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Niti Aayog’s unveils vision for India’s Public Health Surveillance by 2035

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While the document does not include funding and budget requirements, it suggests next steps, which include the creation of a road-map or blueprint for action

The Niti Aayog has released a white paper with its vision for what public health surveillance in India can be in 2035.

The 76-page “India’s Public Health Surveillance by 2035” is a joint effort of Health Vertical, NITI Aayog, and Institute for Global Public Health, University of Manitoba, Canada with contributions from technical experts from the Government of India, states, and international agencies.

In addition to building on India’s past experience, the document draws on lessons learned from global best practice including examples from Thailand, Taiwan, Germany, UK, US and Canada.

While the document does not include funding and budget requirements, next steps include the creation of a road-map or blueprint for action.

The scope document states that it would be also important to set up effective and responsive governance mechanisms that establish political, technical, digital and managerial leadership in order to enable India reach this vision by 2035.

According to the paper, India’s Public Health Surveillance by 2035 builds on opportunities that include the Ayushman Bharat scheme, the Integrated Health Information Platform of the Integrated Disease Surveillance Program while aligning with the citizen-centricity highlighted in the National Health Policy 2017 and the National Digital Health Blueprint.

It highlights the importance of capitalising on initiatives such as the Clinical Establishments Act to enhance private sector involvement in surveillance and also points out the importance of a cohesive and coordinated effort of apex institutions including the National Centre for Disease Control, the Indian Council of Medical Research, and others. As well, there may be a need to create an independent Institute of Health Informatics.

The document identifies gap areas in India’s Public Health Surveillance that could be addressed and also envisages that going forward, India’s public health surveillance will be based on individual EHR that capture and amalgamate individuals’ health-care related information through the use of a UHID.

Drawing on best practices from India and other developing and developed country experiences, the document suggests seven next steps for India to move forward towards this vision, as a continuous cycle rather than a sequential process.

  1. Establish a governance framework that is inclusive of political, policy, technical, and managerial leadership at the national and state level.
  2. Identify broad disease categories that will be included under Public Health Surveillance.
  1. Enhance surveillance of non-communicable diseases and conditions in a step-wise manner.
  1. Prioritise diseases that can be targeted for elimination as a public health problem, regularly.
  1. Improve core support functions, core functions, and system attributes for surveillance at all levels; national, state, district, and block.
  1. Establish mechanisms to streamline data sharing, capture, analysis, and dissemination for action. These could include the use of situation-aware real-time signals from social media, mobile sensor networks, and participatory surveillance systems for event-based epidemic intelligence.
  1. Encourage innovations at every step-in surveillance activity.

The document excludes a focus on COVID-19, even though India’s capacity and resilience have been challenged by this pandemic. It states that COVID-19 is a great example of the country’s rapid response to a public health emergency of international concern, and its own capacity to accelerate laboratory capacity, and to digitise, analyse and use information for action. Instead, the document focuses on expanding surveillance to be inclusive of non-communicable diseases, occupational, injury and environmental conditions in a One-Health approach for Public Health Surveillance.

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