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Tackling chikungunya

The incidence of chikungunya, the debilitating though non-fatal illness, has reached epidemic proportions in at least eight States. The number of suspected cases is nearing a million, Karnataka being the worst affected with 5.7 lakh cases. But at the level of the Central Government in tandem with the States concerned, no comprehensive strategy to meet the challenge seems to be in the making as yet. Andhra Pradesh, Karnataka, Maharashtra, and Tamil Nadu, for their part, held a joint meeting of Health Ministers recently, and followed it up by submitting a memorandum to the Centre. Their chief demand is for Central assistance. One of the specific requests is that viral diagnostic facilities be made available in the States: these now exist only in Pune and Bhopal, which are unable to cope with the load. Karnataka for one was told not to send any more blood samples for testing. The National Institute of Virology and the National Institute of Communicable Diseases, which function in different States, can be provided grants to set up full-fledged diagnostic laboratories. The States have made a plea for Rs. 92.48 crore — to deploy fogging machines, supply symptomatic drugs, and hire temporary health workers. The Central Government needs to respond urgently to their specific pleas for action.

No accurate epidemiological picture of the illness seems to be available even at this point. It is clear that, without the collection and collation of data on patterns of incidence, spread, and degrees of severity, chalking out a comprehensive strategy will be an impossibility. In fact, three months ago when the number of persons afflicted by this disease started rising at a disturbing rate, official reactions at the State level ranged from denial — as in the case of Tamil Nadu, which now has at least 24 of its 29 districts affected — to an insensitive response. Had the public health system been galvanised at that point and preventive measures taken on a war footing, it is unlikely that the march of the illness would have been this relentless. Considering that it is the poor who are hit the hardest by way of the loss of workdays and sheer misery, the livelihood issues involved are significant and have implications for the economy as a whole. The situation calls for joint and swift action by the affected States and those that are geographically contiguous to them, with necessary help from the Centre in terms of surveillance, prevention, early detection and control in a synchronised mode. Madhya Pradesh, Gujarat and Rajasthan — as also the Andaman and Nicobar Islands — that have so far not been involved in making a joint approach should be brought on board. Meanwhile, other vector-borne viral illnesses such as Japanese encephalitis, dengue fever, and malaria are spreading in certain pockets, including in Uttar Pradesh. It is imperative that efforts under the National Vector Borne Disease Control Programme are redoubled without delay.

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