ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)
(a) to (c): The detailed status of the major communicable diseases prevalent in the country like Malaria, Dengue, Chikungunya, Japanese Encephalitis, Leprosy, Tuberculosis HIV/AIDS including of deaths reported is given at Annexure-1 (A) to (C). No death directly attributable to Chikungunya is reported from any State/Union Territory (UT). As Leprosy is non-fatal disease, no death has been reported by any State/UT.
Health being a state subject, it is the prerogative of the State Governments to provide treatment for health conditions including the communicable diseases. The central government augments the efforts of the State Governments through various National Health Programmes like the National Vector Borne Disease Control Programme (NVBDCP), National Leprosy Elimination Programme (NLEP), Revised National Tuberculosis Control Programme (RNTCP) and the National AIDS Control Programme. All these National programmes have wide outreach throughout the country. Various initiatives taken by Government to address these diseases are as under:-
REVISED NATIONAL TB CONTROL PROGRAMME (RNTCP)
The Ministry is implementing the RNTCP with the aim of eliminating TB by 2025.
The key focus areas are:
• Early diagnosis of all the TB patients, prompt treatment with quality assured drugs and treatment regimens along with suitable patient support systems to promote adherence.
• Engaging with the patients seeking care in the private sector.
• Prevention strategies including active case finding and contact tracing in high risk / vulnerable population
• Airborne infection control.
• Multi-sectoral response for addressing social determinants.
NATIONAL VECTOR BORNE DISEASES CONTROL PROGRAMME (NVBDCP)
Malaria, Dengue, Chikungunya, Kala-azar (KA), Lymphatic Filariasis (LF) and Japanese Encephalitis (JE) are the six vector borne diseases prevalent in the country.
The Initiatives taken by the Government are:
Malaria:
• The National Framework for Malaria Elimination (NFME) 2016-2030 and National Strategic Plan (NSP) for Malaria Elimination (2017-22) have been prepared and launched.
• Rapid Diagnostic Tests (RDTs) and effective anti-malarial drugs are being provided for effective diagnosis and treatment of malaria cases.
• In order to prevent malaria transmission, LLINs (Long Lasting Insecticidal Nets) have been provided to high endemic areas of the country.
Dengue/Chikungunya
• Monitoring and supervision for early case detection and prevention and control through reviews and video conference at higher level.
• Advisories were issued to sensitize the States.
• Guidelines on case management were developed and shared with the states for wider circulation.
• Free diagnostic facilities through Sentinel Surveillance Hospitals (SSHs) and Apex Referral laboratories (ARLs) identified across the country. Test kits are supplied by GoI free of cost.
Japanese Encephalitis:
• Strengthening of critical care services by establishment of Pediatric ICUs in 31 identified districts.
• 139 Sentinel Sites have been identified for diagnosis of JE where JE diagnostic kits are available free of cost.
• JE vaccination in identified districts for prevention.
Lymphatic Filariasis (LF):
• Annual Mass Drug Administration (MDA) for prevention of new infections in LF endemic districts.
• National Filaria Control Programme (NFCP) units are functional in LF endemic states which detect and treat filarial cases and carry out vector control activities.
• Accelerated plan for Elimination of Lymphatic Filariasis launched by Hon’ble HFM on 13.06.2018 in 10th meeting of Global Alliance to Eliminate Lymphatic Filariasis (GAELF) at New Delhi.
• A new initiative of Triple Drug Therapy IDA (Ivermectin + DEC + Albendazole) is being rolled out in five selected districts Arwal (Bihar), Simdega (Jharkhand), Nagpur (Maharashtra), Varanasi (Uttar Pradesh), Yadgir (Karnataka). District Arwal (Bihar) has already undertaken MDA with IDA on 20.12.2018.
Kala-azar:
• Single dose single day treatment of Kala-azar cases with Liposomal Amphotericin B.
• Indoor Residual spray with synthetic pyrethroid
• Provision of pucca houses in Kala-azar affected villages upto saturation level
• GOI raised Accredited Social Health Activists (ASHAs) incentives from Rs 300 to Rs 500 for ensuring treatment of Kala-azar cases
• GoI raised incentives for complete treatment of Post-kala-azar dermal leishmaniasis (PKDL) cases from Rs 2000 to Rs 4000.
NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP)
Initiatives taken by Government to address problem of Leprosy are as below:-
Early case detection: Three pronged strategy i.e., i) Leprosy Case Detection Campaign (LCDC) (specific for high endemic districts), ii) Focussed Leprosy Campaign (for hot spots i.e., rural and urban areas where G2D is detected), iii) Special plan for case detection in hard to reach areas.
Enhanced early case reporting:
i) Sparsh Leprosy Awareness Campaign (SLAC)
ii) ASHA based Surveillance for Leprosy Suspects (ABSULS)
iii) Prevention of leprosy / Interrupt transmission: Post Exposure Prophylaxis administration to contacts of new cases detected in LCDC districts.
iv) Overall strengthening of the programme: i) Nikushth an online reporting system with Patient tracking mechanism, ii) Grade II disability case investigation.
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The above mentioned activities have given the needed impetus to programme and as an effect of the same the rising trend of Grade II disability is showing decline, the Grade II disability per million which was 4.48/ million population as on March, 2015 has decreased to 3.34/ million population as on March, 2018 against the target of <1 case of Grade II disability/ million population, given by World Health Organization (WHO) Global Leprosy Strategy, 2016 - 2020.
HIV/AIDS
HIV/AIDS is one of the communicable diseases in the country. As per HIV estimations 2017, India is estimated to have an adult HIV prevalence of 0.22% with 21.20 lakhs HIV infected people in country. Ministry of Health & Family Welfare, Government of India implements National AIDS Control Program under Central Sector Scheme for prevention, detection and treatment of HIV infections. The program is being implemented in all States/UTs of country through State AIDS Control Societies. Government has recently implemented Test and Treat policy, HIV/AIDS Prevention and Control Act, Community Based Screening and Routine Viral Load Testing to address the disease of HIV/AIDS in country.
(d): The funds released to States / UTs in last three years in respect of above diseases are at Annexure 2 (A) to (D).
(e): Some important Information Education Communication (IEC) / Behaviour Change Communication (BCC) activities to increase awareness are as under:
• Rural and Outdoor Media
• Mass media campaign through Radio, Television, cinema slide,
• Print media, and
• Social media
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