Neglect of Public Health in India

Synopsis:  India needs to prioritize public health along with Healthcare. It will be helpful to tackle both communicable and non-communicable diseases effectively.

What is the difference between public health vs Health care?
  • Health care deals with individual patients, whereas Public health deals with the community at large.
  • The goal of public health in disease prevention and control. Whereas healthcare is focused on treatment and disease cure (Therapy).
  • Public health employs a deliberate, intervention-based mechanism to reduce the disease burden in a population.
  • Though India ranks among the world’s best in health-care capability, India’s success in providing public health is very poor.
What are the issues in India’s Public health management?
  • First, ineffective public health surveillance leading to a lack of reliable data collection on all diseases
      • Reliable data is required for real-time monitoring of disease burden and to know the trend of declining infection prevalence in a population. This is one of the important tasks of public health which is done through diagnosis.
      • For example, diagnosis of polio in the under-five population through acute flaccid paralysis (AFP) and laboratory tests were crucial for the elimination of polio in India.
      • Through diagnosis, we could know about the disease burden of polio. When it reaches zero, we will consider that polio has been eradicated.
      • Yet, India’s public health management does not have an effective plan for collecting data on all diseases and deaths through diagnosis.
      • Using alternatives such as the COVID-19 epidemic curve or serosurveys on random samples does not provide the real no. of disease burden.
      • Further, Post-vaccination surveillance is not conducted. It is considered vital for assessing vaccine efficacy and safety. This points towards the lack of an effective public health surveillance system.
  • Second, lack of authentic public health education
      • Timely public health education (Social Vaccine) is needed to nudge the population’s behavior towards tackling any diseases. For example,
      • For preventing the spread of COVID-19, both non-pharmacological preventive interventions such as face masks, hand hygiene, physical distancing, and pharmacological prevention by vaccination were strategized.
      • However, the lack of Social vaccines from Public health management authorities delayed the control of COVID-19. Also, it has given rise to the issue of ‘Vaccine Hesitancy’.
      • It has to be noted that, during the HIV/AIDS epidemic, India’s AIDS Task Force designed and successfully applied a ‘social vaccine’ to control the disease spread.
  • Third, Public health in India does not address both social and environmental determinants to control the disease. For example,
      • COVID-19 has strong social determinants of infection transmission. Such as overcrowding, urban-rural divide in health awareness and education.
      • Similarly, disease such as Typhoid, cholera, leptospirosis has environmental determinants.
      • Contrary to India,  in countries where public health is given equal status, addresses both social and environmental determinants.

Many infectious diseases in India can be controlled if we adequately invest in Public health. Investment in public health will result in health, wealth, and prosperity.

Source: The Hindu

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