Lok Sabha Question No. 423 (STARRED), answered on 2017-03-31
Subject: Communicable and NonCommunicable Diseases
Ministry: HEALTH AND FAMILY WELFARE
Asked by: N.K. PREMACHANDRAN

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA STARRED QUESTION NO. 423 TO BE ANSWERED ON THE 31 ST MARCH, 2017 COMMUNICABLE AND NON COMMUNICABLE DISEASE S

## *423. SHRI N.K. PREMACHANDRAN:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government proposes to introduce programme for prevention communicable diseases and if so, the details thereof;
- (b) whether the Government has conducted any study re gar ing the gravity of communicable diseases in the country and if so, the details thereof;
- (c) whether the Government has taken initiative for control -communicable diseases and if so, the details thereof;

of

- (d) the steps taken by the Government t o create awareness among the citizens regarding food habits and healthy lifestyle so as to control such disease with the details of financial assistance given by the Government to the St implementation of projects to control life style disea ses State/UT - wise; and
- (e) the details of the initiatives taken by the Government for control of infectious diseases during the last three years?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE ( SHRI JAGAT PRAKASH NADDA )

(a) to ( e):  A statement is laid on the Table of the House

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 423* FOR 31 ST MARCH , 2017

(a) A number of National Health Programmes have already been introduced by the Government with a view to preventing specific communicable disease These include National Vector Borne Diseases Control Programme (NVBDCP), National  Leprosy  Elimination  Programme  (NLEP)  and  the  Revised  National Tuberc ulosis Control Programme (RNTCP). The Integrated Disease Surveillance  Programme  (IDSP)  has  also  been  started  in  all  States/UTs detecting and responding to outbreaks due to epidemic prone diseases. All national programmes have wide outreach throug hout the country.  Funds under these  programmes  are  provided  to  all  States/Union  Territories  to  stren public health care system.

(b) Studies/surveys  have  been  conducted  under  various  programmes  at  th national and the regional levels for detection/ elimination of the communicable diseases from time to time.  These include:

- i. A National study to estimate Malaria cases and deaths due to malari the country by the National Institute of Malaria Research, Indian Co of Medical Research (ICMR) in col laboration with the National Institute of  Medical  Statistics  and  National  Vector  Borne  Disease  Contro Programme;
- ii. National Sample Survey conducted by the National JALMA Institute of Leprosy  and  Other  Myco - bacterial  Diseases  (NJIL&OMD),  Agra,  to estimate  n ew  leprosy  case  load,  assess  leprosy  burden  by  recordin Grade- I  and  Grade - II  disability  cases  and  assessing  the  magnitude  o stigma and discrimination prevalent in the population.
- iii. A National Drug Resistance Survey for Tuberculosis has been conducte by th e National Tuberculosis Institute(NTI), Bengaluru.

(c)   While health is a state subject, the Central Government supplemen efforts of the State Governments to provide health care including tertiar health  care  for  Non - Communicable  Diseases  (NCDs).The  following  major programmes have been launche d for controlling NCDs by the Government:

- i. The National Programme for Prevention and Control of Cancer, Diabetes Cardiovascular  Diseases  and  Stroke  (NPCDCS)  for  interventions  up  t District level under the National Health Mission. It focuses on awar generation on behavioural risk factors such as unhealthy food habits lifestyle changes, screening and early diagnosis of persons with high of  risk  factors  and  their  treatment  and  referral  (if  required)  to

facilities for appropriate manageme nt, development of Human Resource and setting up of infrastructure such as NCD clinics.

- ii. Under  the  National  Dialysis  Programme,  more  than  one  lakh  patient have  undergone  about  11  lakh  dialysis  sessions  in  various  dist hospitals in the country till date .
- iii. Under Tertiary Care Cancer Centre (TCCC) Scheme, the Government of India is assisting the States to establish State Cancer Institute ( TCCCs in different parts of the country.
- iv. For  population  level  screening  for  diabetes,  hypertension  and  comm cancer  viz.  oral,  breast  and  cervix,  Operational  Guidelines  have shared with State Governments with the request to submit their propo in  their  State  specific  Programme  Implementation  Plans  (PIP)  und NHM.
- v. Under  Pradhan  Mantry  Swasthya  Suraksha Yojna  (PMSSY),  6  new AIIMS have been made operational. Up - gradation of identified Government medical colleges/ institutions, for higher specialty faci has been undertaken.

(d)   The Ministry of Health and Family Welfare has requested all States and  the  Ministry  of  Human  Resource  Development  to  issue  appropriate directions to schools and colleges for withdrawing foods high in saturat and carbonated drinks from canteens and promoting healthy food habits. Joi the two Departments have als o designed booklets for school children to promote healthy life styles.  The Food Safety and Standards Authority of India guidelines for making available wholesome, nutritious, safe and hygienic to  school  children  in  India  on  12 - 10- 2015  whereby the  availability  of  most common  HFSS  (High  in  Fat,  Salt  and  Sugar)  Foods  in  schools  has  been restricted/limited. These guidelines have also been uploaded on the webs FSSAI.

FSSAI has launched campaign on social media such as Face - book, documentaryfilms on YouTube, educational booklets, information on FSSAI website,  stalls  at  Fairs/Melas/Events  and  mass  awareness  campaigns,  etc disseminate information on safe and nutritious food. Details of funds rele State/UT Governments under NPCDCS dur ing last three years and for setting up/establishing SCIs and TCCCs under NPCDCS are at Annexures I & II .

(e):The Government has taken a series of steps to prevent the sprea outbreaks including those of emerging infectious diseases. Under the Integr Disease Surveillance Programme, States/UTs have been provided with additional manpower, training has been imparted to identified Rapid Respo Team (RRT) members for outbreak investiga tions, laboratories for detection of epidemic  prone  diseases  have  been  strengthened  along  with  provisions  of tools/equipment. Funds are also released under IDSP to all States as gran -in -aid to undertake diseases surveillance and outbreak response act ivities. As part of the IDSP,  a network of 12 labs is running for Influenza Like Illne Severe Acute Respiratory Infection Surveillance work of pandemic H1N1Influenza in the country since 2009.

NCDC is also providing referral diagnostic services in respect of various emerging  infectious  diseases  (zoonotic  &  arboviral)  viz.  rabies,  bruce leptospirosis, rickettsial diseases, Japanese Encephalitis, Dengue, Chikun Anthrax.  Preparedness  for  laboratory  diagnosis  of  emerging  infections  w pose potential threat viz. Ebola fever, Yellow Fever, Zika virus disease e National  Institute  of  Virology  is  the  major  National  Monitoring  Center Influenza, Japanese encephalitis, Rotavirus, Measles and Hepatitis.

Under RNTCP, the strategies adop ted include strengthening and improving quality of basic TB services, addressing TB HIV co - infection, other co- morbidities and MDR - TB.  Further, targeted interventions in the vulnerab population, integrating newer molecular diagnostics for TB in the heal th system for early diagnosis of TB, Information Communication Technology(ICT), et have  been  leveraged  for  TB  notification  and  strengthening  of  monitoring using the Nikshay software.

## ANNEXURE-I

## Statement showing State/ UT-wise Release of funds for NPCDCS under NHM for the years 2013-14, 2014-15 and 2015-16

(inRs. Crore)

| Sl. No.   | Name of State            | 2013-14   | 2014-15   |   2015-16 |
|-----------|--------------------------|-----------|-----------|-----------|
| 1         | Andaman &Nicobar Islands | 0.05      | 0.25      |      0.55 |
| 2         | Andhra Pradesh           | -         | 5.61      |     14.78 |
| 3         | Arunachal Pradesh        | 0.76      | 3.54      |      5.7  |
| 4         | Assam                    | 17.14     | 5.79      |     35.78 |
| 5         | Bihar                    | 9.72      | 12.08     |     22.34 |
| 6         | Chandigarh               | 0.16      | 0.13      |      0.69 |
| 7         | Chhattisgarh             | -         | 5.04      |      8.47 |
| 8         | Dadra &Nagar Haveli      | 0.05      | 0.17      |      0.63 |
| 9         | Daman &Diu               | 0.04      | 0.13      |      0.35 |
| 10        | Delhi                    | 2.47      | 1.41      |      2.23 |
| 11        | Goa                      | 0.22      | 1.27      |      0.23 |
| 12        | Gujarat                  | -         | 6.66      |     20.98 |
| 13        | Haryana                  | -         | 7.99      |      4.93 |
| 14        | Himachal Pradesh         | -         | -         |      4.78 |
| 15        | Jammu &Kashmir           | -         | 9.13      |      8.16 |
| 16        | Jharkhand                | 3.32      | 8.35      |     10.57 |
| 17        | Karnataka                | -         | 9.76      |     14.29 |
| 18        | Kerala                   | -         | 5.45      |      5.18 |
| 19        | Lakshadweep              | 0.01      | 0.13      |      0.07 |
| 20        | Madhya Pradesh           | 4.62      | 16.94     |     26.82 |
| 21        | Maharashtra              | 5.86      | 12.89     |     27.54 |
| 22        | Manipur                  | -         | 2.96      |      3.08 |
| 23        | Meghalaya                | 1.63      | 1.47      |      2.46 |
| 24        | Mizoram                  | 0.6       | 1.76      |      1.42 |
| 25        | Nagaland                 | 1.09      | 3.46      |      2.63 |
| 26        | Orissa                   | -         | 12.34     |     16.19 |
| 27        | Puducherry               | 0.18      | 1.52      |      0.29 |
| 28        | Punjab                   | -         | 8.03      |      6.71 |
| 29        | Rajasthan                | 0.59      | 11.8      |     27.04 |
| 30        | Sikkim                   | -         | 1.76      |      0.95 |
| 31        | Tamil Nadu               | 0.89      | 13.55     |     17.16 |
| 32        | Tripura                  | 2.02      | 1.76      |      2.55 |
| 33        | Uttar Pradesh            | 13.98     | 20.27     |     54.39 |
| 34        | Uttarakhand              | -         | 5.45      |      6.62 |
| 35        | West Bengal              | 10.27     | 7.54      |     13.03 |
| 36        | Telangana                | -         | 4.01      |      9.41 |
| Total     | Total                    | 75.67     | 210.4     |    379    |

Note:  Releases  are  of  Central  Government  Grants  & do  not  include  State  share.  Since  2015-16, releases are done under NCD flexipool for NCD Programmes including NPCDCS.

## ANNEXURE - II

## State - wise funds released for setting up/establishing SCIs and TCCCs under NPCDCS

## (1) Funds released during the financial year 2014 - 15:

(Rs.in Crore)

| S No.   | State/UTs       | Name of the Institute                                 | SCI/ TCCC     |   Amount Released |
|---------|-----------------|-------------------------------------------------------|---------------|-------------------|
| 1       | Karnataka       | Kidwai Memorial Institute of Oncology(RCC), Bangaluru | SCI           |             67.5  |
| 2       | Kerala          | Government Medical College, Kozhikode                 | TCCC          |             25.03 |
| 3       | Tripura         | Cancer Hospital(RCC), Agartala                        | SCI           |             55    |
| 4       | Gujarat         | Gujarat Cancer Research Institute,                    | Ahmedabad SCI |             67.5  |
| 5       | West Bengal     | Government Medical College, Burdwan                   | TCCC          |             22.24 |
| 6       | Jammu & Kashmir | Sher- i - Kashmir Institute of Medical Srinagar       | Sciences, SCI |             47.25 |
| 7       | Tamil Nadu      | Cancer Institute (RCC) Adyar, Chennai                 | SCI           |             67.38 |
| Total   | Total           | Total                                                 | Total         |            351.9  |

## (2)

## Funds released during the financial year 2015 - 16: (Rs.in Crore)

| S No.   | State/UTs        | Name of the Institute                                          | SCI/ TCCC     |   Amount Released |
|---------|------------------|----------------------------------------------------------------|---------------|-------------------|
| 1       | Himachal Pradesh | Indira Gandhi Medical College, Shimla                          | TCCC          |            14.87  |
| 2       | Bihar            | Indira Gandhi Institute of Medical Patna                       | Sciences, SCI |            33.06  |
| 3       | Mizoram          | Civil Hospital, Aizawl                                         | TCCC          |            14.64  |
| 4       | Uttar Pradesh    | Sanjay Gandhi Postgraduate Institute Medical Sciences, Lucknow | of TCCC       |            11.43  |
| 5       | Rajasthan        | S P Medical College, Bikaner                                   | TCCC          |            17.123 |
| 6       | Karnataka        | Mandya Institute of Medical Sciences                           | TCCC          |            17.257 |
| 7       | Telangana        | MNJ Institute of Oncology& RCC, Hyderabad                      | SCI           |            18.12  |
| Total   | Total            | Total                                                          | Total         |           126.5   |

- (3) Funds released during the financial year 2016 - 17 (till 17

## th January 2017): (Rs.in Crore)

| S No   | State/ UTs   | Name of the Institute                                               | SCI/ TCCC   |   Amount Released |
|--------|--------------|---------------------------------------------------------------------|-------------|-------------------|
| 1      | Kerala       | Regional Cancer Centre, ThiruvananthapuramSCI                       |             |           46.957  |
| 2      | Punjab       | Govt. Medical College, Amritsar                                     | SCI         |           51.58   |
| 3      | Delhi        | LokNayak Hospital                                                   | TCCC        |           25.4    |
| 4      | Punjab       | District / Civil Hospital, Fazilka                                  | TCCC        |           20.119  |
| 5      | Odisha       | Acharya Harihar Regional Cancer Centre, Cuttack                     | SCI         |           35.829  |
| 6      | Nagaland     | District Hospital, Kohima                                           | TCCC        |           10.17   |
| 7      | Haryana      | Civil Hospital, AmbalaCantt                                         | TCCC        |            9.2253 |
| 8      | West Bengal  | Murshidabad Medical College & Hospital, Berhampore, Murshidabad     | TCCC        |           10.9793 |
| 9      | Maharashtra  | RashtraSantTukdoji Regional Cancer Hospital Research Centre, Nagpur | & TCCC      |           15.3196 |
| 10     | Rajasthan    | SMS Medical College, Jaipur                                         | SCI         |           40.6683 |
| Total  | Total        | Total                                                               | Total       |          266.248  |