The national capital has witnessed a recent surge in dengue cases, reporting over 300 cases in the first five days of October, taking the annual count to over 1,000 cases. The rise of dengue cases across all serotypes across the country is a rising challenge. While cases spike usually during the monsoon, the recent unseasonal rain in New Delhi has caused a sudden spurt in vector-borne diseases.
Dengue cases have been increasing across urban and rural India creating pressures on public health. As cases rise, government bodies have stepped forward to mitigate risk and help those suffering from vector-borne diseases. The government has advised hospitals to reserve 10-15% of beds for such patients and directed them that no patients shall be denied admission due to paucity of beds. While the government has been making concerted efforts to fight dengue and malaria, it is key to understand that a large group of affected people accesses healthcare through the private sector. It is therefore important that private healthcare providers integrate efforts with the public healthcare system to provide adequate care to patients. Private sector has played a significant role in healthcare delivery and there is an pressing need for public private partnerships to eliminate and control VBDs.
While post-diagnostic efforts will help control mortality, we must undertake preventive measures to mitigate disease and reduce burden. The government takes precautions such as monitoring water bodies in the city and spraying insecticide in risk prone areas. There is a need for community engagement with support from private partners to disseminate information, provide precautionary tools such as sprays and insecticidal nets and expertise to public health workers.
Private health sector plays a significant role in the health service delivery however, there is under-utilization of the resources, technical skills, innovations of the private sector to achieve public health goals. It is estimated that the private sector accounts for around 80% is out of pocket expenditure. 70% access to private health care formal / informal of all healthcare delivered in India and this share is increasing rapidly. Active involvement of the private sector has proven effective in fighting COVID-19. Given the wide-spread impact of vector borne diseases on the social and economic landscape of the country, it is important that we include the private sector in efforts to address the impending public health crisis. The public and private sectors complement each other and help strengthen the system. Through private partnerships, investments, access to technology and innovation, financing can be leveraged to lessen the burden of diseases.
Controlling mosquito breeding is one of the most effective tools against vector-borne diseases. India has made considerable progress in its fight against malaria with support from private sector partners and through community engagement with the help of NGOs and local bodies. Earlier this year, prior to the monsoon season, the Union Health Minister suggested working in partnership with civil society organizations and support agencies through micro-plans with time-bound outcomes. However, the battle against vector-borne diseases is becoming complex as mosquitoes continue to evolve. This calls for new vector-control tools, scaling up of access to LLIN long-lasting insecticidal nets, expansion of larval source management, entomological surveillance & insecticide resistance monitoring to control vector-borne diseases.
The private sector, through pharmaceutical companies, research institutions and healthcare bodies, will only help amplify efforts geared at disease control and management. Large corporates need to bring in their resources and strengths to support the control of vector-borne diseases. Facilitating reporting and referral and establishing training linkages between the public and private sectors requires the active involvement of the private sector. With the private sector getting involved in addressing vector borne diseases, India will be able to accelerate its efforts towards achieving elimination for diseases such as malaria. The lack of an established, near real-time, case-based surveillance system challenges India’s ability to mount a cohesive and integrated malaria elimination agenda.
The involvement of the private sector will be significant in crossing this barrier. A robust policy and mechanisms to ensure reporting for vector borne diseases like dengue and malaria among others from India’s private health sector will help identify the inapparent micro-clusters and interrupt transmission. Other practices such as fever management depots can be created at community level as created for Malaria. Collaboration of the private sector through CSR will help pool in resources, innovations, technology for prevention and control vector borne diseases thus addressing the management of a dengue and vector borne disease outbreak that includes outbreak preparedness by early diagnosis and management, integrated vector surveillance, establishment of warning systems, supply of sufficient diagnostic kits, development of locally adapted integrated vector control measures involvement of private sector and community awareness.
Vector borne diseases being climate sensitive creates obstacles in maintaining public health. It is key that the private sector works in conjunction with the public sector to help strengthen the health infrastructure and facilitate healthcare provision at the last public private partnerships ( PPP) can enhance Malaria elimination drive and control of other VBDs. Private partnerships is going to prove crucial in fighting the mosquito menace arising in New Delhi and across India.
Authored by – Pratik Kumar, Country Director, Malaria No More India.