Dr Kakkar did his MBBS from the University College of Medical Sciences, Delhi and MD from Maulana Azad Medical College (MAMC) in New Delhi and his Masters in Public Health from Harvard University, Boston, USA. (Pic Courtesy : PHFI)
"Irony is that we don't have an effective system. A robust functional health system is essential. Currently, there is an inability in the system to effectively tackle epidemics. Systems not ready at all levels. While the response at the center even if quick, will not be of much use until state governments too have a system in place. If you go down to state levels, preparedness remains an issue as the resources are not enough," Dr Manish Kakkar, senior health specialist, Public Health Foundation of India (PHFI) told BioSpectrum's Rahul Koul over the phone.
"As far as the 1987 Epidemic Act is concerned, there is a major lacuna. There is an absence of a solid framework. Technical leadership has been working but the political system has failed," he stated further.
Speaking about the role of the government, Dr Kakkar opined, "Several efforts have been reported from the Indian government. India was smart enough to invest into developing a system to deal with such issues. India was one out of many developing nations to contain H1N1. For example, Indonesia suffered on that account because of a lack of any such response. That is something that gave us experience. Consolidation of efforts happened. However, I feel it is too little and too late. We require more consolidation of efforts."
Dr Kakkar feels that it is not possible to have quick responses to infections. He explained, "Emerging infections are not pre-determined. So we cannot fully prepare a response. It is also not possible to keep a solution ready for an infection which might not even be big enough. Pharma companies cannot invest heavily into such drugs as they too have business considerations and market demands."
Dr Kakkar finds the GM issue not relevant here. He added, "We seem to be mixing issues here as not every drug is derived from crops. Although bypassing steps for quick passage through trials can hamper quality, in situations like this, policymakers had no other choice but to fast track the Z Mapp drug against Ebola."
"PPPs are definitely required to increase preparedness against any such epidemic. As seen in case of Serum Institute of India and Bharat Biotech, the PPPs have helped in developing vaccines to tackle few key disease areas. That is the way as it reduces the burden on government which cannot care for all in a situation like in Indi," concluded Dr Kakkar.
