Eliminating diseases- One region at a time

Source-This post on Eliminating diseases- One region at a time has been created based on the article “Eliminating diseases, one region at a time” published in “The Hindu” on 20 March 2024.

UPSC Syllabus–GS Paper-2– Issues Relating to Development and Management of Social Sector/Services relating to Health, Education, Human Resources

Context– The Carter Center, a leader in the global elimination and eradication of diseases, has recently reported that guinea worm disease is 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.

What is the difference between Elimination and eradication of transmission?

Eradication of transmission– This is the permanent cessation of infection by a pathogen with no risk of reintroduction.
It is a highly desirable objective to enhance the health of the people, especially the poor who are most vulnerable to infectious diseases.

Elimination of transmission – It targets achieving zero transmission in a defined region. It is a step towards eradication.

What are the reasons to recommend disease elimination as a public health strategy?

1) Meeting SDGs-It energizes the public health system to meet the sustainable development goal of ending the epidemics of malaria, tuberculosis and Neglected Tropical Diseases by 2030.

2) Improvement at grassroot level– It would result in improvement in primary health care, diagnostics and surveillance.

3) Encourage participation of workers– It will ensure increased involvement of field staff and community health workers because they have a clearly defined goal before them.

4) Nudge politicians– It generates high political and bureaucratic commitment, and public support. These efforts positively impact the health system.

Read more- Guinea worm disease

What are the challenges in elimination of disease?

1) Cost-Elimination of transmission is challenging and resource intensive.

2) Neglect of other diseases-It imposes an additional burden on the system and could lead to the neglect of other important health functions, especially for weak health systems.

What should be the strategy to eliminate diseases in India?

1) Pathogen specific approach-It will be strategic to focus on pathogens whose impact on the population is high and whose numbers are low enough to make elimination feasible.

2) Capacity building-The government must invest in developing robust surveillance systems that could capture every incidence of the disease. The government needs to strengthen laboratories for screening and confirmation, train the workforce for meeting elimination goals and ensure availability of medicines.

3) Adopting region specific approach– It will be difficult to achieve elimination of many diseases for whole country. Thus, the government should adopt region specific approach. For ex- kala azar is now limited to just few blocks of 5 States in India. So,only these blocks can be targeted specifically.

4) Multisectoral Collaboration-There is a need for multisectoral collaboration and innovative strategies which prefer locally effective solutions at regional level. However, regional implementation needs constant technical and material support from centre.

In India, national elimination can be achieved most effectively, by starting with elimination and scaling it up, region by region, across the country.

Question for practice

How can India eliminate some diseases by adopting region specific approach?