Media in the state of Kerala, India, has reported prominently another vaccine preventable death in the state. A 15 year old boy from Malappuram district was the latest victim of the lethal mix of religion, conspiracy theories and pseudoscience. He died yesterday due to diphtheria.

Diphtheria outbreaks and deaths are not a big news in rest of India. India has 10-15 times more Diphtheria cases than any other country in the World. But it is news in Kerala state as it has comparatively much better health care record. Here in Kerala the diphtheria cases and thereby deaths are extremely rare in the last 10-15 years. Average annual incidence of diphtheria was around 10 cases in the whole of the state. But last two years saw a sudden spurt of cases from Malappuram and Kozhikode districts. There were also two deaths last year.

Primary reason for the resurgence of Diphtheria was a fall in immunisation coverage percentage from 80 in 1998 to 75 in 2005.  Most recent statistics say there are around 170,000 children between 7 and 15 years in Malappuram district alone who have not been vaccinated.

Poverty, illiteracy, lack of healthcare infrastructure and staff are the reasons for poor vaccine coverage in most of the places in India. But this is not true for Kerala, as it is a fully literate state with fairly good health care facilities.

So why this fall in coverage and resurgence of diseases ?

Quacks practicing naturopathy and some homeopaths are very actively campaigning against vaccinations in certain parts of Kerala including Malappuram. Misleading articles linking vaccinations to a large number of diseases was written and widely propagated in mainstream media. Unfortunately many post modernist intellectuals including some doctors also joined the anti vaxxers camp. They feel boosting the immunity through ‘natural’ ways is the best thing to do. Their claim is unnecessary vaccines are imposed on third word countries to maximise the profits of big pharma.

Some sections of Muslim clergy and Islamist political outfits are also campaigning against vaccines in the Muslim predominant Malappuram and adjoining districts. Their propaganda is US imperialism is using Indian government to carry out the agenda of reducing population of the third world, especially that of Muslims. According to them  childhood vaccination causes impotence and sterility in adulthood.

One of the reasons for people believing in quacks is the fact that  the government itself is promoting them. Indian government websites and publications propagate pseudoscience and equate it with science. Many prominent politicians and celebrities are fans of pseudoscience practitioners. The public at large lacks scientific temper and are getting easily fooled.

Also the success of vaccines is making vaccine preventable diseases less visible in the public eye in Kerala. Thus for many there is no real life experience of the dangers posed by vaccine preventable diseases. Thus there is an inertia in taking the kids to health centres to get the shots.

Too much concentration by the health authorities on eradication of Polio at the expense of routine immunisation work may also be a reason in falling rates of vaccine coverage.

The governments, both at the central and state levels are slowly waking up to face this huge threat to public health in India. Central government launched a program called Indradanush in selected districts which are very behind in vaccination coverage. The Kerala government is actively considering a move to make routine vaccinations mandatory for school admissions.

Control of a large number of lethal diseases through universal vaccinations was a major achievement of science in the 20th century in the developed world. It’s 2016 now and it’s a shame that India still lags much behind in controlling and eliminating these diseases. Poverty, social inequality, lack of political will and misplaced priorities has ensured that India is falling behind in this aspect even among poorer nations of the world.

Kerala was a silver lining in this bleak Indian health scenario. Even that silver lining is being blackened by a lethal mix of pseudoscience and religion.