health care and universal health coverage, increasing commitment and demand for immunization, improving coverage and equity, integrating immunization with other health interventions, responding to outbreaks and emergencies, ensuring supply and sustainability, and fostering research and innovation.

A local impact for health and well-being

The elephant vaccine delivery is making a positive impact on the health and well-being of the communities living in the Changlang district. The district has a population of about 150,000, mostly belonging to the Chakma, Tangsa, and Singpho ethnic groups. The district also hosts the Namdapha National Park and Tiger Reserve, which is home to diverse wildlife, including eight forest elephants.

The forest elephants are provided by the Department of Environment and Forest, Namdapha National Park and Tiger Reserve, to the Department of Health in the Miao sub-division in Changlang district. The elephants also carry food rations and medicines to areas cut-off during floods, and help in forest patrolling and protection activities.

The vaccinators are accompanied by the WHO National Public Health Support Network (NPSN) team, which is providing technical and monitoring support for routine immunization and vaccine-preventable diseases to the Government of Arunachal Pradesh, with a special focus on strengthening services in hard-to-reach areas.

The vaccines are administered at the Ayushman Bharat Health & Wellness Centre Deban (AB-HWC), which serves 929 households with a population of 4936. The AB-HWC has improved the access and quality of health services for the communities, by providing electricity, tap water, network connectivity, and an ambulance service. The AB-HWC also has three Accredited Social Health Activists (ASHA) who go house-to-house to mobilize mothers to bring their children for immunization.

The immunization programme covers nine diseases – diphtheria, pertussis, tetanus, polio, measles, rubella, severe form of childhood tuberculosis, hepatitis B, and meningitis and pneumonia caused by hemophilus influenza type B. The programme also plans to introduce vaccines against rotavirus diarrhoea, pneumococcal pneumonia, and Japanese Encephalitis in the near future.

A story of courage and compassion

The elephant vaccine delivery is a story of courage and compassion, of how humans and animals can work together to overcome challenges and save lives. It is a story of how a global vision can be translated into a local action, and how immunization can be a catalyst for health and development.

The story also highlights the role of women in immunization, as mothers, ASHA workers, and Auxiliary Nurse Midwives (ANM). They are the ones who ensure that their children are protected from vaccine-preventable diseases, and that their communities are empowered to demand and access quality health services.

The story also showcases the potential of innovation and technology, such as drones and digital tools, to enhance the efficiency and effectiveness of immunization programmes. These innovations can help reach the unreached, monitor the progress, and ensure the quality and safety of vaccines.

The elephant vaccine delivery is a testament to the power of vaccines to fight disease, save lives, and create a healthier, safer, and more prosperous future for everyone, everywhere.