Burying the truth: The Indian govt has risked lives by not declaring Zika cases

The Health Ministry has to come clean on what happened.

Voices Health

The information petered out in a World Health Organisation (WHO) Disease Outbreak News section of Member States last Friday.

It said on May 15, India's Health Ministry reported three confirmed cases of the Zika virus in Gujarat. The cases were detected during testing in February and November 2016 while one was detected in January this year. The alarming piece of information did not attract public attention till Saturday, as the world health body was presumably buried under work with its annual meeting. “These findings suggest low level transmission of Zika virus and new cases may occur in future,” the WHO read out stated. Other than advising caution, the WHO said there was no travel ban to India.

That is not what the Atlanta– based Centres for Disease Control (CDC) in the US says. According to information on their site, “India has a risk of Zika. Because the infection in a pregnant woman can cause severe birth defects, pregnant women should not travel here.” The advisory does not make any reference to the recent outbreak, but has maintained India on a list of countries with risk for a while now, including the travel ban advisory.

India’s Health Ministry officials have been quoted as saying the states are following standard protocols and there is “nothing to worry." The Ministry cited one confirmed case of Zika from January of this year in Gujarat in response to a question in Parliament. But here’s the problem. While all three cases were reported and confirmed in January 2017, the Minister of State for Health Anupriya Patel confirmed only one case in her written reply to a lawmaker on March 17. Why?

One of the three cases reported by India is that of a pregnant woman. I am appalled. Nothing is worse than silence when a story of this nature surfaces and officials behave as if it were routine. We live in times when outbreaks have wreaked havoc on communities and economies, not to mention fear among communities. At the time of writing, there is no world from the Ministry of Health and Family Welfare about the delay in reporting the outbreak. Others TNM spoke to about reporting protocols and the information chain say there is a WHO office in Delhi which is also where the South-East Asian Regional Office (SEARO), is situated. The WHO cannot report outbreaks unless it gets the go ahead from its member states. This kind of bureaucratic passing the buck is most unhelpful - it is even dangerous.

Information and communication is key especially when prevention is the only way to avoid infection. How are people expected to protect themselves if they don’t know? During a recent meeting with Indian health officials in Geneva, TNM was told that media advocacy has a key role to play in spreading awareness. I agree. But how are we supposed to advocate, inform and alert if information is suppressed? Even after Friday’s news, it has been impossible to get any official position on what really happened, what are the reporting protocols a country engages in before WHO announces the outbreak, and why India kept such an important piece of information under wraps for months – if that is what happened.

In its most recent outbreak, Zika, which is mainly a mosquito-borne disease, was identified in Brazil in 2015 and has been spreading globally. The virus is transmitted through the bite of an infected Aedes aegypti mosquito which also transmits dengue and chikungunya. When the virus infects a pregnant woman, it can cause a range of health defects including microcephaly, where the baby’s head is abnormally small.

The WHO says the risk of further spread of Zika virus to where competent vectors - Aedes mosquitos - are present is "significant" and that it continues to monitor the epidemiological situation and conduct risk assessment based on the latest information available. That "latest" information has to come from countries and it is not uncommon for capitals around the world to delay reporting because of bad optics and consequences for tourism and trade.

Trust is a key component of communication especially in public health where people's lives can be in danger. The worst thing the Health Ministry can attempt now is damage control. It has to come clean on what happened.