ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Challenge to Public Health

ECONOMIC AND POLITICAL WEEKLY Challenge to Public Health Avian influenza or bird flu poses one of the biggest challenges for India

February 25, 2006


Challenge to Public Health

vian influenza or bird flu poses one of the the threat. Public health experts advise that the successful biggest challenges for India’s creaky public management of fears over a possible pandemic is crucial health system. The highly publicised cordoning for effectively battling the disease. The first response off in Navapur tehsil of Nandurbar district of Maharashtra, of government at all levels has failed on this count. The which reported the first presence in India of the H5N1 necessary information was not provided to people in the virus, and the subsequent mass culling of poultry, area; neither the media nor the state found it important to suggested the central and state governments were fully clarify that the virus is still an avian strain, and people were geared to deal with the entry of the viral strain into the not provided with complete information about the noncountry. However, the fact that it took more than 10 risks of consuming chicken foods which are adequately days for the authorities to know of the outbreak and cooked. The failure is galling given that the centralgovernthat too from a newspaper report, is indicative of the ment has repeatedly claimed over the past few months poor state of our information gathering system. that it is fully prepared to meet the bird flu threat.

No country is protected from this new and deadly The public health system, which has suffered from virus. Other than the Americas and Australia, all con-15 years of state neglect, has an enormous task ahead tinents now report its presence, with an acceleration in if it is to prevent the country from being overwhelmed its spread over the past month. While more than half by the bird flu threat. First, institutional and informal

(92) of the 170 humans who have been infected in seven surveillance and information-gathering systems have to countries as of mid-February have died, the H5N1 strain be strengthened on a crisis footing so that the virus does does not jump easily from birds to people. The virus not spread from region to region and cases of human is therefore still very much restricted to birds. The fear infection are reported immediately. There is much to is that with mutation, it will spread rapidly among the learn in this respect from China (which itself learnt human population though that is also likely to reduce enormously from the severe acute respiratory syndrome its virulence (EPW, November 12, 2005). The influenza – SARS – episode of 2003) and also from Thailand epidemic of 1918-20 killed an estimated 20 million (which has reportedly mobilised hundreds of thousands people around the world. Modern medicine and ad-of volunteers for the purpose). Second, the government vanced systems of monitoring and surveillance, if needs to build up stocks of oseltamivir to prepare for harnessed properly, can prevent an epidemic on the the emergence of human infection and be proactive in scale of the 1918-20 disaster. But with the world much issuing compulsory licences to Indian pharmaceutical more integrated now than ever before (especially with companies so that they can produce the drug at low the large trans-border movement of people, and global prices. Third, and most important, there needs to be trade in poultry and feed) and a greater density of greater coordination between the central, state and local population, a pandemic is more likely once the H5N1 level public health authorities rather than have a topvirus mutates. The elderly and the young will be the down approach of the kind visible in Navapur. most vulnerable. The efficacy of the known anti-viral India’s Rs 30,000 crore poultry industry, which employs (and patented) drug oseltamivir is in some doubt and lakhs of workers, faces its biggest ever crisis – a fearthere can never be a successful vaccine for either poultry driven loss of export and domestic markets in addition or humans against a virus which mutates rapidly. to a possible devastation wherever the virus next emerges.

Serious as the situation is, it is the responsibility of the Incentives (a fair compensation for culling of birds) as well central, state and local governments to prevent panic about as disincentives are necessary to encourage hatcheries

to report unnatural deaths. Most important, health experts and government bodies have to come up with an imaginative information campaign that presents an honest picture about the safety of cooked poultry foods. The panic of the past week, marked by outrageous decisions by government bodies like the railways, does more harm than calm people’s fears.


Economic and Political Weekly February 25, 2006

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