World Bank has approved a US$68 million credit to the Indian government for the Integrated Disease Surveillance project

Jul 11 2004

To improve the information available to the government health services and private health practitioners on a set of high priority diseases, such as Malaria, Tuberculosis and HIV/AIDS, as well as other common risk factors, the World Bank approved today a US$68 million credit to the Indian government for the Integrated Disease Surveillance project.

India has made major gains in control of a number of communicable diseases and in improving overall health of its population. Nevertheless, with the increasing age profile of the population, India is in transition with the double burden of significant communicable diseases and increasing non-communicable diseases such as cardio-vascular diseases, cancers, diabetes and cataract blindness, maladies that usually affect higher income countries.

“The surveillance system needs to change to respond to the changing health situation in India,” says Peter Heywood, a Lead Health Specialist with the World Bank. “Surveillance is the foundation of an effective disease prevention and control program. It involves timely collection, analysis and interpretation of health data, followed by dissemination of the findings to take action for prevention and control of diseases.”

Heywood explained that conversely, there are costs to not having an effective disease surveillance program in place. For example, the failure to detect and control the epidemic of plague in 1994 at its early stages resulted in tragic loss of life as well as disruption of trade, transportation and tourism. Estimates of the total cost of the plague are as high as US$1.5 billion. Another recent example is the outbreak of SARS in Asia.

The Integrated Disease Surveillance Project, which this credit supports, is a nationwide scheme to help India detect and proactively address some of these threats, in a coordinated fashion. The proposed project will be implemented over the next five years and it has four components:

• The first component will help the Ministry of Health and Family Welfare establish a new Disease Surveillance Unit at the central level to help coordinate and decentralize surveillance activities.
• The second component will strengthen coordination at the state and district levels, by using modern technology and data management techniques to integrate and strengthen disease’s surveillance.
• A third component will upgrade laboratories at the state level, to improve on-time and reliable confirmation of suspected cases, monitor drug resistance, and changes in disease agents.
• Finally, a fourth component will focus on training programs for health staff, including representatives from the private sector, NGOs and community groups.

Rashmi Sharma, a Social Development Specialist on the project, emphasized that one of the unique features of this project is the engagement of private health care providers and laboratories. “Evidence shows that more than three out of four out-patient cases are treated by private providers. With the disease surveillance project, private health care providers will be encouraged to report to district surveillance units, which in turn will provide them with important feedback , motivating them further to be part of the program.” Private health care providers and laboratories will be encouraged to participate in the outbreak investigations and containment activities.

For more information on the World Bank’s activities in India, visit: http://www.worldbank.org.in/