Inter- Ministerial Convergence towards Prevention and Control of Japanese Encephalitis and Acute Encephalitis Syndrome (JE/ AES) ? An Integrated Multi-pronged Public Health Approach

Japanese Encephalitis (JE) and Acute Encephalitis Syndrome (AES) are not merely neurological manifestations of medical conditions caused by virus, bacteria, protozoa or fungi but a large socio-economic-environmental-health problem with wider ramification in the form of high mortality, disability, impoverishment in already marginalized societies leading to perpetual poverty and low Human Development Index in the endemic areas and are challenges for emerging economies like India. During a special review in 2011, it was observed that approximately 8000 AES cases and 1200 deaths are reported annually from JE/AES endemic districts with poor infrastructure, lack of critical care and rehabilitation facilities, and low priority to preventive activities. This prompted Government to constitute Group of Ministers (GoM) during November, 2011 to suggest a multi-pronged strategy for Prevention and Control of JE/AES. GoM recommended integration of promotive, preventive, curative and rehabilitative activities with identified Ministries to address the issue of complex encephalitis situation in Uttar Pradesh, Assam, West Bengal, Bihar and Tamil Nadu. These Ministries apart from (i) Ministry of Health and Family Welfare included (ii) Ministry of Drinking Water and Sanitation (iii) Ministry of Women and Child Development (iv) Ministry of Social Justice and Empowerment (v) Ministry of Housing and Poverty Alleviation (HUPA) (vi) Ministry of Human Resource Development (Department of Education) and (vii) Ministry of Rural Development. The recommendations of GoM resulted in formulation of National Programme for Prevention and Control of Japanese Encephalitis and Acute Encephalitis Syndrome approval for which was accorded in October, 2012 with a budgetary outlay of Rs.4038 crores (approx. US $ 670 million) for 5 years. It was decided to implement the National Programme in 60 priority districts of 5 states in first phase. The multi-pronged strategy is making steady progress at the field level as all the above Ministries have initiated the process of implementation of their assigned activities as per the reports received from these Ministries. It is expected that after successful implementation of National Programme for Prevention and Control of JE/AES, the disease burden due to encephalitis shall reduce significantly in the identified districts.