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Rs 4000cr to fight disease
- Encephalitis focus on Bengal and four other states

New Delhi, Oct. 18: The Union cabinet today approved a Rs 4,000-crore package of measures to control encephalitis infections that have bedevilled several states despite years of immunisation and a war on mosquitoes.

The cabinet approved a proposal from the Union health ministry for a five-year initiative to prevent and control encephalitis in 60 priority districts with focused actions in five states: Bengal, Assam, Bihar, Tamil Nadu and Uttar Pradesh.

The money will be used to expand vaccination against Japanese encephalitis, a viral infection spread by mosquito bites, and to improve sanitation and access to safe drinking water to curb encephalitis caused by microbes in contaminated water.

An expert panel set up by the Indian Council of Medical Research (ICMR) had estimated two years ago that about 20 per cent encephalitis cases are of Japanese encephalitis, 5 per cent are bacterial infections, and a small proportion are caused by stomach viruses.

The cause of encephalitis in most patients remains unknown, the panel had said. But it recommended that the immunisation of children against Japanese encephalitis, initiated in the affected states in 2006, should continue for five more years.

The proposal approved today sets an outlay of Rs 1,131 crore for the health ministry, Rs 2,301 crore for the drinking water and sanitation ministry, Rs 418 crore for the housing and urban poverty alleviation ministry and Rs 177 crore for the women and child development ministry. The health funds will also be used to improve medical management of patients with encephalitis.

Public health experts estimate that several thousand children have been infected with encephalitis in India in repeated outbreaks over the past decade. In 2011, the health ministry has said, Japanese encephalitis alone caused at least 157 deaths.

Part of the funding will also go into medical and social rehabilitation of encephalitis patients. The government estimates that about 30 to 40 per cent of children who recover from Japanese encephalitis may suffer from physical or mental handicaps.

The health ministry had in 2006 introduced a Chinese vaccine against Japanese encephalitis in a controversial initiative without — as sections of even government scientists had said then — adequately assessing its efficacy in Indian children.

The ICMR expert panel had observed two years ago that post-marketing studies of the vaccine in India, conducted by the ICMR, show that the rate of “sero-conversion” is lower (in India) than that reported in other countries.

The rate of sero-conversion is the proportion of vaccinated people who develop an immune response against the Japanese encephalitis virus. Independent surveys have indicated that the vaccination programme had not adequately covered vulnerable populations.