Japanese Encephalitis – India’s costly delay in giving it attention?

(This is a synopsis of a Hindi-language article originally written by Dr Muzaffar Husain Ghazali and published in the Awaam-e-Hind)

There has been sudden media frenzy following the deaths of 70 children from encephalitis in Gorakhpur in Uttar Pradesh, yet deaths from this disease is not new in this place. Since 1978, there have been several instances of this disease resulting in deaths of both children and adults. In 2016 there were 694 deaths from this illness countrywide. In fact, the mosquito-borne Japanese Encelphalitis (JE) disease has been prevalent in India since 1955 when the first outbreak was reported in the southern state of Tamil Nadu. By 1973, it had spread to 22 states, particularly those where paddy farming is prevalent. Humans get infected when bitten by the Culex mosquito, which acquires the virus from infected pigs and migratory birds. These mosquitoes breed in stagnant water used to cultivate paddy.

The first JE vaccine was approved by the World Health Organisation in 1930. But it took 82 years for a vaccine to be developed in India. First there was a single dose vaccine in 2012 that was expensive and targeted at tourists visiting India. A year later a two-dose vaccine was developed. It appears however that there have been lapses in administering the second dose and the Central and State governments are trading faults at each other. Even neighbouring Nepal fares better at administering the JE vaccine. The health budget is not expanding as rapidly as the demand for health services is. And the ratio of doctors-patient ratio lags the requirement. Although the present state leadership is well-versed with this disease and its challenges, nothing much seems to be changing on the ground to tackle it.