The Union Budget 2021-22 announced Pradhan Mantri AtmaNirbhar Swasth Bharat Yojna and marked Rs 64,180 crore for the new scheme for over six years to combat new and emerging diseases. This will be in addition to the funds provided to the National Health Mission.
The budgetary allocations will be used to strengthen the infrastructure in India to treat and detect new and emerging diseases.
For better access to treatment, funds will be made available to increase the capacity of primary, secondary and tertiary healthcare systems by supporting 17,788 rural and 11,024 urban health and wellness centres. Critical care hospitals will be established in 602 districts and 12 central institutions. Other than this, 15 health emergency operation centres and two mobile hospitals will also be set up.
To improve detection, public health labs will be set up in all districts and 3,382 block public health units in 11 states. An integrated health information portal will be set up to connect all public health labs.
Efforts will be made to improve surveillance too and the national centre for disease control (NCDC), which is equivalent to Centres for Disease Control in the United States, will be strengthened, the budget document said. At present, it has five regional branches and 20 metropolitan health surveillance units.
Along with this, a national institute for Centre for Disease Control and Prevention’s One Health project, a regional research platform for World Health Organization (South East Asia region), nine bio-safety level-III laboratories and four regional branches of National Institutes for Virology.
To ensure proper quarantine and sanitary measures, steps will also be taken at the points of entry for people and materials to check disease spread. Under this, 17 new public health units will be set and the existing units at 32 airports, 11 seaports and seven land crossings will be strengthened.
This is good news for India which regularly struggles with new and emerging diseases. NCDC has played only a fringe role in the COVID-19 pandemic.
An analysis done by Down To Earth released in July 2020 showed that between 2019 and 2020, there were reports of 33 outbreaks of fever and 12 of acute encephalitis syndrome (till week of March 16-22, 2020).
NCDC’s integrated disease surveillance programme (IDSP) does not make final outcomes public. The analysis also showed that IDSP uploaded the reports retrospectively due to which states did not get the support to take precautions against spread of any disease.
Antony Kollannur, a public health expert based in Kochi says that while he is happy about the components and priorities of the PM Atmanirbhar Swasth Bharat Yojana, he is concerned that it has been made into a separate programme and not linked to National Health Mission. This may go against the overall health system strengthening, he said. “Is it a strategy to gain political mileage?”
Health experts feel that the efforts might fall short of achieving the intended. “There is a need to establish research labs like NIV in every region. These labs should have the capability to carry out disease surveillance using sophisticated technology like genomic surveillance in real time,” says Vipin M Vashishtha, consultant paediatrician in Bijnor, Uttar Pradesh, who was part of the team that unravelled the mystery fever in Saharanpur district. The labs should have the capacity to work on any new signals emerging from any location, he added.