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ABSTRACT: In India, the range and burden of infectious diseases are enormous. The administrative responsibilities of the health system are shared between the central (federal) and state governments. Control of diseases and outbreaks is the responsibility of the central Ministry of Health, which lacks a formal public health department for this purpose. Tuberculosis, malaria, filariasis, visceral leishmaniasis, leprosy, HIV infection, and childhood cluster of vaccine-preventable diseases are given priority for control through centrally managed vertical programmes. Control of HIV infection and leprosy, but not of tuberculosis, seems to be on track. Early success of malaria control was not sustained, and visceral leishmaniasis prevalence has increased. Inadequate containment of the vector has resulted in recurrent outbreaks of dengue fever and re-emergence of Chikungunya virus disease and typhus fever. Other infectious diseases caused by faecally transmitted pathogens (enteric fevers, cholera, hepatitis A and E viruses) and zoonoses (rabies, leptospirosis, anthrax) are not in the process of being systematically controlled. Big gaps in the surveillance and response system for infectious diseases need to be addressed. Replication of the model of vertical single-disease control for all infectious diseases will not be efficient or viable. India needs to rethink and revise its health policy to broaden the agenda of disease control. A comprehensive review and redesign of the health system is needed urgently to ensure equity and quality in health care. We recommend the creation of a functional public health infrastructure that is shared between central and state governments, with professional leadership and a formally trained public health cadre of personnel who manage an integrated control mechanism of diseases in districts that includes infectious and non-infectious diseases, and injuries.
The Lancet 01/2011; 377(9761):252-69. · 38.28 Impact Factor
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ABSTRACT: With the disappearance of circulating wild poliovirus and improved sanitation, protective antibody levels may wane over time following oral poliovirus vaccine (OPV) administration. This study evaluated the seroprevalence of neutralising antibodies to vaccine polioviruses among young Indian women who had received at least three doses of OPV as primary immunisation. Of 60 women studied, 27 (45%) had antibody titres of <1:8 to one or more polioviruses, with the lowest levels for poliovirus types 3 and 1. These findings represent a possible immunity gap and this needs to be confirmed with further studies, which could include a challenge with vaccine virus.
Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2011; 105(3):179-80. · 2.16 Impact Factor
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The Indian journal of medical research 10/2010; 132:450-3; author reply 453-5. · 1.84 Impact Factor
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ABSTRACT: Pandemic-09-H1N1 virus caused the pandemic starting in the second quarter of 2009. The world was prepared to face the pandemic since it was anticipated for over one decade. Most countries, including India, had made detailed pandemic preparedness plans well ahead of its actual occurrence. The infection rapidly spread to the whole country within 2-3 months. The national tactics were to slow down its importation through international air travelers and to slow down its spread in cities and major towns. More than 75% of all infected persons were urban dwellers, suggesting that efforts were concentrated in urban communities. In general the illness of pandemic influenza has been similar to endemic/seasonal influenza; however, there is insufficient epidemiological and clinical data on the latter. We hope that the unprecedented experience of managing the pandemic will encourage the Government of India to plan to confront endemic/seasonal influenza more systematically. The pandemic seems to have reached a peak in September/October and has been on the decline since then.
Indian pediatrics 01/2010; 47(1):25-31. · 1.05 Impact Factor
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The Indian journal of medical research 08/2009; 130(1):9-11. · 1.84 Impact Factor
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The Indian journal of medical research 08/2009; 130(2):101-4. · 1.84 Impact Factor
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The Lancet 09/2002; 360(9333):638-9. · 38.28 Impact Factor
