New Delhi, Dec. 23: Bihar has this year failed to use funds allocated by the Union government to tackle severe and repeated outbreaks of encephalitis that have killed hundreds of children across the state over the past several years.
The Union health ministry has estimated that Bihar spent only 1 per cent of Rs 28.57 crore provided by the Centre for fiscal 2014-15 under the national programme to prevent and control Japanese encephalitis and acute encephalitis syndrome. Union health minister J.P. Nadda admitted in the Lok Sabha on Monday that efforts to fight encephalitis have not yielded the desired results amid concerns voiced by members that the disease had claimed over 1,495 lives, including 200 in Bihar.
Bihar has this year reported at least 866 cases of either JE or acute encephalitis syndrome. Neither Bihar's principal secretary (health) Brijesh Mehrotra nor the secretary Anand Kishore was available for comments despite repeated attempts. Public health analysts who have been studying the disease and its implications have blamed the government's over-emphasis on a 'bio-medical approach' instead of simultaneously seeking to correct 'systemic' deficiencies that handicap states grappling with encephalitis.
'It is quite likely that Bihar does not have the capacity to absorb the funds,' said Manish Kakkar, a specialist in communicable diseases at the Public Health Foundation of India, New Delhi, a research and education institution.
He recalled that during his visit to the state's worst-affected districts, such as Gaya and Muzaffarpur, he had observed a gross lack of facilities, infrastructure, and trained medical personnel.
'Our hospitals, especially the primary health centres, are just not prepared to tackle outbreaks of such magnitudes, and there are issues such as sub-optimal healthcare and the lack of access to proper healthcare facilities,' said Kakkar. 'While the government has been stressing on research on the microbes that cause the outbreaks, there has been no improvement on the ground to have a well-equipped healthcare system in place.'
According to the health ministry, 15 districts in Bihar apart from 20 in Uttar Pradesh, 10 in Assam, 10 in Bengal and five in Tamil Nadu, have been marked as high priority districts under the national programme for the disease.
Nadda's statement in Parliament also pointed out that paediatric intensive care units required to manage encephalitis cases at the Gaya Medical College and Patna Medical College require 'upgradation'. Experts believe that paediatric units in Bihar have not performed up to the mark. 'The government typically responds only after a major outbreak has emerged and the situation has run out of control,' said Kakkar. 'In the worst-affected districts of Bihar, the conditions of the paediatric units in even medical colleges have not been improved despite the fact that the disease has been troubling the state for more than seven years now.'
Health minister Nadda has said vaccination against the JE virus, which was started in 2006, has been scaled up in a phased manner over the years.
'From April 2013 onwards, two doses for JE are scheduled under routine immunisation, the first at nine to 12 months and the second at 16 to 24 months of age. Out of the 179 JE endemic districts in the country, 152 have been covered by vaccination from 2006 to 2014,' he said in the statement.
Further, a catch-up round to cover children who had been missed out during campaign and routine immunisation has been carried out in June this year in 10 districts of Uttar Pradesh and eight of Bihar, the minister said.
