By Ritika Sakhuja and Prathiba Raju
New Delhi: Communicable diseases pose a substantial challenge to the public health system in India. With increased public spending on healthcare more attention is the need of the hour, inform domain experts. The emergence of new COVID strains, increasing cases of measles and tuberculosis (TB), Zika virus and Japanese Encephalitis (JE) in various parts of India, highlight the need for increased budgetary spending to strengthen the healthcare industries‘s response to communicable diseases. Furthermore, the Ministry of Health and Family Welfare‘s (MoHFW) goal of making India TB-free by 2025 would require additional funds to increase access to quality healthcare and advanced treatment. The Government of India (GoI) allocated Rs 72 crore to the National Center for Disease Control (NCDC) branches to augment disease surveillance of zoonotic diseases and other neglected tropical diseases Surveillance in the Union Budget 22-23.
ETHealthworld interacted with domain experts to understand the expectations of the healthcare industry from the Union Budget 2023-24especially in terms of communicable diseases, and affiliated healthcare departments that need increased focus on managing and containing the spread of communicable diseases.
More budget allocation needed for disease surveillance of zoonotic diseases and neglected tropical diseases
Dr (Major) RR Dutta, HOD, Internal Medicine, Paras Hospitals, Gurgaon said, “For a population of 1.4 billion people in our country, 72 crore allotment to NCDC in the previous budget was a meager amount. Disease surveillance of zoonotic diseases, neglected tropical diseases, and orphan diseases require more budgetary allocation to strengthen the health workforce, trained epidemiologists at each doctoral level, and enhanced laboratory support.
The emerging outbreak of zoonotic diseases, be it Nipah virus in Kerala or Avian flu in other cities, as well as scrub typhus and JE in Uttar Pradesh, are a reminder of the interconnectedness of human and animal health. The Government of India urgently needs to do everything to start detecting such diseases, which will prepare the country for all future outbreaks, epidemics and pandemics. The Union Budget 2023-24 should pay attention and allocate enough funds for health policymakers to take necessary steps against communicable diseases.
Addressing vector-borne diseases can reduce disease burden in country
Commenting on the need for more funds to be dedicated to communicable diseases to reduce the heavy disease burden in the country, Dr Sushila Kataria, Senior Director, Internal Medicine, Medanta, Gurugram, shared, “Communicable diseases deserve more attention in the upcoming budget, as future generations will continue to face infections, and emerging antibacterial resistance will be a threat in the future. As we can see, vector-borne bone diseases are still creating havoc in our country, eg, dengue and malaria, which affect people in their productive years, and younger people who contribute largely to nation-building. If we address vector-borne bone disease, we can reduce the huge burden of disease in the country.”
“The increasing burden of dengue and malaria should be addressed because these are also overlooked by the health industry, and they need more considerable cooperation between researchers and clinicians. Also, there is a need for high-class diagnostic labs all across the country if there are new diseases, symptoms, or patterns emerging so that the samples can be sent quickly. Improvements in medical education on communicable diseases should also be a focus.”
Communicable diseases need proper attention to strengthen the healthcare industry
“We have seen how alarming the situation could be if proper attention is not given to the infectious diseasesexpecting a good budget strength in the healthcare industry in response to communicable diseases,” mentioned Dr Ankita Baidya, Senior Infectious Disease Expert, HCMCT Manipal Hospitals, Dwarka.
“As we have seen in the COVID era, communicable diseases have come into the limelight, especially viral infections and the modes of prevention, by working in the line of vaccines and mobilizing funds in that area to strengthen our healthcare system. This was on a good note, and I expect that the upcoming Union Budget will reflect the continued efforts in this area.”
“We are still behind when it comes to vector-borne diseases especially the dengue virus and other communicable diseases like TB and HIV. So, though we aim to eliminate these diseases, we must increase healthcare expenditure to appropriately fund the necessary verticals to ensure that the actual goal is achieved. These diseases are what the Union Budget should be focusing on.”
Recent outbreaks highlight emergency contingencies needed for infectious diseases.
Dr Suneetha Nareddy, Senior Consultant, Infectious Diseases, Apollo Hospitals, Jubilee Hills stated, “The recent outbreaks highlight the uncertainty and need for planning emergency contingencies in the budget, especially in the field of infectious diseases. Last year NCDC received only Rs 72 crore to augment surveillance of zoonotic diseases and other neglected tropical diseases surveillance. WHO has brought attention to this area and requested that states step up efforts in this area.
“The 11th five-year plan recommended scaling up healthcare to two per cent of GDP by 2012. In 2017, the government recommended increasing healthcare spending to two and a half per cent of GDP by 2025. The 15th Finance Commission recommended health spending to more than 2.55 per cent by 2024-25. We are still yet to reach the targets.
“In terms of infections, the major killers remain TB, malaria, dengue, and HIV. Special attention needs to be made to these as well in the budget. The other major area of concern is the rapid increase in drug-resistant infections. To tackle these issues to properly contain communicable diseases, Union Budget 23-24 should also focus on healthcare-affiliated areas like research in biotechnology, diagnostics and pharmaceuticals.
Increase budgetary spending to increase health policies awareness
“COVID-19 fastened the advancement in healthcare, and emerged as a lesson to the government, doctors, and even common people, that any type of healthcare emergency can arise and we have to be prepared to handle it effectively. The upcoming budget needs to ensure appropriate budget allocation to tackle such future emergencies,” voiced Dr Sunita Dube, Radiologist and Founder, MedscapeIndia.
“The need of the hour is increased awareness among the masses. Government policies to tackle communicable diseases and education regarding the same need to reach people more strongly. For example, when you talk about Ayushman Bharat (AB), it can become a big, ambitious, and impactful programme. But people are still not aware of the policies. People still don’t know that the Maharashtra government launched the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY). This health care scheme will help with free medical care to the underprivileged and vulnerable sections of society. Medical insurance is also free under this policy. These policies can prove essential in our fight against infectious diseases. So the allocation of the budget needs to be reconsidered to cover the issue of lack of awareness.”
“The outbreak of measles in 2022 highlights the need for strengthened health infrastructure with collaboration from the government, affordable healthcare, technological innovations, and involving doctors, stakeholders, and pharmaceutical companies in the decision-making for a better outcome against the incidence of communicable diseases .”
Bending India’s TB curve crucial to overall health of country
Vikas Panibatla, CEO, Tuberculosis Alert India (TBAI) shared, “The COVID-19 pandemic has had a crippling effect on the nation’s ability to achieve its tuberculosis goal of having a TB-free India by 2025. As one of the top four countries that To account for most TB deaths, and the highest TB burden country in the world, it is imperative that the budget provides increased support towards existing initiatives along with accelerating innovations towards people-centred care, community engagement and the global TB vaccine. India bending the curve on TB is crucial to the overall health of the country and will have a ripple effect the world over.
Budget should pay equal attention to pediatric health across the country
Minnie Bodhanwala, CEO, Wadia Hospital stated, “Ineffective management of communicable diseases is one of the major contributing factors in infant mortality. Airborne diseases such as TB, whooping cough, pneumonia, and measles, tend to take a toll on one’s respiratory tract and lead to higher mortality and morbidity rates in children. To address this issue, newborn care services at health facilities are of prime importance. This budget should pay equal attention to pediatric health across the country, especially in rural areas so that children can lead healthy lives.
To manage fatalities that could be caused by infectious diseases, it is essential to come up with facilities for the care of sick newborns such as special newborn care units (SNCUs), newborn stabilization units (NBSUs), and newborn baby corners (NBCCs) at different levels. It is important to take some effective initiatives to improve pediatric care in rural India. Factors like poor healthcare facilities, unhygienic conditions, and unavailability of proper diet, can impact the child’s overall well-being and catapult health complications caused by infectious diseases.
Allocate enough funds to reduce mortality, morbidity rates due to lifestyle diseases
Dr Vivek Talaulikar, CEO, Global Hospital, Mumbai commented, The government is already working to manage the burden of communicable diseases and we can see the result with a decline in the graph. Now, the focus should be on lifestyle diseases. Heart disease, obesity, type 2 diabetes, stroke, and hypertension are some of the lifestyle diseases that are commonly seen in both young and older populations owing to increasing urbanisation, and these can lead to an exponential growth in complications due to communicable diseases and vice versa.
Union Budget 23-24 should allocate enough funds to the appropriate healthcare organizations that can take measures such as conducting drives and initiatives to reduce mortality and morbidity rates that are seen owing to lifestyle diseases. Lifestyle diseases can prove fatal when combined with infectious disease ailments. Early cancer detection and prompt treatment should also be encouraged in people. We need appropriate infrastructure and healthcare resources to reduce the incidence of lifestyle diseases.
Invest in infrastructure and innovation to reduce burden of infectious diseases
Yuichi Nagano, Managing Director, Sakra World Hospital, Bengaluru, remarked, “As a country, India has shown remarkable growth and progress while managing a pandemic and becoming a preferred destination for medical treatments over the last few years. However, we are still reeling with certain infrastructural shortcomings that must be addressed in the upcoming union budget to effectively manage the spread and contain the infections from communicable diseases.
While we are taking steps towards becoming a digitized nation, we must also look into strengthening the medical fraternity holistically in terms of healthcare education, training and skill development and thereby, increasing the number of doctors available geographically for every nook and corner of the country, Invest towards building more care and awareness programs for intensive care and preventive healthcare which includes mental health and overall wellness. It is only after we start investing in infrastructure and innovation, that we can look at strong private and public partnerships to create a technologically-advanced robust healthcare ecosystem that offers affordable, newer, out-of-the-box, innovative healthcare solutions to further reduce the burden of infectious diseases.