‘We are not taking any chances’

Interview with Union Health Minister Harsh Vardhan.

Dr Harsh Vardhan: “In India, there have been no Ebola deaths or even suspected cases.”

ELECTIONS to the Delhi Legislative Assembly are nearing, but Dr Harsh Vardhan, the Bharatiya Janata Party’s chief ministerial candidate in the Assembly elections last year in Delhi, says he has more pressing things on his mind, such as Ebola. Handling the portfolio of Health & Family Welfare in the Narendra Modi government at the Centre, Harsh Vardhan wants to set targets that are achievable within the next five years . In an interview to Frontline , he outlined the government’s plans for tackling Ebola and also discussed the other health initiatives in the pipeline.

What precautions is the government taking to tackle Ebola?

In India, there have been no Ebola deaths or even suspected cases. Even if there is the slightest doubt about some kind of direct or indirect contact with an Ebola-affected person or if somebody has come from an Ebola-affected country, then we subject that person to the maximum technical and scientific scrutiny by collecting his/her health history, assessing all the factors, and keeping them under observation or in quarantine. We are tracking every person entering the country through sea or by air right from entry to the his/her final destination in the country. Around 19 airports in 12 States have been covered. India has been highly proactive, doing everything even before the World Health Organisation makes a recommendation. The WHO recommends health history recording and screening at the exit point, that is, when somebody is leaving an Ebola-affected country and not while entering a country.

But we are not taking any chances. We started these precautions much before there was a hue and cry about Ebola, and that’s why we are confident of being able to handle it. All passengers of national and international airlines coming directly or indirectly to this country are being scrutinised with the help of the Civil Aviation Department and the aircraft crew. There are health checks at immigration points, including a thermal scan and blood sample collection if required. A passenger is let off only when the health personnel are fully satisfied about his/her condition. If the person tests positive, then we keep him/her under observation for 20 days. We have trained all the relevant staff, doctors, and nurses; master trainers are created who train others. We have a world-class surveillance system that was endorsed and approved by the WHO during the polio-eradication effort. Blood tests have been done on around 100 persons, and 20,000 to 25,000 people have been screened so far.

The WHO reported that so far 10,000 people have been infected with Ebola and 4,900 have died. At the same time, it released a report stating that three million people with tuberculosis were being “missed” by health systems every year because there was no diagnosis or because the cases went unreported. So exactly how real is the Ebola scare for India?

There have been 20-24 epidemics of Ebola in the past, but the Ebola strain this time in West Africa is very strong. Until now, 10,000 people have been affected, over 5,000 have died and many medical personnel have also died. That way, you cannot afford to take the disease casually. Even if there is a 1 per cent mortality rate, you have to take the disease seriously. The good thing about Ebola is that it is not an airborne disease. The bad thing is the official mortality rate, which is very high—up to 80-90 per cent though it is 55-60 per cent according to the WHO. But the precautions we are taking for Ebola are not at the cost of tuberculosis, which also needs attention in a big way.

What are the other priority areas in the health sector for the government?

We intend to eliminate diseases such as measles, neonatal tetanus, leprosy, filaria and kala azar [leishmaniasis]. We have launched a programme in Bihar and the four States adjoining it to eliminate kala azar by next year. A programme for the elimination of filaria will also be launched in one and a half years. While the WHO has set a target for the elimination of measles by 2020, I want to achieve it by 2018. Then, there are diseases we want to check through early diagnosis such as diabetes, hypertension, cancer and cardiovascular ailments by providing treatment at early stages. The National Health Assurance Mission is going to be the biggest activity that will be rolled out in the near future. It will ensure that all people in the country can access a package of services, that essential drugs are assured, that the Indian system of medicine is expanded, and that an insurance mechanism is in place to deal with tertiary-care issues.

We also intend to focus on medical education reforms. There is a need to drastically change the curriculum and add new subjects such as environmental medicine, occupational medicine, and ethics.

Then, we have to asses the deficit in the availability of health workers, doctors, nurses and paramedics.

How prepared is the country to launch a timely response to a disease such as Ebola? What is the government doing to strengthen the health-care system?

We have a fairly good, responsive public health system in the country. We have a very good-quality surveillance mechanism and research laboratories.

One of the early decisions taken by the Modi government was to establish a dozen more AIIMS [All India Institutes of Medical Sciences]. We are in the process of upgrading our medical colleges to superspecialty hospitals, upgrading our district hospitals, opening 60-70 cancer centres and State-level cancer institutes. We are in the process of developing a lot of infrastructure in the near future. We are going to push Ayurveda in the biggest possible way through the Ayush Mission whereby not only Ayurveda but all other Indian health-care systems such as Siddha, Unani, homeopathy, yoga and naturopathy will grow. We will help State governments to develop these in a big way.

We’ll further strengthen the existing dispensaries and research centres of Ayurveda. With our help, State governments can create more institutions and facilities to carry out research on Ayurvedic medicines. We will involve the government and the private and corporate sectors to develop the infrastructure and manpower.