Inter alia is my fortnightly Saturday op-ed column for Business Standard newspaper.
Friday, June 16, 2017
Zika virus and the unimportance of some people
All is not well with the government's response to public health
(Published on June 3, 2017 in Business Standard)
Of the Prime Minister’s many annoying acronyms, one stands out for being positively the most dishonest: EPI, or “Every Person is Important”. Phooey! Nobody who thinks Every Person is Important would compare people getting murdered to puppies getting run over. Plus, it’s the exact opposite of majoritarianism. Here’s an example of its dishonesty.
In November 2016, a case of Zika virus was detected in Gujarat. This is the virus that, when it rampaged through Brazil last year, was declared an international public health emergency, and almost derailed the Rio Olympics. Zika is transmitted by the Aedes aegypti mosquito — the same vector that will soon be bringing dengue and chikungunya to a nasty puddle near you — and has likely been hanging around India for decades, so, as the World Health Organization (WHO) has said, an eventual outbreak here is inevitable. It can also be transmitted sexually, remaining in semen for months.
Symptoms, if you develop them, include fever, rashes, joint pain, and conjunctivitis. They’re fairly mild, require no special treatment, and go away in a few days. But the Zika virus is a huge health hazard because if you’re pregnant, there’s a good chance that your baby will be born with microcephaly — a head smaller than normal, with an underdeveloped brain. The condition is associated with seizures, a shorter lifespan, poor brain and motor function, and dwarfism.
Even unimportant people don’t want that for their kids.
Sounds nasty, doesn’t it? It’s the kind of thing that might motivate people to be more careful about wearing long sleeves and insect repellent, keep their environment clean, and screen themselves if they’re sexually active. It’s definitely the kind of thing that people, even unimportant people, have the right to know.
By January 2017, three cases were confirmed in Ahmedabad. Three is not an outbreak. But you can’t be complacent about serious disease; Singapore had a few isolated cases, and then an outbreak months later. So the Indian government swung into action, scanning for the virus, testing over 34,000 blood samples and over 12,000 mosquito samples (more since then). It got the Indian Council of Medical Research (ICMR) to increase disease surveillance. It mobilised health workers to identify vector breeding spots and disease. It monitored for microcephaly. All good steps.
But guess what it didn’t do? It didn’t tell anyone that we were dealing with Zika. It didn’t tell state and local authorities. It didn’t tell the health workers. And it didn’t tell the public. It said it was investigating malaria and dengue, not a new and dangerous disease unfamiliar to the Indian public. The Integrated Disease Surveillance Programme disease maps did not mention Zika. The health ministry responded to a question in Parliament saying that one case had been confirmed (when in fact three had been), that the states had been advised, and that a travel advisory was out.
But Indians only found out about all this at the end of May, a full five months later, when the WHO posted its report on its website — having waited two months for the government’s replies to its questions.
Why the secrecy? How can an administration withhold a serious health hazard from the public, and the international community? How can it ignore disease control protocols? It hasn’t yet even finalised, according to the WHO report, information and communication materials for the public.
The silence wasn’t born of incompetence or oversight. Chief Secretary of Gujarat J N Singh said it was deliberate, to “avoid spreading panic”. To say that it was just saving Indians from their own chicken-headedness is contemptible government paternalism at best. But there’s a more grotesque and more likely explanation: According to The Hindu, the government hushed up Zika partly because the Vibrant Gujarat Summit was just days away. It wasn’t going to jeopardise millions of dollars just because of a few small-headed Indian babies birthed by a few dispensable Indian women.
The government has refused, so far, to waste its valuable time holding a press conference on the subject so that we can better understand why it failed to disclose, to citizens, a health threat to citizens. Health Minister J P Nadda also refused to address Zika, and the odd five-month silence about it, in an interview published a few days ago about three years of the Narendra Modi-led government. At least this demonstrates the worth of another of the PM’s acronyms: ART, or “Accountability, Responsibility, Transparency”.
To summarise, it is obvious that EPI is total hooey and should be binned. I’d like to offer a usable replacement: USP. As in, this government’s USP is the Unimportance of Some People.