Getting public health right

What is the issue?

Amidst rise in various diseases and health concerns, it is high time that India addresses the issue of understanding "public health" appropriately.

What is the misconception with public health?

• "Disease-care" is something which includes the different types of biomedical interventions to restore ill-health.
• This, in popular parlance, is called the “healthcare” which addresses the visible infrastructure of clinics and hospitals and  is  labour-intensive.
• On the other hand, "public health" is all about invisible infrastructure, working to mitigate social and environmental determinants of diseases.
• However, the term ‘public health’ has long been misappropriated to mean healthcare in the public sector.
• This confines the focus to only state-run hospitals.

What impact does this create?

• The lack of understanding has hampered the efforts to have a separate public health department.
• India has established a few community-level interventions to prevent certain diseases.
• This includes stand-alone vertical projects against tuberculosis (TB), malaria, leprosy, filariasis, AIDS, etc.
• However all of these remain silos in the absence of an integrated public health infrastructure.
• This is the reason why most of these individual verticals has not delivered its potential in disease prevention.
• Ex: The rampant drug resistance in TB is largely man-made as  a result of lack of application of public health expertise in TB control measures.
• Various vaccinations programmes are undertaken by the government.
• But, with the lack of public health infrastructure, monitoring the benefits and controlling the diseases are not happening.

What should be done?

• Establishing a specialised public health machinery to address the social and environmental causes and prevent diseases before hand is essential.
• Public health must be managed by professionals trained in public health and empowered to work for the health security of all people.
• Medical students should be made aware of not only disease diagnosis, treatment and individual preventive medicine, but also of environmental and community risk factors in terms of public health.
• A functional public health infrastructure can go a long way in preventing the possibly preventable communicable diseases.

Source: Livemint