Dengue has killed 23 people in Tamil Nadu, while over 10,000 cases have been reported this year, according to the state government. With three children dying in Chennai from the vector-borne disease last weekend alone, the state has been forced to declare a “sporadic outbreak” of dengue in Chennai, Cuddalore, Tiruvallur, Kanchipuram and Thanjavur districts.
‘Declare Dengue a Public Health Emergency’
But with dengue showing no signs of being controlled in the state, former Director of Public Health and President of the Indian Public Health Association (IPHA) – Tamil Nadu chapter, Dr S Elango says the state should declare the disease a ‘public health emergency’.
“For the last six to seven months, the government is taking steps to control the problem. But the deaths are not declining. While in some areas, the number of cases are coming down, new areas are being added. If you are not able to control vector borne diseases within 90 days, you have to declare a block, district, or a geographical area as a public health emergency,” says Dr Elango to TNM.
He argues that by doing so, the entire system will act like it is war. Dr Elango states, “If one district is declared as a public health emergency, all resources will be pooled in. It will receive resources from international and national agencies as well and will get an immediate response.”
‘Politics being played at cost of public health’
It has been nearly a year since the expiry of the term of the local bodies in Tamil Nadu and the absence of elected representatives such as mayor, chairperson or ward councillors is affecting the fight against dengue, says the IPHA Tamil Nadu President. Having surveyed three districts in the state, Dr Elango points out, “In the absence of local body representatives, officials are afraid of taking emergency measures to allocate or create funds. While the state government has given a small amount for fogging, and provides manpower, chemicals and equipment, there is no money for operational costs such as for fuel. This money is allocated from local bodies.”
Alleging that politics is being played at the cost of public health, Dr Elango observes that the government should not hide or under report dengue cases.
He notes that future steps can only be taken if the right data is available. “This will help administration epidemiologically, to find out why in three months so many children or people have died. Real scientific intervention with national and international expert agencies is the need of the hour,” says the former Director of Public Health.
Water sources allowing breeding of aedes mosquito
TN govt says no such terminology as public health emergency
Refuting Dr Elango’s suggestion, Tamil Nadu’s Health Secretary J Radhakrishnan, however, argues that there is no such terminology of declaring a public health emergency under the Public Health Act. “Under the Public Health Act, there is no such thing. It is an American terminology. The World Health Organisation has said focus on source reduction. The cause has to be prevented and our focus is on mosquito breeding source eradication,” says the Health Secretary to TNM.
He also insists that declaring a public health emergency could create panic. Radhakrishnan says, “A multi-departmental approach with people’s participation is required. We are focusing on preventing morbidity and mortality.” Pointing out that an attitudinal change was required from the public, he says the state government on Monday decided to engage in fumigation of schools, waterbodies and other high-risk places.
In addition, the Tamil Nadu government has also announced that every Thursday will be anti-dengue day. What this means, Radhakrishnan says, “On a weekly basis, we would like to cut the cycle of dengue breeding. This has succeeded in Cuddalore.”
And despite the recent spike in dengue cases, the Health Secretary observes, “Dengue is not limited to Tamil Nadu. We have about 17,000 cases in Kerala, the same upsurge in Karnataka, Nellore, Sri Lanka, Malaysia and other countries. It is more a habitat issue though case management cannot be ignored. But sustained success can only be by cause management of the aedes mosquito breeding sources.