Recently, the NITI Aayog published a white paper titled “Vision 2035: Public Health Surveillance in India”. This document sets out to guide the future of Public Health Surveillance (PHS) in India with an aim to establish India as a global leader in this field. A white paper usually serves the purpose of highlighting the features and benefits of a solution, product, or service. In this case, the white paper is a vision document for the future of PHS in India.
Background of the Initiative
The primary role of the NITI Aayog is to provide strategic direction to different sectors of the Indian economy. Its health vertical released four working papers compiled into a volume titled ‘Health Systems for New India: Building Blocks-Potential Pathways to Reforms’ in November 2019. This white paper is an extension of these previous efforts to bolster health systems.
About the White Paper
This document is a collaborative effort featuring contributions from the Health Vertical of NITI Aayog, Institute for Global Public Health, University of Manitoba, Canada, and technical experts from the Government of India, States, and international agencies. The paper articulates India’s 2035 vision for PHS, suggesting the integration of three-tiered public health systems into Ayushman Bharat while proposing the utilization of individual electronic health records for surveillance.
Main Features of the White Paper
The paper emphasizes the need to strengthen non-communicable disease prevention, detection, control, and to minimize individual and family out-of-pocket expenses. It builds on existing initiatives like the Integrated Health Information Platform of the Integrated Disease Surveillance Program and the National Digital Health Blueprint. The paper also stresses the importance of cohesive coordination between national institutions like the National Centre for Disease Control and the Indian Council of Medical Research.
Vision Outlined in the Document
The vision in the document aims to make India’s PHS system more proactive, responsive, and citizen-friendly. It seeks to enhance data-sharing mechanisms between different levels of government for improved disease detection, prevention, and control, while providing regional and global leadership in managing public health emergencies.
Current Challenges Faced by PHS
Several issues currently vex PHS in India. These include problems with data collection and sharing, the generation of low-quality data, limited ability for program implementation structures to coordinate with research organizations, missing linkages between mortality and morbidity data, an inadequate number of public health professionals, underdeveloped NCD surveillance systems, and a lack of occupational health surveillance.
Emerging Challenges for PHS
Emerging challenges that PHS in India needs to address include growing antimicrobial resistance, the emergence of new infectious diseases or new strains of existing ones, and an increasing rate of NCDs.
Suggested Pathways for Improvement
The paper lays out several suggestions for advancement including creating a skilled workforce dedicated to surveillance activities, integrating NCDs, reproductive and child health into PHS, amalgamation of plant, animal, and environmental surveillance in a One-Health approach, prioritization of diseases for elimination as public health problems, and encouragement of innovations at all stages of surveillance activity.
Despite present challenges, India has made significant progress in improving its surveillance system. The implementation of the vision outlined in this paper can catapult India to be a global/regional leader in PHS. The foundation for this vision is a federated system of governance between the Centre and states, a new data-sharing mechanism that leverages new analytics, health informatics, data science, and innovative ways of disseminating ‘information for action’.
