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A year later, no lessons learnt: Dengue, Swine Flu hurt India again

Delhi and Maharashtra have been leading the country in the list of deaths from Dengue and Swine Flu respectively.

twitter-logo E Kumar Sharma        Last Updated: September 28, 2015  | 18:15 IST

E Kumar Sharma, Associate Editor, Business Today
Delhi and Maharashtra, home to the nation's political and financial capital, have also sadly been leading the country in the list of deaths from Dengue and Swine Flu respectively. With over 25 deaths in Delhi due to Dengue and over 600 deaths on account of Swine Flu in Maharashtra, it looks as if nearly a year after the earlier round of outbreak and deaths, we have learnt little and have again been caught under prepared. Here is what the National Health Profile 2015, just brought out by the Central Bureau of Health Intelligence, Directorate General of Health Services, Ministry of Health and Family Welfare, has to say: "Dengue and Chikungunya transmitted by Aedes mosquitoes, are a cause of great concern to public health in India. Every year, thousands of individuals are affected and contribute to the burden of health care. Dengue outbreaks have continued since the 1950s but severity of disease has increased in the last two decades." Similarly, in its findings for Maharashtra, the Integrated Disease Surveillance Programme (IDSP) of the Union Health ministry, points out that since January 1 this year, 6,843 cases of seasonal Influenza A (H1N1) or Swine Flu and 623 deaths were reported till 35th week ending August 30, 2015.

What is the point if we get the act together after emerging diseases like Swine Flu, dengue and others reach threatening proportions? Far from seeking long-term solutions and investing in research to analyse (using various modeling tools that are today available) the various viruses and their mutations with climate change, what is in the least required is an effective preparedness in the short term with basic things like emergency preparedness plan, better stocking of vaccines, more focus on training of health professionals. If possible, there can also be potential investments into building diagnostic capabilities.
It is not without reason that experts and thought leaders are upset with the way India is handling some of these viruses. Consider this: in a recent article written by K Sainath Reddy and N R Narayana Murthy (the president and chairman respectively of the Public Health Foundation of India) that Reddy shared with this writer, they say: "This virus (dengue) is no stranger to Delhi, or many parts of India, which are endemic (favoured residence) to it. Yet, each monsoon season, we react as though it is a stealth bomber catching us by surprise. We are familiar with all four strains. Often, viruses tend to transmit rapidly as the human host population increases in size and density. This can portend future danger for big cities. Mosquito vectors breed merrily when afforded the safe sanctuary of stagnant water from intermittent rains or careless collections in homes. Mosquito breeding will become even more intense as temperatures rise with climate change. We should be prepared to combat dengue, malaria, chikungunya and other diseases of that ilk with better design and delivery of health services."

Others agree. "Nothing seems to have changed compared to last year. There is also no policy as yet in place on stockpiling of vaccines. There are sporadic cases of demand for vaccines (for Swine flu) from private medical practitioners and we meet that but there is really no sustained demand from the government. We therefore just keep a minimum stock of (swine flu) vaccines - about 40,000 doses - so that by the time  its expiry date approaches, we have fresh stock ready to replace it," says Suresh Jadhav, executive director of Pune-based Serum Institute of India, a leading producer of vaccines in India. Though he does point out that the Maharashtra government has in the last three months or so taken measures to vaccinate pregnant women against swine flu. For this, it is importing "inactivated influenza vaccine" as these are not made in India. These vaccines are being made available at state-run hospitals to be administered on pregnant women and to be given to doctors and paramedics.

The Delhi government's decision announced on September 9th to set up 55 dedicated fever clinics across Delhi where staff has been deputed to conduct check-ups for fever and suspected dengue complaints. Surely, steps in the right direction and a pointer to what is possible. But then, there is a long way to go.


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