Here are well-supported Problem Statements for Chickenpox (Varicella) - 2 global points and 2 India-specific points, plus a 5th bonus point on vaccination gaps:

1. Massive global disease burden with ongoing mortality Chickenpox affects an estimated 140 million people worldwide every year, causing approximately 6,400 deaths annually (down from 8,900 in 1990, per GBD data). Despite being a vaccine-preventable disease, varicella continues to cause significant morbidity - with 2-4% of cases developing serious complications such as bacterial skin infections, pneumonia, and encephalitis. In developing countries, the case fatality rate can be 20-50 times higher than in high-income nations, highlighting a stark global health inequity.

2. Unequal vaccine access leaves billions unprotected While countries like the United States have achieved a 97% reduction in cases through universal childhood vaccination (introduced in 1995), the majority of low- and middle-income countries have no national varicella immunization program. The WHO has not yet universally mandated varicella vaccination in its Expanded Programme on Immunization (EPI) schedules for all nations, leaving large populations - especially children under 10 - without protection and sustaining endemic transmission globally.

3. High burden with a disproportionately adult-onset pattern India recorded 269 chickenpox outbreaks accounting for 27,257 documented cases between January 2015 and May 2021 alone (IDSP surveillance data). Unlike temperate countries where most infections occur in early childhood, India sees a significant proportion of cases in older children and adults, leading to more severe disease outcomes. Historical surveillance data from India showed a case fatality rate of 52 per 100,000 cases - roughly 20 times higher than in the US/UK.

4. Varicella vaccine absent from India's national immunization schedule Despite the availability of licensed varicella vaccines, India has not included the varicella vaccine in its Universal Immunisation Programme (UIP), making it an out-of-pocket expense available only to families who can afford private healthcare. Coupled with low seroprevalence in young adults (only 26% of healthcare workers in India are immune to VZV), this creates serious vulnerability - both in communities and within hospital settings - where secondary attack rates can reach 90% in institutional settings.

5. No widespread VZV surveillance system in India India lacks a standardized, nation-wide active surveillance mechanism for varicella morbidity and mortality. Most burden estimates rely on small hospital-based or district-level studies, making it difficult to quantify the true national burden and build a strong health-economic case for vaccine inclusion in the UIP. This data gap delays policy action and perpetuates underestimation of the disease.

These points are suitable for use in a research proposal, project introduction, or public health report. Let me know if you need these formatted for a specific document type (e.g., a thesis, poster, or presentation).