Kant and Krishnan BMC Public Health 2010, 10(Suppl 1):S11 http://www.biomedcentral.com/1471-2458/10/S1/S11 Integrated Disease Surveillance Project The Union Ministry of Health & Family Welfare adopted an Integrated Disease Surveillance Project (IDSP) to connect all district hospitals and state-run medical colleges to facilitate tele-education, training of health professionals and monitoring of disease trends. The disparity between states’ urban and rural regions is bridged using modern information and communication technology (ICT). The goal of this World Bank-assisted project (USD 102 million), is to establish a decentralized, state-based disease surveillance system. The project aims to detect early warning signals of impending disease outbreaks and initiate eﬀective and rapid health actions with the help of ICT at the district, state and national levels. The project is implemented through the Central Surveillance Unit within the National Centre for Disease Control (NCDC) at New Delhi [4]. The IDSP is being strengthened to make it compliant with IHR(2005) requirements by supporting a nationwide eﬀort for the immediate reporting of outbreaks. The establishment and operation of decentralized surveillance system meeting performance standards, with technical support from the WHO and the U.S. Centers for Disease Control and Prevention (CDC) in the areas of disease surveillance and outbreak investigations, health infor- matics, and laboratory-based surveillance, has been vital in implementation of IHR(2005). Several speciﬁc steps have been taken to: 1) enhance the quality and frequency of use of communi- cation network; 2) further training for district level epidemiologists and data managers on use of portal; 3) streamline the urban surveillance component; 4) enhance networking of infectious disease hospitals; 5) improve quality and timeliness of reporting. Components of the IDSP Some of the key components of the IDSP in India include: • Integration and decentralization of surveillance activities through establishment of surveillance units at national, state and district levels; • Human Resource Development through training of State Surveillance Oﬃcers, District Surveillance Oﬃcers, multi-disciplinary Rapid Response Teams, and other medical and paramedical staﬀ on all aspects of disease surveillance; • Use of ICT for the collection, collation, compilation, analysis and dissemination of data through a web portal; • Strengthening of public health laboratories. In addition to monitoring diseases like vector borne infections, diarrhoeal diseases, respiratory diseases, and vaccine preventable diseases, the IDSP also has a category called ‘unusual clinical syndromes,’ which would alert Page 2 of 4 public health professionals to an intentional release of any biological-agent. The local governments in each state have the option to add any other health condition to the list as deemed appropriate. The ICT network is then used for the collection, analysis, and rapid communication of data. Structure of the ICT network Eight hundred sites have been identiﬁed to be part of an ICT satellite network. Sites include District Headquarters (604), State Headquarters (35), academic institutions like Government Medical Colleges (133), premier medical institutions (15) and Infectious Disease Hospitals (7). At the national level these are connected to the National Informatics Centre, the Central Surveillance Unit (at the NCDC) and the Ministry of Health & Family Welfare. [5] Infrastructure The India Space Research Organization (ISRO), through its Education Satellite (EDUSAT), has connected 360 of the 400 ICT network sites. The network operation centre (the principal teaching end) is housed at the NCDC, and the Satellite Interactive Terminals (SITs) are located at State Headquarters, District Surveillance Units and Government Medical Colleges. ISRO connects all sites in northeastern states, hilly and island states, Tamil Nadu, Gujarat, and Maharashtra. The National Informatics Centre (NIC) has provided terrestrial (broadband) connectivity to 776 of the 800 sites. It has also provided high-end video conference equipments at all state and Union Territory headquarters. Upon completion, the network will enable 800 sites on a broadband network of which 400 sites will have dual connectivity with satellite and broadband [5,6]. IDSP portal The NIC has created a single-stop web portal (www.idsp. nic.in) with options for data entry and analysis from the district level upwards related to disease surveillance. It is quicker, easier, and more powerful to update than print- based media. The portal can also convert data into charts and graphs. The data entry operators and data managers have been trained in data entry, analysis and trans- mission. The portal also has information on media and outbreak alerts. Media Scanning and Verification Cell India has a very vibrant and active media. There are close to 70,000 newspapers (as of 31 March 2008) [7] and over 500 television channels [8]. Media is therefore a very important source of information and its power is now being harnessed to detect outbreaks. A Media Scanning and Veriﬁcation Cell was established at the NCDC in July 2008. This cell collates reported unusual health events on infectious diseases within the country and informs the