Cease and disease

Last week, when a 30-year-old Delhi resident lost his life to malaria, the capital recorded its first death to the disease in five years. Last known, chikungunya had claimed 10 lives in the city, belying the commonly held medical belief that the disease, though extremely debilitating, is not fatal. More than 1,000 cases of chikungunya have been reported from the capital this year, nearly half of them in the first week of September. The capital registered nearly 400 cases of dengue in the first 10 days of September — the disease is known to assume its severest proportions in October. The city has also been struck by a mystery fever, symptomatically like dengue and chikungunya, but testing negative for these mosquito-borne diseases. While vector species are on the rampage, Delhi’s AAP-run government and its lieutenant governor have found another reason to extend their political wrangle. Najeeb Jung blames the capital’s monsoon morbidity on the government’s negligence, while Arvind Kejriwal’s government loudly argues that it can do little with its hands tied. Bogged down by political kerfuffles, the AAP government seems to have lost its committment to urban health issues.

The raging viral epidemic exposes the frailties of India’s approach to vector-borne diseases. The country has traditionally relied on mosquito control to check the diseases it carries. Muncipal corporations run campaigns asking people to check breeding of mosquitoes. They also conduct checks at the neighbourhood and household levels and periodically undertake fogging operations. These are clearly not enough. Mosquitoes breed too rapidly and indifferent monitoring by municipal authorities is no match for their fecundity. The health ministry has rejected the French drug and vaccine company Sanofi’s request to waive additional clinical studies required to introduce the dengue vaccine, Dengvaxia, in the country. There have been sporadic attempts to develop indigenous vaccines for dengue and chikungunya, but recent outbreaks have not brought a sense of urgency to these efforts. In 2013, the International Centre for Genetic Engineering and Biology (ICGEB) in Delhi reported success in its attempt to develop a dengue vaccine. The endeavour was lauded in the international press but of late, scientists have been complaining that a fund crunch has stymied their efforts to fast-track the project.

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The squabbles between the Delhi government and the city’s lieutenant governor, the prevarication over the dengue vaccine and the general failure to develop a concerted strategy to deal with vector-borne diseases become even more glaring in the light of the economic costs of morbidity. A chikungunya patient takes days, even weeks, to recover. Dengue is similarly debilitating. There have been reports of an exodus of workers from Delhi. That does not augur well for a country that aims to scale up GDP growth to 8 per cent over the next year.