Geneva: Despite carrying the highest disease burden in the world, the Narendra Modi government chose to send a small delegation to the World Health Assembly (WHA) that began on Monday, giving the country little say in the way the global health agenda is being set and inadequately reflecting its priorities, several participants said.

The 69th meet began with a call to address unprecedented challenges facing the global health sector. “In an interconnected world characterized by profound mobility of people and goods, few threats to health are local anymore," said Margaret Chan, director general of World Health Organization (WHO).

Air pollution, anti-microbial resistance, non-communicable diseases, child obesity and health emergencies such as the Ebola outbreak are among the major challenges to global public health, analysts said.

India ranks first among the nations in incidence of diseases such as diabetes, cardiovascular disorders, hypertension, tuberculosis, malnutrition, child and maternal health.

For a population of more than 1.2 billion people, India sent just four officials. Health minister J.P. Nadda, who chaired the WHA last year, failed to make it to the ongoing session because of the NEET controversy.

The Indian delegation is led by Ayush minister S.Y. Naik, who is accompanied by Dr J. Prasad, director general of health services, C.K. Mishra, additional secretary for health, and A. Prakash, joint secretary for health.

Due to the acute shortage of officials with expertise in global health issues from the health ministry, the Indian delegation was largely represented by two officials—Prakash and an official from the Geneva mission.

In contrast, Thailand sent a delegation of 60 officials to articulate their concerns related to women, children and adolescent health, nutrition and medicines.

“For our government, issues in the health sector are a major concern and we ensure that our views are taken into consideration for drafting the resolutions and decisions," said Sinsakchon Arunprom-me, a Thai official.

Thailand, for example, has proposed a major resolution in maternal, infant and young nutrition, calling for “ending the inappropriate promotion of foods for infants and young children", Arunprom-me said.

Although our resolution is supported by many countries, including India, we are facing severe opposition from western countries, including the US, the Thai official said.

Due to the absence of adequate representation from New Delhi, India was not able to participate in parallel negotiations to finalize key resolutions and decisions at the WHA. During the negotiations for FENSA (framework for WHO’s engagement with non-state actors such as private sector and NGOs) and ending inappropriate promotion of foods for infants and young children on Tuesday and Wednesday, India was unable to attend marathon meetings from the beginning to the end, according to participants familiar with the development.

India, which chaired the meeting on research and development: financing and coordination on Thursday, is also unable to attend the informal consultations on other issues of importance such as child nutrition negotiations, said a participant at the WHA.

“Today, unlike before, India is not standing in a corner," Prime Minister Narendra Modi had told The Wall Street Journal on Wednesday.

But the Indian delegation at the WHA is definitely standing in a corner not knowing how to represent the government’s priorities in multiple negotiations at the same time, according to western health officials.

At a time when WHA is grappling with emergency outbreaks, particularly Ebola, India remains unprepared to respond to potential outbreaks, said Unni Krishnan, director for Save the Children, a non-profit that works for child rights.

“Ebola demonstrated that once the outbreak starts, in the absence of robust pandemic preparedness measures, it can lead to catastrophic impacts. The impacts are manifold, including on health, psychological, travel, trade, etc. Children are often the worst-affected," he said.

“Today, countries such as India are more global and mobile than ever before and people can carry infections across the world (in and out of the countries) in hours," he said.

“It is crucial that pandemic preparedness and response is taken up as a priority, and disaster management maxim teaches that if you prepare well for one disaster, it helps to prepare for several," he argued.

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