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In A first of its kind move to deal with communicable diseases in the country, India has quietly started training a small batch of public health professionals in association with the Centers for Disease Control and Prevention (CDC), Atlanta, to become part of an elite Epidemic Intelligence Service (EIS).

This was one of the agreements in the memorandum of understanding signed during the visit of US President Barack Obama in November 2010, between the National Centre for Disease Control (NCDC), CDC, Ministry of Health and the Department of Health and Human Services of the US.

It also included establishment and operation of a Global Disease Detection Centre in India, for which $926,666 was sanctioned for the first year.

The first EIS batch of 2012 with eight trained personnel will graduate in 2014 – there were 12 seats but all didn't get filled because of a very rigorous selection process. With high hopes from the programme, the capacity has been increased to 15 for the class of 2013 though the ministry insists that should the right candidates not be found, seats would continue to be kept empty.

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The two–year programme gives training in preventing disease outbreaks, identifying them at inception if and when they happen, mitigating the impact and taking immediate steps to manage the situation.India trains experts to spot, control epidemics. The idea is to have mostly regular employees of central or state health service or equivalent (local autonomous bodies), apart from three self–sponsored candidates. The number of self–sponsored candidates can be increased as per need. The applicants have to hold at least MBBS and MD degrees, or MBBS degree with several years of experience.

The candidates that are sponspored by the state are to receive their salaries for the duration of the programme, while others are given a stipend of Rs 40,000 per month. There are plans to place such candidates in national programmes, but there is no bond for these candidates to serve in government as the priority at the moment is to have trained professionals, regardless of whether they work in the private or public sectors.

"This programme is a major initiative to enhance the availability of public health specialists with state–of–the–art training. It is expected that public health specialists trained in the programme will contribute in their respective states... There is a dearth of such specialists in the country," said Joint Secretary, Health, Anshu Prakash.

The recent Uttarakhand disaster bore out the importance of trained public health professionals such as through the EIS. Even though the Integrated Disease Surveillance Programme stepped in to pre–empt an outbreak of communicable diseases, especially water–borne ones that are common after such largescale floods, the director of the NCDC and the director of the Emergency Medical Response Division of the Health Ministry had to camp in the state for 12 days to bring the situation under control.

Having an EIS with personnel posted in every state would bring that level of expertise and efficiency on the ground much faster, the government hopes.

India's communicable disease burden is very high. As per 2008 data, an estimated 21 per cent deaths in the country were caused by infectious and parasitic diseases. Of the 9.2 million cases of TB that occur in the world every year, nearly 1.9 million are in India, accounting for one–fifth of the global TB cases. About 2.5 million persons have HIV infection in India – the third highest in the world. More than 1.5 million persons are infected with malaria every year. Diseases like dengue and chikungunya have emerged in different parts of India and a population of over 300 million is at risk of Acute Encephalitis Syndrome (AES)/Japanese Encephalitis (JE). One–third of global cases infected with filaria also live in India, while nearly half of leprosy cases detected in the world in 2008 were contributed by India. More than 300 million episodes of acute diarrhoea occur every year in children below five years of age.


Source
Indian Express
22 July 2013,New Delhi, India.

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