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NEWS ROUNDUP: Ganapati Mudur Joint public-private initiative aims to boost public health in India BMJ 2006; 332: 813 [Full text]

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Public-private initiative to boost public health in India.

T.Jacob John   (2 May 2006)

Public-private initiative to boost public health in India. 2 May 2006
T.Jacob John, Retired Vellore, Tamil Nadu, India Send response to journal: Re: Public-private initiative to boost public health in India.	Editor, According to a news item in BMJ(8 April, 2006) the Public Health Foundation of India, launched in New Delhi recently, intends to boost public health by building 5 schools of public health, and by serving as a think-tank for the government and the private sector. While some experts in public health and health activists have welcomed this initiative, I suspect it may further delay in the rebuilding of India’s much deteriorated public health system by providing false hope and by deflecting us from the essential tasks. Before applying an assumed solution we must assess and define the problem. There is no functional, responsive and responsible public health system in India. There are “vertical” single-disease control programmes for poliomyelitis, tuberculosis, malaria, leprosy, lymphatic filariasis, visceral Leishmaniasis and AIDS, managed through special schemes. Except for polio, there is no functional disease surveillance (information for action). There are also the programmes of national childhood immunization against the cluster of vaccine-preventable diseases and ante-natal screening and tetanus vaccination, both provided in lieu of primary health care. Together the above set of activities mask and masquerade as public health. The successes and failures of their achievements against targets are widely known and nothing to be proud of. For all other innumerable public health problems, the responses are ad-hoc and calibrated according to the media noise – ranging from denial to massive mobilization. Neither approach, vertical or ad hoc action helps build the basic public health infrastructure. There have been attempts to assess the needs and to design solutions improvements, but a Foundation was not one of the answers. India needs to design and re-build a functional, local-need-responsive public health system Today in most states (with exceptions of Tamil Nadu and Maharashtra) there is no need to have any public health training for state or district “Medical Officers of Health”, whose major functions are to administer the network of hospitals and primary health centres. Orthopedicians or obstetricians have equal chance to become such officers as physicians or pediatricians. In Tamil Nadu and Maharashtra, Health Officers have special training programmes and institutions – either at diploma level or MD level. Other than these there is no career path for other public health trained personnel. Trainiing first or career path first? Professor T.Jacob John, (Retired Head of Clinical Virology Dept. at Christian Medical College, Vellore, India) 439 Civil Supplies Godown Lane, Kamalakshipuram, Vellore, TN, 632 002, India. Competing interests: None declared