Microbiologist Udaiveer Rana talks about the country's revamped disease institute.
On 30 July, India allocated 5.1 billion rupees (US$110 million) over three years to convert its 100-year-old communicable diseases institute in New Delhi into the Indian equivalent of the US Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.
Microbiologist and veterinary scientist Udaiveer Rana, joint director of the zoonoses division at the new centre, has been a troubleshooter at the institute ever since he joined it 28 years ago. He has rushed to the sites of many diseases outbreaks in India — pneumonic plague in Surat in 1994, leptospirosis in Kerala in 2002, SARS in Goa in 2003, anthrax in Mysore in 2004 and bird flu in West Bengal in 2008. Nature talks to him about the institute's new responsibilities.
Why has the government decided to revamp it's communicable diseases institute into the National Centre for Disease Control (NCDC)?
The 1994 outbreak of pneumonic plague was a wake-up call. It caught the country unprepared. Reagents and antisera for diagnosis were not in stock and India had stopped making anti-plague vaccines five years earlier. A government committee found that the epidemic was due to failure of the surveillance system and called for it to be strengthened. The NCDC is the result of this.
So it has taken 15 years to do this?
Not really. A $100-million World Bank project launched in 2004 created the backbone for a disease surveillance system, which now covers all 600 districts with a disease surveillance officer and rapid response team in place in each district and 24-7 satellite communication links with Delhi. The NCDC will build on this existing infrastructure using the fresh funding to modernize equipment and augment manpower. A network of public-health institutions will be created to improve diagnostic capabilities for emerging and re-emerging infections.
What is the agenda of the NCDC?
As health minister Ghulam Nabi Azad says, India has to deal with unsolved problems such as malaria and tuberculosis at the same time as new and re-emerging infectious diseases. Over two dozen new disease-causing agents have emerged during the last 30 years. While the CDC caters to global needs, the NCDC will concentrate on southern and south-east Asia as well as our country. But it will be a long process.
What challenges will the NCDC face?
The main problem is a shortage of manpower at a time when new outbreaks of diseases such as leptospirosis are coming in. It is hard to find epidemiologists. Most of those who nurtured our institute are about to retire. There were 20 officers in microbiology and zoonosis divisions in 1994 but now only 10 remain.
How do you plan to tackle this?
One way is to forge large-scale collaborations with leading national laboratories and universities that have research programmes related to our work. Because 70% of new diseases appearing in India originate in animals [called zoonoses], tie-ups with veterinary institutes scattered across the country will help.
Remember we do not know what new animal diseases will strike, or when. The government has also taken care of some manpower problems. The rules have been amended to allow the recruitment of scientists as consultants. There is not only much better coordination among officials, from ministers all the way down, than there was before, but every report generated in the field now goes to cabinet, which means prompter action by the government.
How about international collaboration?
Scientists from the CDC have been coming periodically to advise us. The first batch of scientists from our institute would have gone to the CDC last month, but for the swine-flu epidemic in India. The NCDC expects to have closer interactions with health systems in south and south-east Asian countries and the World Health Organization is promoting such collaborations. Over the coming year, faculty from the NCDC will conduct a workshop on zoonoses in Thailand, which is working on creating its own CDC. We hope in the years to come NCDC can take a bigger role in this region with the WHO's help.
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Jayaraman, K. India upgrades its disease surveillance network. Nature (2009). https://doi.org/10.1038/news.2009.825