Vision 2035: Public Health Surveillance in India

In 2020, the NITI Aayog signed a Letter of Agreement with the University of Manitoba, Winnipeg, Canada to develop a working paper on a Vision for Public Health Surveillance in India by 2035

NITI Aayog released a white paper: Vision 2035: Public Health Surveillance in India with the vision:

• To make India’s public health surveillance system more responsive and predictive to enhance preparedness for action at all levels.
• Citizen-friendly public health surveillance systems will ensure individual privacy and confidentiality, enabled with a client feedback mechanism.
• Improved data-sharing mechanism between Centre and states for better disease detection, prevention, and control.
• India aims to provide regional and global leadership in managing events that constitute a public health emergency of international concern.

What is a white paper report? A white paper is an in-depth report or guide about a specific topic and the problems that surround it. It is meant to educate readers and help them to understand and solve an issue.  In other words, A white paper is an authoritative report or guide that informs readers concisely about a complex issue and presents the issuing body’s philosophy on the matter. A white paper can be about any subject, but it always makes suggestions to improve the way things work. They are usually published by the government for follow-up action or at least a conclusion The term “white papers” originated in England as government-issued documents.

‘Vision 2035: Public Health Surveillance in India is a continuation of the work on health systems strengthening. 

• • It contributes by suggesting mainstreaming of surveillance by making individual electronic health records the basis for surveillance. 
  • Public health surveillance (PHS) is an important function that cuts across primary, secondary, and tertiary levels of care. 
  • Surveillance is ‘Information for Action’.
• It envisions a citizen-friendly public health system, which will involve stakeholders at all levels, be it individual, community, health care facilities or laboratories, all while protecting the individual’s privacy and confidentiality.’
• The white paper lays out India’s vision 2035 for public health surveillance through the integration of the three-tiered public health system into Ayushman Bharat. 
• It also spells out the need for expanded referral networks and enhanced laboratory capacity. 
• This document identifies four building blocks for this vision. These include 
  • An interdependent federated system of Governance architecture between the Centre and States
  • New data collection and sharing mechanisms for surveillance based on unitized, citizen-centric comprehensive Electronic Health Records with a unique health identifier, amalgamating existing disease surveillance programs, complemented by information from periodic surveys
  • Enhanced use of new data analytics, data science, artificial intelligence and machine learning; and 
  • Advanced health informatics. 

This vision document on India’s Public Health Surveillance by 2035 builds on opportunities that include the Ayushman Bharat scheme that establishes health and wellness centers at the community level- to strengthen non-communicable disease prevention, detection, and control and assures government payment for hospitalization- to reduce out of pocket expenses of individuals and families at the bottom of the pyramid. 

• It builds on initiatives such as the Integrated Health Information Platform of the Integrated Disease Surveillance Program. 
• It aligns with the citizen-centricity highlighted in the National Health Policy 2017 and the National Digital Health Blueprint. 
• It encourages the use of mobile and digital platforms and point of care devices and diagnostics for amalgamation of data capture and analyses. 
• It highlights the importance of capitalizing on initiatives such as the Clinical Establishments Act to enhance private sector involvement in surveillance. 
• It 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. 

• India can create a skilled and strong health workforce dedicated to surveillance activities. 
• Non-communicable disease, reproductive and child health, occupational and environmental health and injury could be integrated into public health surveillance. 
• Morbidity data from health information systems could be merged with mortality data from vital statistics registration. 
• An amalgamation of plant, animal, and environmental surveillance in a One-Health approach that also includes surveillance for anti-microbial resistance and predictive capability for pandemics is an element suggested within this vision document. 
• Public Health Surveillance could be integrated within India’s three-tiered health system. 
• Citizen-centric and community-based surveillance, and use of point of care devices and self-care diagnostics could be enhanced. 
• Laboratory capacity could be strengthened with new diagnostic technologies including molecular diagnostics, genotyping, and phenotyping. To establish linkages across the three-tiered health system, referral networks could be expanded for diagnoses and care

SIGNIFICANCE:

• The document becomes even more relevant as India and the world tackles the pandemic of COVID-19. 
• The paper released recently is envisaged to serve as a vision document to propel public health surveillance in India and establish India as a global leader in the area.