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Lessons for Global Health from India - event blog

Introduction

The symposium on "Lessons for Global Health from India" held on Wednesday 20 June at UCL Institute of Child Health was an occasion to discuss some of the latest research on India, and its implications for global health.

The event, organised by UCL Interdisciplinary Society for International Development together with the UCL Grand Challenge of Global Health and UCL Public Policy gathered a collection of academic researchers, students, medical professionals and policy-makers, as well as think-tanks and NGO representatives who discussed public health in India. Emphasis was placed on practical lessons that could be drawn from such research for addressing global health challenges and the implications for public policy at national, regional and global level.

Session 1

The first session saw Dr Vinay Bothra (UK Health Protection Agency) and Dr Sushrut Jadhav (UCL Medical School) discussing infectious and mental diseases, which are seen together as two main threats to wellbeing of people in India.

Dr Bothra highlighted the problem of vaccine-preventable diseases such as measles. While they still remain the biggest killer of children in India, it was encouraging to hear that the situation has been improving in recent years and that research centres such as the newly established Centre of Infectious Diseases in India are making an enormous effort to address the problem with the ambition of eliminating vaccine-preventable diseases in the foreseeable future.

Dr Jadhav talked about mental health and the surprisingly significant impact of the human-elephant conflict on people's wellbeing. Many people in rural India are under a constant threat of being attacked by elephants. This leads to excessive alcohol consumption (as it is believed that alcohol gives people courage to face the animals), which, combined with constant fear may lead to development of mental diseases. Dr Jadhav told a poignant story of a young man from rural India, one of the many victims of an elephant riot, who following an attack, lost all of his property, documents and employment, and thus developed a long untreated mental disease. As a final remark an emphasis was given to the need for better recognition of mental illness in the developing world, and to the importance of recognising local contexts when considering global health issues.

Session 2

The second session addressed the problems of social exclusion and took a more global perspective, highlighting the role of Indian manufacturers in the vaccine development.

Dr Babken Babajanian (Overseas Development Institute) talked about discrimination and economic exclusion in India, focusing on the development of the RSBY Health Insurance Scheme in order to improve health care access and utilisation in India. Many patients in rural India do not seek medical treatment not only because of discrimination (including gender, racial and religious discrimination), but also due to financial barriers. The out-of-pocket expenditure incurred in accessing medical services is an important obstacle in improving the access to healthcare in the developing world. As Dr Babajanian concluded, the Health Insurance Scheme may prove to be a good way to address the need for social protection activities and appropriate institutional arrangements.

Dr Tarit Mukhopadhyay (UCL Department of Biochemical Engineering) gave an engaging speech on vaccine development in India. I was very surprised to hear that despite the public health problems in rural India, its pharmaceutical industry is actually one of the most developed with half of the world’s children being treated by vaccines developed by the Serum Institute of India. The Institute, which collaborates with global partners such as SynCo Bio, finds it worthwhile to produce doses at an extremely low cost of 0.50c (making actually a loss on every dose!) and thus giving access to otherwise unreachable Western technology. During the past few years, incredible progress has been made in vaccine development. The high percentage of vaccine-preventable diseases among the Indian population is due to limited distribution of vaccines, rather than low production levels.

Discussion

One of the many questions asked by the audience which I found particularly important was: "Is the public health system in India sustainable?" In other words, how can we actually address the problems of most of the population who live in rural areas if there are not enough doctors willing to move out of the big cities to treat them? 

This question might have been partly answered by Dr Marcos Vera-Hernández (UCL Economics) who talked about a multi-partner project launched by Duke University which evaluates the gains from bringing new technologies to getting people to doctors. The researchers have used a social franchising telemedicine in Bihar, India which not only allows patients to have a webcam consultation with a doctor in Delhi, but also uses special technological solutions to e.g. measure patient's blood pressure and have a prescription printed at the surgery of WHP rural health care provider. While at first the project, which still remains at an evaluation stage, sounded too much science-fiction for me, after more consideration I started to think that maybe we actually need these kind of advanced technological solutions which, if launched, may bring a completely new approach to tackling health problems in the developing world. After all - necessity is the mother of invention!

Page last modified on 27 jun 12 16:05