2025 in Review: Closing the under-immunisation gap in India

Introduction by Suvita’s CEO

We completed 6 years last year! Through our government partnerships in Maharashtra and Bihar, Suvita now reaches 1 in 10 of India’s newborns with vaccination reminder messages, equivalent to 1.5% of the world’s newborns. We have significantly advanced the novel Immunisation Ambassadors model, growing the network to over 14,000 volunteers, and with exciting partnerships and plans underway to drive further innovation.

Last year, we intentionally shifted from rapid expansion toward strengthening leadership and internal capabilities, while continuing to deliver at scale in India. Some of the capabilities we prioritised strengthening include government partnerships and evidence generation to inform our plans for the next few years. The final quarter of the year was particularly formative. The Board and Co-Executive Directors decided that now is the right time for Suvita to shift from a Co-Executive Director model to having a sole CEO. I have now stepped into the role of CEO, and Fiona stepped away from the organisation in January 2026 after a thoughtful transition. 

I believe Suvita is at an inflection point. In an early 80,000 Hours podcast, we spoke about 10 million children missing their basic vaccinations in India every year. We are confident that the number is now closer to 4 million because of a significant decrease in the under-immunisation gap over the last few years. With a sharp and value-aligned team of over 60, dedicated to driving our impact, we realise building our team capacity even further to leverage opportunities and have maximal impact will be an important theme over the next few months. 

Warmly,

Varsha

Scale and Programme Reach

• SMS reminders: Suvita sustained large-scale reach throughout 2025, enrolling a total of ~1.77 million new children and ~1.6M pregnant women into its SMS reminder programme across Maharashtra and Bihar. In Maharashtra, 1.65 million children were enrolled, while 124,300 children were enrolled in Bihar.

• Ambassadors: The ambassador programme continued to expand alongside the SMS programme, with 2,763 new ambassadors recruited in Maharashtra and 2,019 in Bihar, strengthening community-level demand generation and outreach.

Evidence, Learning and Strategic Insight

• A core priority in 2025 was strengthening Suvita’s evidence base to inform future strategy, including completion of the first phase of a national needs assessment, mapping the size and geographic distribution of India’s remaining immunisation gap. What is clear from this study is how the number of under-vaccinated children in India has reduced from ~10 million of 26 million children born each year in 2015 to about 4 million of 22 million children born each year in 2025. This is a major cause for celebration, and also for further reflection on Suvita’s future.

• Representative surveys of 1,400 caregivers across Maharashtra and Bihar indicated that Suvita’s SMS reminders were more salient than other at-scale messages by the government, and comparably useful to ASHA worker reminders. ASHA workers are trained female community health volunteers under India's National Health Mission, who are key intermediaries between communities and public health systems.

• Suvita continued to advance its collaboration with J-PAL and refined the study design and recruitment processes to better understand the most cost-effective pathways for scaling Suvita's ambassador programme. We hope to initiate and complete the study in 2026.

  
  

Government Engagement and Systems Integration

• Suvita made a deliberate shift toward deeper engagement with government systems. We are working to be more agile and responsive to the government’s needs and demands by embedding in government units, setting up a separate government engagement vertical, and intentionally developing our in-house expertise and intuitions by learning from peers and senior advisers. 

• Our discussions with central-level actors on U-WIN SMS messaging informed Suvita’s approach to government collaboration.

  • In Bihar we initiated an early-stage collaboration with the state government to assess U-WIN data quality across four districts, with the aim of improving data completeness and exploring more targeted SMS and WhatsApp communication.

• Our engagement with state-level government engagement strengthened significantly. The Chief Minister's Office in Maharashtra publicly endorsed Suvita’s SMS programme, with coverage across multiple newspapers.

• Suvita was invited to submit a proposal to work with the Pune Municipal Corporation on demand-side challenges in urban immunisation, including the National Measles Campaign. This presented an opportunity to understand government priorities in routine immunisation, especially in an urban setting, and our ability to be responsive to them in the Pune area.

  
  

Systems, People, Finances, and Organisational Maturity

• We planned for a leadership restructuring in collaboration with Suvita’s board. Varsha and Fiona have led Suvita since 2019. In 2025, we led a thoughtful transition process with the board, and together decided to move to a single CEO structure. In early 2026, Varsha stepped into the role of CEO, and Fiona transitioned into a Strategic Advisor role. Fiona has played a pivotal role in driving Suvita's impact and in building the organisation to the strong position we are now in. She moved to India to set up and evolve our ambassador programming and spearheaded the state-wide scale-up of our SMS reminders across Maharashtra. We're very grateful for her many contributions over the last six years.

• Suvita invested heavily in institutional technology capacity, including the creation of a unified village dataset across government and health systems, optimisation of technical infrastructure. We launched a Bihar Double Data Entry App, which enabled automatic data flow from field submissions to Data Entry Officers; this removed manual validation steps, made processing real-time, reduced reconciliation errors, and removed people dependency, and we launched an internal wiki to centralise organisational knowledge.

• We strengthened people and operational capacity across programmes, operations, monitoring and evaluation, finance, and government engagement. We also introduced new team rituals to support cohesion, wellbeing, and productivity, including a monthly “People and Culture Open Hour” and a monthly “Panchayat” (similar to All Hands meeting). 

  
  

Looking Ahead

• Moving to targeted SMS reminders in identified geographies: Learning from our needs assessment, we are at the early stage of moving towards targeted reminders in select geographies. We will further look into the data in the coming months and discuss with the government and funding partners on the way forward.

• Looking at other opportunities for our ambassador programme: We hope to explore (in 2026 and beyond) whether our platforms, phone-based reminders and ambassadors can be used to disseminate other crucial health information within their localities and whether this ambassador model can work in urban and semi-urban areas.

• Recruiting for senior roles: We will be investing in several new senior and mid-senior hires over the next few months, as well as recruiting trustees.