Dhanada Kanta Mishra
The front page of ‘South China Morning Post’ at Hong Kong, in the first week of January, was chock-a-block with news of a strange new viral infection. Wuhan in China’s Hubei province had detected about 44 cases of the mystery infection and another 120 odd people were placed under observation. In Hong Kong, there was concern as four people were suspected to have travelled to Wuhan; the government immediately went into an emergency mode to tackle any fallout. This came partly from the experience Hong Kong gained following the outbreak of SARS, or bird flu, in 2002. But more importantly, it speaks volumes of the importance authorities in Hong Kong give to public health.
Compare that with India. Recently several newborns in Rajasthan and Gujarat died at hospitals. It was part of a series of such terrible incidents to occur at regular intervals, including the one at a hospital in Gorakhpur, UP, in 2017, and the Muzzaffarpur incident last year in Bihar. In 2016, 19 children died from malnutrition and subsequent infection at Nagada, a tribal village in Jajpur. This was not long after the death of more than 100 children from encephalitis in Malkangiri.
These incidents paint a gloomy picture of public healthcare in the country. Infant and maternal mortality are high, and the non-infectious disease burden is skyrocketing. Over and above that is the acute poverty, increasing pollution and climate change are making the future challenges seem even more daunting.
The role of human capital (comprising public health and education) is critical to sustainable development. In spite of having the best resources, such as highly skilled clinicians, millions of patients of every kind possible, many hospitals and pharmacists, and above all, best mathematicians and statisticians, India has not managed to develop a single drug or device in the history of modern medicine (except for a male contraceptive).
A major reason for this is the high cost in terms of money, manpower and time required for quality public health research, be it epidemiology or clinical trials. Neither the government not drug companies in India have bothered to invest in this important area to make India self-reliant. Even multi-million-dollar research projects funded by MNCs or agencies of developed countries are being carried out largely in Southeast Asian countries, Africa and South America and not India.
Odisha has a population of over 42 million, its southern districts have high levels of poverty and poor maternal and child health, particularly among SC/ST communities. A silver lining in this otherwise gloomy scenario has been the almost two-decade long research on infant mortality caused by early age sepsis (which kills almost a million infants in India alone every year). The results of this research led by Dr Pinaki Panigrahi were published in the journal ‘Nature’. The team identified the root cause of the problem and discovered a relatively simple treatment that proved effective in significantly reducing mortality. It illustrates the importance of public health research in positively impacting health outcomes on a large scale.
These examples illustrate the importance of the health sector at local, national and international levels. Public health organisations in government and private sectors engaged in policy, research, implementation and education have a major role in strengthening clinical trials, training allied health professionals and conducting field research. All these activities are currently addressed largely in an unorganized or non-specialised manner, which are inefficient and/or expensive.
Specialised healthcare institutions must bring together experts, government, academia, students, the media and the public to deliberate on these challenges and come up with suggestions for future policy directions. Only then can we come to a stage when potential future crises can be handled effectively.
The writer is a civil engineering professor and principal of KMBB College of Engineering and Technology currently visiting Hong Kong University of Science and Technology as a research scholar. He can be reached by email at dhanadam@gmail.com.