The recently articulated vision of Tamil Nadu Chief Minister M.K. Stalin, for decentralised district level health management, is very timely in the post-pandemic era. Tamil Nadu is ahead of most other States in socio-economic development, thanks to the high priority given to health and education, by successive governments.
During the British Raj, doctors were mandated to report every case of 24 “notified communicable diseases” to health officers, enabling the Public Health Department to detect, count and counter specific diseases, control outbreaks and document all data. During major epidemics, public health assumed extraordinary powers through the 1897 Epidemic Diseases Control Act, recently invoked in 2020 to face the COVID-19 pandemic.
Independent India assigned public health to the Ministry of Health, and disease surveillance fell by the wayside. India became notorious for not collecting or verifying data on diseases or causes of death. For want of functional public health infrastructure, the National Disaster Management Agency (NDMA) acted after the disaster struck; public health would have forecast the emergency and intervened pro-actively.
