The government’s move to bar Public Health Foundation of India from accepting foreign funding has put a question mark on two blindness prevention programmes that PHFI was implementing in partnership with the Ministry of Health and state health departments.
The four-year programmes for diabetic retinopathy (blindness caused by diabetes) and retinopathy of prematurity (blindness in premature babies because of overexposure to oxygen inside incubators) were supported by the Queen Elizabeth Diamond Jubilee Trust of UK through a £7 million grant, of which £4.3 million has been paid. But the rest cannot be processed because of the restrictions on PHFI.
Speaking to The Indian Express, chief executive of the trust, Dr Astrid Bonfield, said: “It was very impressive to see that the programme has been integrated into the national governme’t’s health system because unless that was done, there was no point really. It (the support) will continue for the next two years. I would not like to talk about Indian government business but at the moment, clearly, there are no payments being made (to PHFI).”
Dr Bonfield is on her first review tour of India since the grant was approved.
Ironically, one of the reasons why PHFI was selected, she says, was because of its excellent links with the government; the grant was approved during the previous UPA regime.
With an estimated 69.2 million diabetes patients in India, ballpark estimates suggest that if the proportion of diabetics whose sight is threatened remains constant, an additional 10 million would be added by 2035.
As more premature babies survive in middle income countries like India, retinopathy of prematurity (ROP) remains a condition about which awareness levels are low. A 2015 study published in the journal Indian Paediatrics found incidence in premature babies to be as high as 44 per cent.
Sources say work on the two programmes are in “suspended animation” not just because fresh funds cannot come in but also due to the curbs placed on PHFI by the Ministry of Home Affairs from accepting foreign contribution with retrospective effect for alleged violation of norms. There is no clarity on whether funds that have already come in can be spent, they said.
The Queen Elizabeth Diamond Jubilee Trust was set up in 2011 at the Commonwealth heads of government meeting as a five-year charitable programme. The target in India was to integrate eyecare for people living with diabetes and newborns. India was the only country where ROP was taken up while the project to prevent blindness due to diabetes (DR) was taken up in 13 countries.
The DR project is currently under implementation across ten states spearheaded by a task force set up by the health ministry in 2014 and headed by deputy commissioner in the ministry, Dr Damodar Bachani. Its first meeting was held in July that year. It has representation from both government and non-government sectors. The district level models are pilots that are expected to be scaled up across states.
Following the national ROP summit in October 2013, a national task force headed by a joint secretary was constituted by the health ministry. Using the government of India database, 10 states, where sick newborn care units (SNCUs) had been functioning for at least two years, were identified for the programme.
The ROP prevention model includes a cluster of one medical college or teaching hospital and three-five district hospitals. Screening for retinopathy happens in SNCUs of these hospitals on a fixed day in a week. Treatment is given in the medical college or the teaching hospital.