Note4Students: 

Mains: Health Care System in India and Major Challenges;

Mentor comments: “United we stand divided we Fall”. Recently, there has a significant progress made in eradicating guinea worm disease, with a reduction from 3.5 million cases in 1986 to just 13 cases in five countries by 2023. This success underscores the importance of focusing on disease elimination as a crucial step towards eradication, aligning with the Sustainable Development Goals of ending epidemics like malaria, tuberculosis, and Neglected Tropical Diseases by 2030. There is a need for adopting effective solutions at the local level is more effective for disease elimination.

Let’s learn. 

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Why in the News?

Multisectoral collaboration, encouraging innovation and adopting locally effective solutions that facilitate disease elimination, is more effective at the regional level.

Context:

• The Carter Center, a leader in the global elimination and eradication of diseases, recently reported that guinea worm disease was close to eradication.
• From 3.5 million cases a year in 21 countries in 1986, the number had come down to 13 in five countries in 2023, a reduction of 99.99%. This would be the second disease after smallpox to be eradicated and the first one with no known medicines or vaccines.
• This has created increased attention to disease elimination, the first step in eradication. Ending the epidemics of malaria, tuberculosis, and Neglected Tropical Diseases by 2030 is one of the Sustainable Development Goals set by the United Nations.

What are the Current requirements for the Public Health System?

1) Collaborative efforts:

• Rigorous Certification Requirements: International agencies impose stringent criteria for certification, necessitating thorough preparation. Preparation for certification drives improvements in primary healthcare, diagnostics, and surveillance systems.
• Increased Involvement of Field Staff and Community Health Workers: The pursuit of certification encourages greater engagement from field staff and community health workers, motivated by the clearly defined goal.
• Attraction of International Support: Certification efforts attract international support, bolstering resources and expertise.
• Political and Bureaucratic Commitment: The pursuit of certification fosters high levels of commitment from political and bureaucratic entities.

2) Feasibility of Elimination in India:

• Strategic Focus: Recommend focusing on pathogens with high population impact and low enough numbers to make elimination possible.
• Gradual Approach: The initial aim should be to reduce disease numbers to a practical level through disease control before pursuing elimination.
• Understanding Processes and Costs: Reduction in disease numbers enables understanding of elimination processes and associated costs.
• Strengthening Health Systems: Provides an opportunity to strengthen existing health systems to effectively implement elimination strategies.

3) Need for surveillance systems

• Comprehensive Data Collection: Surveillance systems are crucial for capturing every instance of the disease within a population, providing accurate and real-time data for decision-making.
• Monitoring Progress: Surveillance systems allow for monitoring the progress of disease elimination efforts, assessing the effectiveness of interventions, and identifying areas that require additional support or resources.
• Confirmation and Diagnosis: Strengthening laboratories for screening and confirmation ensures accurate diagnosis of cases, facilitating appropriate treatment and management.
• Ensuring Availability of Resources: Surveillance helps in identifying gaps in resources such as medicines and consumables, enabling authorities to ensure their availability to support elimination efforts.
• Training and Capacity Building: Surveillance systems facilitate training of healthcare workers on the requirements of elimination strategies, ensuring a skilled workforce capable of implementing surveillance protocols effectively.

What are the Challenges of the Healthcare System?

• Resource Strain: Eliminating the transmission of diseases is difficult and requires significant resources. The process places a heavy burden on the healthcare system, potentially diverting attention from other essential health functions.
• Potential Neglect of Health Functions: Focusing on disease elimination may divert attention and resources away from other critical health priorities, especially in weaker health systems.
• High Prevalence of Diseases: Diseases with high prevalence and significant impact on populations pose greater challenges for elimination, requiring comprehensive strategies and interventions.
• Cost-Benefit Analysis: Careful analysis of the costs and benefits is crucial to ensure that the resources invested in disease elimination yield optimal outcomes and minimize adverse impacts on healthcare systems and communities.

Measures that need to be taken at Regional level (Way Forward)

• Regional Effectiveness: Multisectoral collaboration and innovation are more effective at the regional level for disease elimination. Smaller units allow for better resource management without neglecting essential tasks.
• Ownership by Governments: While elimination efforts can proceed regionally, both national and state governments must take ownership of the process.
• Phased Approach: Regional elimination efforts should be phased to culminate at the national level. Planning from a national perspective is essential to ensure coordinated progress across the country.
• Technical and Material Support: Regional implementation requires technical and material support. Progress in regional elimination efforts needs to be closely monitored.
• National Control: The Union government plays a crucial role in dealing with diseases spreading across states and at ports of entry to prevent reintroduction.

Conclusion: Enhancing surveillance systems, fostering multisectoral collaboration, and adopting a phased regional approach under government ownership is crucial for successful disease elimination. Scaling up efforts gradually across India is imperative for national elimination goals.

https://www.thehindu.com/opinion/op-ed/eliminating-diseases-one-region-at-a-time/article67973191.ece