From Data to Action: India’s Public Health Vision for 2035

Public health surveillance is a vital tool for disease prevention, control, and timely response. Recognizing its importance, the NITI Aayog, in collaboration with experts, has charted a comprehensive roadmap for India's public health surveillance system by 2035. This vision builds on existing successes and leverages technological advancements to address both current and future health challenges.

Public Health Surveillance in India" is a plan created by NITI Aayog to improve how diseases are tracked and managed in the country. It aims to make India’s health surveillance system more modern, efficient, and ready for future challenges. The plan focuses on using technology, involving communities, and working together across government and private sectors to ensure better health for everyone.

India has already achieved big successes in public health, like eradicating smallpox and eliminating polio. These achievements were possible because of strong disease monitoring systems. However, the current systems are often fragmented, outdated, and unable to handle newer health problems like non-communicable diseases (NCDs) or pandemics. The COVID-19 pandemic showed how important it is to have real-time data and community-based health actions.

Instead of having separate systems for different diseases, the vision proposes a single system that tracks both infectious diseases (like TB) and non-communicable diseases (like diabetes and heart conditions).

The plan focuses on using tools like electronic health records (EHR), artificial intelligence (AI), and data analytics. These tools will help predict outbreaks, track health trends, and respond faster to health emergencies. The system will ensure that people’s privacy is protected while involving communities in health monitoring. It will also focus on reducing health inequalities and making healthcare accessible to everyone.

This approach recognizes that human health is connected to animal and environmental health. For example, diseases that spread from animals to humans, like COVID-19, need to be tracked in a broader way. The plan aims to make India a leader in public health surveillance, helping other countries and contributing to global health security.

The "VISION 2035 PUBLIC HEALTH SURVEILLANCE IN INDIA" document highlights that strong disease surveillance helps prevent outbreaks, control diseases, and save lives. It is not just about tracking diseases but also about using this information to take timely action. By improving how health data is collected, shared, and analyzed, the vision ensures India is better prepared for future health challenges.

In simple terms, "Vision 2035" is a roadmap to make India’s health systems smarter, faster, and more inclusive, ensuring healthier lives for everyone.

Key Highlights of Vision 2035

• Predictive and Integrated Surveillance The future system aims to predict outbreaks before they escalate, ensuring timely interventions. Integration across all levels—community, district, state, and national—will break the silos of current surveillance systems. By addressing both communicable diseases (like tuberculosis and COVID-19) and non-communicable diseases (NCDs like diabetes and cardiovascular conditions), the system ensures inclusivity and preparedness for diverse health challenges.
• Citizen-Centric Approach A key feature is the use of de-identified individual health records, protecting privacy while enabling comprehensive data collection. These records will be linked through a unique health identifier (UHID), ensuring seamless tracking of patient histories across healthcare facilities, laboratories, and insurance systems.
• Global Leadership India aims to lead in managing public health emergencies by aligning with International Health Regulations. This includes a commitment to rapid response during outbreaks and contributing to global health knowledge and innovations.
• Strengthened Governance Governance will follow a federated model, balancing roles between central and state authorities. Key functions include:Policy-making: Allocating resources, enacting laws, and setting guidelines.Technical Oversight: Establishing disease priorities, outbreak thresholds, and response protocols.
• Management: Planning, implementing, and evaluating surveillance programs.

Building Blocks of Vision 2035

• Unified Health Records: The vision emphasizes creating a unified electronic health record (EHR) system that integrates: Public and Private Sector Data, ensuring contributions from all healthcare providers. Laboratories and Insurance Records, capturing diagnostic results and healthcare utilization patterns. Environmental and Occupational Health Data, merging human, animal, and environmental health insights for a holistic "One Health" approach.
• Advanced Analytics: Predictive analytics and artificial intelligence (AI) will revolutionize how diseases are tracked and managed. Key features include; Risk Factor Identification, using AI to detect emerging patterns in disease spread. Automated Alerts, systems that notify authorities when predefined thresholds are exceeded. Data Integration, combining clinical, laboratory, and environmental data for comprehensive analysis.
• Enhanced Laboratory Networks: Laboratories will be equipped with advanced diagnostic tools like molecular diagnostics and genotyping. Expanded referral networks will connect local health centers with high-level diagnostic facilities, ensuring accurate and timely results.
• Community-Based Surveillance: Health and Wellness Centers (HWCs), established under Ayushman Bharat, will play a pivotal role in local monitoring. These centers will:Conduct screenings for infectious diseases and NCDs. Engage communities in health education and surveillance activities.Serve as a bridge between local populations and larger health systems.

Opportunities and Challenges

Opportunities: Digital Advancements, Initiatives like the National Digital Health Blueprint and Integrated Health Information Platform (IHIP) provide a foundation for modernizing surveillance. Mobile Technology, High smartphone penetration enables real-time data capture and dissemination through apps and digital platforms. Ayushman Bharat, The program's dual focus on primary care (through HWCs) and financial protection (through insurance) creates a robust framework for surveillance.

Challenges: Fragmented Systems, existing data is scattered across multiple platforms, limiting comprehensive analysis. Private Sector Involvement, minimal participation from private healthcare providers restricts data coverage. Human Resource Gaps, shortages in trained personnel at state and district levels hinder effective implementation. Limited Integration, occupational and environmental health data are often excluded from mainstream surveillance efforts.

Steps Towards Realization

• Governance Framework Establish a governance structure that includes political, technical, and managerial leadership. This ensures accountability and coordinated action across all levels.
• Scaling Up IHIP Expand the Integrated Health Information Platform to cover all states, integrate private sector data, and include new disease conditions.
• Capacity BuildingTrain healthcare professionals in data analytics, AI, and surveillance techniques.Develop specialized public health training programs to create a skilled workforce.
• Innovations in TechnologyUse point-of-care diagnostics for timely detection of diseases.Leverage mobile apps and AI-driven tools for real-time data collection and analysis.
• Community EngagementPromote citizen participation in surveillance through awareness campaigns.Use social media and digital platforms to disseminate health information and gather feedback.

Conclusion

The Vision 2035 document sets a bold agenda for India's public health surveillance, aiming to transform it into a predictive, responsive, and integrated system. By leveraging technology, fostering cooperative federalism, and prioritizing citizen-centric approaches, India is poised to lead globally in public health. This transformation is a step towards a healthier, more resilient nation, ready to tackle the health challenges of tomorrow.