While a respite from swine flu will be good news, one would be ill-advised to also put the issues around it on the back burner. But then, going by our experience, we run the risk of doing this again.
"Since 2010, every year from July to end of winter, India sees a spurt in H1N1 (swine flu) cases and some deaths, though not in large numbers as was the case this time. And if we need to save those lives, then some policy has to be in place, particularly with respect to stockpiling and replenishing the expired stock of vaccines," says Suresh Jadhav, Executive Director, Serum Institute of India, a leading producer of important vaccines like those for diphtheria, tetanus and pertussis.
The view seems to be widely held that in health there is a crying need to plan properly. "Swine flu is a very good example that tells us that we don't seem to be doing enough forward planning, thinking and allotting enough resources to undertake new research," says Kiran Karnik, former president of the National Association of Software and Services Companies (Nasscom) and one who has been tracking and writing on the subject of public health, among other areas, after his stint at Nasscom.
Consider the draft National Health Policy 2015 of the government. It touches upon an important subject of Universal Immunization Programme. "One of the immediate challenges is to further increase immunization coverage with quality and safety.
Better adverse event reporting and compensation policies would be built up. Vaccine security through encouragement of multiple suppliers and appropriate procurement policies is also a frontier," it says. But it stops short of setting targets or discussing resources.
"Studies have shown that India's spend on immunization as a percentage of healthcare investment has also shown a gradual decrease, from 9 per cent in 2007/08 to 4 per cent in 2013/14," says Mahima Datla, Managing Director of Biological E, a leading biopharmaceutical company based in Hyderabad with a focus on low-cost vaccines.
She adds: "Immunization being the most cost-effective strategy to reduce IMR (infant mortality rate) and child deaths, the outlay on immunization needs to be expanded to at least mid-income country levels from the current levels. Investment in sanitation and clean drinking water also goes a long way in removing waterborne diseases like Hepatitis A, cholera and jaundice."
Datla suggests launching a "Nirmal Jal Abhiyaan" to provide clean water, which would be in line with the government's Swachha Bharat Abhiyaan.
What is worrying, she points out citing a UN report, is that two countries - India (21 per cent) and Nigeria (13 per cent) - together account for more than one-third of deaths among children below five years of age.
"And that is not all. India ranks highest in vaccine-preventable deaths", she says, referring to diseases such as tuberculosis, poliomyelitis, diphtheria, measles, tetanus, meningitis, Japanese encephalitis, and cervical cancer.