If bird flu arrives, what will India do?

Monday 15 March 2004

India is a hotbed not only of strange diseases but of stranger disease surveillance and control institutions. Every year, known and unknown fevers erupt in all parts of the country, and the New Delhi-based National Institute of Communicable Diseases (NICD) swings into inaction. The procedure is a standard one: it claims to have investigated the epidemic, but, when asked, is unable to provide any information on the causative agent

-- INDIA is a hotbed not only of strange diseases but of stranger disease surveillance and control institutions. Every year, known and unknown fevers erupt in all parts of the country, and the New Delhi-based National Institute of Communicable Diseases (NICD) swings into inaction. The procedure is a standard one: it claims to have investigated the epidemic, but, when asked, is unable to provide any information on the causative agent.

This is why the recent nomination of NICD as the nodal institute to track down and rein in the bird flu epidemic in the South Asia region is a matter of extreme worry. Governments the world over have responded with alacrity to possible pandemics such as the deadly avian flu or SARS -- stepping up surveillance, investing more on research and control programmes. Nothing of the sort is visible in India. One thus wonders: how will NICD go about fulfilling this task? How can the institution convince civil society that it is prepared and ready to combat a rapidly evolving virus?

Fact is, India's attitude to infectious disease control is that of abject neglect. Consider the way NICD works. It is a central institution, and can hunt a disease down only if it receives a request from a particular state. The states, in their turn, have no incentives to involve central agencies. Health is a state subject, states therefore prefer to keep disease outbreaks to themselves: why invest in research and control when the proverbial cloak of secrecy can be flung to use? Moreover, NICD has a basic bio-security laboratory level 2: it is technically not equipped to handle extremely infective diseases such as bird flu. NICD isn't up to the mark. What about the Pune-based National Institute of Virology? For the past three years, the institution has been headless; the boss is an acting director who role is merely administrative. Also, last year, the Comptroller and Auditor General of India hauled up the institution for poor performance and misappropriating funds.

So should India cower before avian flu? NICD should see the latest pandemic as an opportunity, using its role as regional watchdog to upgrade and equip itself with new technologies and capacity. Else a bird flu pandemic, if it occurs here, could cause an already-weak disease control regime to crumble.

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