The first challenge for the Mission on Immunization wasn’t technological per se, it was infrastructure-, supplies- and decision-making-related. India’s record of childhood immunization was abominable. A large percentage of the children had never been immunized against measles/mumps/rubella. But polio was then a much graver problem. In 1987 India had the largest number of polio patients in the world. Polio vaccines had been around for over thirty years, and we had still not been able to accomplish anything close to universal immunization. It was a national disgrace.
There was one simple bottleneck with regard to the polio issue—an ongoing conflict between those who wanted to use the Sabin oral vaccine and those who favoured the Salk injected vaccine. The two camps of physicians and medical scientists were fighting it out in public. The citizens, of course, had no idea what to think. Everyone was confused, and meanwhile parents lived in fear over their children’s health.
When we understood what was going on, I called a meeting of seventy of India’s top immunization people. Jairam and I met with the assembled experts in Delhi. I told them, ‘We have three days. We won’t be leaving this place until we can tell the nation what our stand on the polio vaccine is. Are we going to go with oral vaccines, or the injected variety? But we need one voice. I‘m not qualified, you are qualified. Now you have to decide.’
Dr Jacob Jones was an expert on vaccines, and he provided the necessary leadership during these difficult discussions. Everyone decided, finally, that oral immunization was preferable. The problem here was that the oral vaccine is a lower-virulence live-virus vaccine, which means it needs to be kept cold during transportation and storage. It requires what is called ‘cold chain’ handling, which mandates the use of cold-chain equipment. But how do you get refrigeration into every part of India? So I called a meeting of industrialists at CII (Confederation of Indian Industries). The whole logistics of the cold chain had to be worked out.
And they did work it out. It took time to get everything in place and start immunizing, but the process worked its way through until almost every Indian child had been immunized. And in 2013, twenty-five years after our intervention, India was finally declared polio-free.
The immunization intervention had other consequences as well. In 1987, when the Technology Missions were launched, India had zero polio-vaccination production capability. I wondered then: How is it that India has the world’s largest number of polio patients and perhaps the world’s largest population of children with polio, and we don’t produce a polio vaccine?
No one had an answer to that, so we did the research and I went to the prime minister. I told him it would cost us up to 300 million dollars to establish proper polio-vaccine production. When he approved the initiative, we sent teams to France and the USSR to study their methods. After that we drew up plans and the government made the investment. In a few years the company that had been established under the science and technology ministry was blending and producing all of India’s polio vaccine indigenously.
In fact, some of the problems addressed by the Technology Missions were as much societal as they were specifically technological—immunization, for example, and literacy. These areas often required a driving hand with strong political backing to break logjams and create new procedures. In a broad sense, creating new processes to solve problems was itself a kind of technology, at least according to my definition. In my view, ‘technology’ encompassed the design of new production systems as well as breakthroughs or advances in hardware. Technology is not merely a device or a gadget. It is, at its heart, a way to solve a problem, whether it involves software or hardware.
The Mission on Literacy illustrated that. New devices were helpful here. We developed and put into production a solar-powered lantern, so that people in areas without electricity would be able to read and perform all their other functions at night with ease. We designed and produced plastic blackboards that performed much better than the traditional models and didn’t use up wood resources. But improving literacy was not primarily technological in that sense. Instead, it had to do with motivating people and providing training and materials—but most especially, it was about motivating people.
Vastly improved literacy (and numeracy) was crucial to India’s socio-economic development. But it was also a prodigious challenge. When the Technology Missions got under way the country’s literacy rate was at just about 50 per cent. Several hundred million adults were illiterate, the majority of them women.
The question was—What is the best way to attack this? Children were being taught to read in schools, but adult education depended on, first, motivating people to learn and, second, providing teachers and study materials. With such vast numbers, it was clear to me that some kind of mass mobilization was necessary, which was not something the education department was set up to do. The plan of action now included launching literacy campaigns throughout the countryside. We set up organizing committees and created a massive volunteer effort. We sent street theatre, acting, circus and music troupes into villages, endeavouring to teach whole populations about the importance of literacy in an entertaining, appealing manner. We wanted them to know what being able to read could mean for people’s economic lives and well-being.
With over 2 million committed volunteers, we flooded rural India with information. We set up continuing-education programmes in hundreds of districts. We made tremendous progress. In our initial years we began cutting substantially into the illiteracy rate. In 1989, two years after we established our campaigns, the Technology Mission on Literacy was awarded UNESCO’s coveted Noma Literacy Prize. After the first year we understood a good deal about how to communicate to people the importance of literacy, and also how to teach reading to adults. At that point we began exploring how to grow and sustain these efforts.