India must be more transparent about disease threats

June 9, 2017 by Santosh Vijaykumar, The Conversation
Aedes aegypti mosquito. Credit: khlungcenter/Shutterstock

The first laboratory confirmed case of Zika in India was detected in a hospital in Ahmedabad, Gujarat, on November 9, 2016. A further two cases were subsequently confirmed – one in January 2017 and another in February. None of these cases were reported to the World Health Organisation (WHO) until May 15.

Why the government decided against publicly announcing these for nearly six months after first confirming them is unclear, but it reflects ongoing low levels of transparency in India's public health system. Not surprisingly, India ranked second to last in a recent study of transparency in health systems across 32 countries.

The WHO strongly encourages governments to quickly report potential and actual public health threats so that the problem can be nipped in the bud. But, for various reasons, some countries fail to comply. Reasons for doing so include potentially negative impacts on business and tourism, loss of public confidence and negative impacts on the career prospects of politicians.

In 2003, China withheld information about a major SARS outbreak, which put its own public and those of other countries under grave risk. Other countries might have fewer human, economic or infrastructure resources than China and so are unable to detect and report cases on time. India's disease surveillance system is vast, but it is limited by a fragmented structure and lack of coordination.

Valid justification?

Indian officials justified not informing the WHO within 24 hours – a requirement under international health regulations requirement – by citing the WHO's declassification of Zika as a of international concern in November 2016. The director general of the Indian Council of Medical Research further clarified that the government chose to avoid creating panic.

But other facts emerged that raised suspicions. Authorities chose to withhold the information from even the local civic authorities who could have swiftly prepared local communities to undertake preventive measures. The authorities conducting Zika surveillance also misinformed some of the public that the tests were for malaria. And the authorities excluded Zika cases from the official infectious disease monitoring and reporting website even after news of the cases was released.

Unused resources

The Indian government developed a communication plan to tell the public about Zika before the first laboratory Zika case was identified last November. What is puzzling is why they chose not to put this plan into action and spread word about their control measures through the media – which, in India, is enormous and far-reaching. If they had, they might have reassured the public that everything was under control.

Since assuming office in May 2014, India's prime minister, Narendra Modi, has repeatedly spoken about his vision for a "digital India". But the mobile apps, social media accounts and slick websites that the government created in order to increase transparency and communication with its citizens, were left untouched as the Zika cases emerged. Instead, the public learned about this important health threat from the WHO.

The importance of transparency

A lack of transparency on critical matters of public health can lead to a loss of trust in the government and suspicion among the public. For instance,media reports suggested that the government was silent about the Zika cases as it might have negatively affected business (an international business summit was held in Gujarat around the time the second case emerged).

Risk communication experts point to the importance of transparency – through clear, constant communications – in building public trust during a disease outbreak. A lack of trust makes it tougher for governments to manage future outbreaks efficiently.

With few Zika cases and a comprehensive surveillance system, India is fortunate to have avoided disaster – so far. But the threat of a larger outbreak in India, and in neighbouring countries, is still very real.

The Indian may have failed in its duty to report a threat, but it's not too late to learn from this experience. Doing so will offer them an opportunity to set an example to other low and middle-income countries, and strengthen its position as a responsible player in global . Compromising on , on the other hand, will imperil India and its neighbours, and may even have global ramifications.

Explore further: India confirms first Zika virus cases: WHO

Related Stories

India confirms first Zika virus cases: WHO

May 27, 2017
The Indian health ministry has confirmed its first cases of the Zika virus, the World Health Organisation has said, the latest nation to be affected by the mosquito-borne virus that sparked global concern.

India reports its first three cases of the Zika virus

May 28, 2017
India has reported its first three cases of the Zika virus, including two pregnant women who delivered healthy babies.

Brazil calls off Zika emergency

May 11, 2017
Brazil's government on Thursday declared an end to a national emergency over the Zika virus which was detected in the Latin American country late in 2015 before becoming a global concern.

Zika birth defects in 5 percent of infected women in US islands

June 8, 2017
Five percent of women in the US territories who were infected with the Zika virus while pregnant had fetus or babies with defects, including microcephaly, government health data said Thursday.

Cuba reports a surge of Zika but still fewer than neighbors

May 18, 2017
Cuban state media report a surge of Zika on the island, though the overall number of cases is still far fewer than elsewhere in the Caribbean.

Bolivia reports first three Zika-linked microcephaly cases

November 2, 2016
Bolivia has detected its first three cases of microcephaly caused by the Zika virus, local media reported Wednesday, citing health authorities.

Recommended for you

Infants born to obese mothers risk developing liver disease, obesity

November 16, 2018
Infant gut microbes altered by their mother's obesity can cause inflammation and other major changes within the baby, increasing the risk of obesity and non-alcoholic fatty liver disease later in life, according to researchers ...

New study shows NKT cell subsets play a large role in the advancement of NAFLD

November 16, 2018
Since 2015 it has been known that the gut microbiota could have a direct impact on nonalcoholic fatty liver disease (NAFLD), which affects up to 12% of adults and is a leading cause of chronic liver disease. In the November ...

Antibiotic prescribing influenced by team dynamics within hospitals

November 15, 2018
Antibiotic prescribing by doctors is influenced by team dynamics and cultures within hospitals.

Discovery suggests new route to fight infection, disease

November 14, 2018
New research reveals how a single protein interferes with the immune system when exposed to the bacterium that causes Legionnaires' disease, findings that could have broad implications for development of medicines to fight ...

Zika may hijack mother-fetus immunity route

November 14, 2018
To cross the placenta, Zika virus may hijack the route by which acquired immunity is transferred from mother to fetus, new research suggests.

New research aims to help improve uptake of hepatitis C testing

November 14, 2018
New research published in Scientific Reports shows persisting fears about HIV infection may impact testing uptake for the hepatitis C Virus (HCV).

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.