Articles by T Jacob John

The number infected with SARS-CoV-2 in early May in India is estimated by a method utilising the unequivocal number available, namely deaths due to COVID-19. The estimated numbers are far in excess of reported numbers and indicate the systemic flaws in reporting deaths in India, augmenting the extent of underestimation. Additionally, there is the overestimation of the doubling time of infection. A realistic picture of the epidemic at the community level is presented, which informs us about the level of preparedness required to deal effectively with the epidemic.

The government has not taken the outbreak of influenza virus seriously enough. While it had managed to curtail the spread of the H1N1 virus in 2010, it has not put in place the public health measures which would collect data and allow for policies which will protect the most vulnerable populations. An explanation of the dangers of influenza and what can be done to address these.

There is no policy in India for tuberculosis control and the centrally-run Revised National Tuberculosis Control Programme has neither mandate nor agenda for TB control. There are short, medium and long term remedies for the maladies of the revised programme which are detailed in this article. TB is both a biomedical and a social, cultural and economic problem. Citizens must demand a national policy for TB control.

Overcoming formidable biological and sociocultural barriers, India eliminated wild polioviruses from its territory in January 2011. Looking back, it is obvious that the best policy would have been to introduce the inactivated poliovirus vaccine to prevent polio in every vaccinated child, and to use oral poliovirus vaccine by pulse campaigns to eliminate WPVs rapidly. This would have eliminated polio decades ago. Now that WPVs have been eliminated, IPV must be introduced as a prelude to withdrawing OPV. The road ahead is bumpy, but with the important lessons learnt so far, India can no longer pretend that it is too difficult to design a permanent public health infrastructure to control other communicable and non-communicable diseases.

Sapna Desai’s commentary “Keeping the ‘Health’ in Health Insurance” (epw, 19 September 2009) is insightful and timely. It focuses on public health, the missing element in India’s health system.