This article explores several questions concerning the inclusion of hepatitis B vaccination under the universal immunisation programme in India, such as the prevalence of the disease in the population, cost-effectiveness and international experience. There are strong indications that the vaccine policy in India, rather than being determined by disease burden and demand, is increasingly driven by supply push, generated by industry and mediated by international organisations. The debate on hepatitis B in India underscores the need for a strong health information and disease surveillance system, local capability building and rigorous economic evaluation studies with regard to health policies.
