Duty free

Uttar Pradesh can't deliver vaccines to its children. But it wants to import vaccine

Published: Saturday 15 October 2005

-- on September 21, 2005 came a press release. "A Task Force on Health Tourism constituted by the Ministry of Health and Family Welfare would assess the opportunities for promoting India as a health destination, recommend action to be taken by the Central and State Governments and specially recommend about super speciality medical care, outsourcing of medical services to Indian it based institutes and gainfully utilize the expertise available in traditional medicines."

Meanwhile, in an unrelated incident, the number of deaths from Japanese encephalitis in eastern Uttar Pradesh this monsoon rose to 783 on September 21. Mostly children. The district administration is yet to declare an epidemic, a decision supposed to be taken jointly by the district magistrate (dm) and the chief medical officer (cmo). From July 12 to September 23 -- roughly the peak of the epidemic -- the district didn't have a working cmo. There was no point declaring an epidemic, the district administration clarified. All requisite steps had already been taken. Declaring epidemic would only bring bad publicity and panic. And perhaps create the liability of dealing with it. This is precisely the kind of side-stepping that has made a rare disease into an epidemic.

up's plan to deal with je is simple: import vaccine. A state with a 16 per cent vaccination record among its children wants to spend crores of rupees of public money on importing vaccine. And everybody -- the opposition parties included -- is demanding more vaccine. Nobody is talking about the state's (in)ability to deliver those vaccines to the needy. Because the state's health department itself is in the emergency ward. The blame goes to the politicians and bureaucrats of the state, not to lower level employees. Government employees in up think only of transfers; work isn't a priority.

There is a range of business interests just waiting to exploit inefficient states like up. There are health ambassadors with friends in the pharmaceuticals industry. An entire class of parasites that make regular killings on all government expenditures. All the attention that the media is paying to procurement of vaccines has to shift to the administration's capacity to deliver those vaccines. And to the fact that "vaccine" is not a solution in itself. A lot more is required, including not being duty free.

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