TAMING THE OUTBREAK

• Four years after the outbreak of Covid-19, an expert group constituted by NITI Aayog has recommended a comprehensive framework to manage future public health emergencies or pandemics effectively.
• The group’s report, titled "Future Pandemic Preparedness and Emergency Response: A Framework for Action," was published on September 11, 2023. Here are the key recommendations:

Enactment of Public Health Emergency Management Act (PHEMA):

• Need for PHEMA: The Epidemic Diseases Act (EDA) of 1897 and the National Disaster Management Act (NDMA) of 2005, invoked during the Covid-19 pandemic, were found inadequate. The EDA lacks definitions for “dangerous,” “infectious,” or “contagious diseases” and does not provide for drug/vaccine dissemination or quarantine measures.
• Proposed Solution: PHEMA would empower central and state governments to respond effectively to pandemics and other health emergencies, including non-communicable diseases, disasters, or bioterrorism. This law would provide public health agencies with the authority to take urgent action and create national and state-level public health cadres trained as first responders.

Empowered Group of Secretaries (EGoS):

• Formation of EGoS: A committee of officials led by the Cabinet Secretary will be created to prepare for public health emergencies and monitor preparedness during non-crisis periods.
• Responsibilities: EGoS will guide governance, finance, R&D, surveillance, partnerships, and other necessary functions for immediate response. It will develop Standard Operating Procedures (SOPs) for pandemics and establish sub-committees for these functions.

Strengthen Surveillance:

• Disease Surveillance Network: Strengthening the disease surveillance network is crucial. Historical data show that many epidemics and pandemics, including Covid-19, were caused by viruses linked to bat species, highlighting the need for constant monitoring of human-bat interfaces.
• Biosecurity and Biosafety Network: Establishing a national network involving leading research institutions, biosafety containment facilities, and genome sequencing centers. This system should operate in a harmonized, autopilot mode that activates upon the first warning sign.
• Emergency Vaccine Bank: Setting up a bank to source vaccines from within or outside the country.

Network for Early Warning:

• Epidemiology Forecasting and Modelling Network: Building a network that can predict the transmission dynamics of infectious diseases and monitor the effectiveness of countermeasures, including vaccination, in different scenarios.
• Centres of Excellence (CoE): Creating a network of CoEs for research on priority pathogens. These centers would develop diagnostics, therapeutics, and vaccines for priority pathogens identified by the World Health Organization.

Independent Drug Regulator:

• Clinical Trial Network: India needs a well-developed clinical trial network accepted by international regulatory authorities to ensure quick access to innovative products during public health emergencies.
• Reform CDSCO: The Central Drugs Standards Control Organisation (CDSCO) should become independent and have special powers. Currently under the Ministry of Health, CDSCO regulates the import, sale, manufacture, and distribution of drugs.

Conclusion:

• The expert group's recommendations highlight the necessity for a robust framework to manage future public health emergencies, emphasizing legal reform, strengthened surveillance, early warning systems, and independent regulation. Implementing these measures will enhance India's preparedness and response capabilities, ensuring swift and effective management of future pandemics.