Public Policy

Ebola: A Wake up Call for India.

The Ebola virus was first discovered by scientists in September 1976 in Antwerp, Belgium. They had received two samples in Thermos from a nun in Yambuku. The nun was fatally ill. The scientists soon realised that they were dealing with a deadly and unknown virus. They named the infection “Ebola” after a local river which is sixty miles away from Yambuku.

In the past three decades, there have been about twenty Ebola epidemics. Each was confined to a small town or village in Central Africa and claimed fewer than 300lives. The present epidemic is different. It has claimed more than 4,500 lives in Guinea, Sierra Leone and Liberia. These countries have been worst hit by the deadly virus. The virus has spread sporadically to the other African countries, to Spain and America.

The Chief of the World Health Organisation called the epidemic “the most severe acute public health emergency in modern times”.

As the outbreak of Ebola virus disease (EVD) shows no signs of containment, India is slowly waking up to the risk of transmission of virus within its borders. A large number of Indians work in the countries affected by the epidemic and are travelling to India during the epidemic.  There is a legitimate concern in India about the state of preparedness and the general state of public health infrastructure in the country.  The high mortality rate of the disease is attributed to the underdeveloped immune response to the virus. Therefore, there is a crying need for more government spending and research on health.

India’s response

India’s response has been to screen passengers returning from Ebola-hit countries at airports. Immigration officers and flight crews have been trained to follow the standard operating procedures.

A number of people have expressed doubts about the manpower and resources for screening of people at the airports. The officials deployed are only checking whether individuals have cough or fever. Quarantining is the biggest challenge. The screening done is only in the nature of formalities getting fulfilled.

According to the Ministry of Health and Family Welfare, over 30,000 people have been screened so far. Out of these, there have been 67 suspected cases. These people are either at medium or at high risk. They have been quarantined. As many as 3,126 passengers have been put under surveillance across the country and are being tracked by the Integrated Disease Surveillance Programme. But, as of now, no Ebola case has been reported.

The National Institute of Virology (NIV), Pune, undertakes the testing for Ebola virus. The National Centre for Disease Control (NCDC) is carrying out molecular diagnosis. The NCDC has earmarked laboratories in various cities to support these tests at regional level.

Sixty-two hospitals have been identified in the States and Union Territories to tackle Ebola. But, according to the health officials, there is no exact data on the number of beds available in these hospitals and they do not know whether isolation wards have been set up in these facilities.

High Cost of PPE and Therapy

The personal protective equipment (PPE) which is worn by health workers and volunteers when they come in contact with infected persons are manufactured by private companies and are very expensive. Each set of PPE costs $100.  There is no cure for Ebola and persons infected with it have to be put on oxygen and antibiotics. In the absence of a proper vaccine, an experimental therapy called ZMapp (consists of monoclonal antibodies prepared from the plasma of the person infected) is given to the patients. Both the medicine and the therapy are very costly. They cost $4,000 a patient a day. India’s public expenditure on health, both planned and non-planned, accounts for less than one per cent. Therefore, the Indian government is financially ill-equipped to handle an epidemic like Ebola.

Doctor-Patient Ratio

The number of doctors and health workers has not kept pace with the population growth.  The 40,000 doctors and 284 medical colleges are hardly enough to meet the challenge of the epidemic in a country of 125 billion plus people.

Dr. K.P Kushwaha, head of BRD Medical College in Gorakhpur has suggested the government an epidemiological control authority on the lines of the National Disaster Management Authority to tackle an epidemic situation.

Low Public Awareness

Public awareness about Ebola is low in India since no confirmed case has been reported. But it is important that people are made aware about the disease. The people should also be responsible enough to report to the health systems in case they have any symptoms of the disease. If even a single case is missed, the outbreak can spread across the country.

Maximalist Approach

Ebola like epidemic calls for a maximalist response towards health care. The hospitals should keep some of their beds vacant so that they can respond to the situations of emergency. The government should also mark places where the infected can be isolated .There should be an efficient system of notifying diseases. The symptoms of Ebola are similar to dengue hemorrhagic fever. The government and the hospitals should be prepared for tackling epidemics on an ongoing basis, and then only, they will be able to tackle an epidemic like Ebola. There has to be integration between the clinical and city health office. Chennai and Kolkata are the only cities in India which have such a system in place.

The Ebola disease outbreak is a wake -up call for the government to spend more on public health infrastructure. India can take a vital lesson from Nigeria, which has a spectacular story of containing Ebola, despite being one of the poorest countries in the world.

About the Author

IMG_0603Diva Choudhary 

Diva is presently pursuing first year, B.A.LL.B at Symbiosis Law School, Pune. She is an avid reader and a dog lover. She loves photography, travelling and creative writing. She is also a staunch feminist.



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