Introduction

The white paper has been published by NITI Aayog in December 2020 with input and guidance from the Institute of Global Public Health at the University of Manitoba, Canada. Based on the foundations of the National Health Policy 2017, this vision document lays the groundwork for integrated surveillance of all forms of diseases.

This document is a continuation of the work on Health Systems Strengthening, which is a very essential factor for disease detection, prevention and control. India has witnessed multiple disease outbreaks in the past and is also battling the current COVID-19 pandemic. Given this situation, India needs to respond proactively when it comes to putting into force detection, prevention and control measures. In this step, the document clearly lays out the vision, illustrates the architecture, charts out the flow of information and identifies other considerations that are required to expand the scope of public health services in India.

The document successfully identifies and addresses the gap areas in the Public Health Surveillance capacity by recommending the following: a) creating a strong and skilled health workforce for the surveillance activities, b) integrating non-communicable diseases, reproductive and child health and occupational and environmental health into the surveillance system, c) merging morbidity data from health information system with mortality data, d) devising citizen-centric and community-based surveillance and e) enhancing laboratory capacity with new diagnostic technologies such as molecular diagnostics, genotyping and phenotyping.

To support the above areas, the report envisages four building blocks: a) an interdependent federated system of government architecture between Centre and States, b) a new method of collection and sharing of data based on unitized, citizen-centric comprehensive Electronic Health Records (EHR), c) use of data analytics, ML and AI and d) advanced health informatics. The document is of the vision that in the near future the country’s public health surveillance will be based on individual EHR that will capture all health-related information through the use of a unique health identifier (UHI). 

Relevance of the Report

The vision document takes into account best practices from developed and developing countries to recommend steps so as to enable India to achieve the above vision. However, the recommendations come as a continuous cycle rather than a one-time exercise which will raise the profile of surveillance. In addition to this, the report also details out the key considerations in creating this document such as the goals, immediate next steps, leveraging existing talent and providing data access to all stakeholders. Above all, the document gives an optimistic view that if the recommendations are followed, India will be one of the global leaders in public health surveillance.

Key Takeaways

• Surveillance is an important aspect of Public Health and is essential for disease detection, prevention and control.
• India should build a public health surveillance system by 2035 that will be integrated, predictive, responsive and inclusive.
• The surveillance system should include the health and wellness centers at the community level to strengthen non-communicable disease prevention and assure government payment for hospitalization so as to reduce out-of-pocket expenses of an individual.
• The multiple gaps in the present health surveillance system needs to be plugged in using a comprehensive approach involving both Centre and States.
• Use of latest diagnostic technologies, data analytics and AI will be key ingredients in achieving the desired vision.