Published in IJCP July 2019
RTI
Lack of Coordination Amongst Various Departments of Ministry of Health: Diseases are Notifiable but there is no Vaccination Policy for Them
July 12, 2019 | KK Aggarwal, Ira Gupta
     


In India, the Cabinet Secretariat functions directly under the Hon’ble Prime Minister. The Cabinet Secretariat is responsible for the administration of the Government of India (Transaction of Business) Rules, 1961 and Government of India (Allocation of Business) Rules, 1961 facilitating smooth transaction of business in Ministries/Departments. The Secretariat assists in decision-making in Government by ensuring Inter-Ministerial coordination, ironing out differences amongst Ministries/Departments and evolving consensus through the instrumentality of the standing/Ad-HoC Committees of Secretaries.

However, is there really coordination at the Inter-Ministerial level and even among various Departments of the same Ministry?

The answer is NO. The main problem in India is lack of coordination among various departments within the same ministry. Forget about Inter-Ministerial coordination.

Heart Care Foundation of India (HCFI), a national level Public Charitable Trust vide Right to Information (RTI) Application dated 27.08.2018 had asked a simple question from Ministry of Health and Family Welfare. The question was: “Is there any notified list of communicable diseases in India?

The Public Information Officer of Ministry of Health and Family Welfare forwarded the said RTI to its three departments and asked all the three departments to give relevant information. It is quite astonishing that all the three departments of the same Ministry of Health and Family Welfare gave different answers for same question. Also, the answer given by the Directorate General of Health Services (DGHS) is different.

The answers given by three departments and DGHS are:

National Centre for Disease Control, Integrated Disease Surveillance Programme (IDSP) of Ministry of Health and Family Welfare vide reply stated that: “IDSP is a disease surveillance programme which is routinely collecting data of 22 communicable diseases. Health is a state subject and each State has its own list of notifiable diseases.”

The PH (IH) Division of Ministry of Health and Family Welfare vide reply dated 23.10.2018 stated that: “This division deals with implementation of International Health Regulations (IHR) at Points of Entry and Public Health Emergencies of International Concern (PHEIC). This division does not have any information pertaining to notified diseases and their vaccinations in India.

Immunisation Division of Ministry of Health and Family Welfare vide reply dated 15.10.2018 has stated that: “in this regard, the matter regarding list of notifiable communicable diseases doesn’t pertain to Immunisation section hence your RTI application is being transferred under Section 6(3) of RTI Act, 2005 to DGHS for providing information directly to you. However, the list of diseases against which vaccination provided under Universal Immunisation Programme (UIP) is enclosed herewith.

DGHS vide reply dated 17.10.2018 has stated: “in this regard, the matter regarding list of notifiable communicable diseases doesn’t pertain to Immunisation Section hence your RTI application is being transferred under Section 6(3) of RTI Act, 2005 to DGHS for providing information directly to you. However, the list of diseases against which vaccination provided under UIP is enclosed herewith.

Vide RTI application, HCFI has also asked “Is there any policy or law or scheme under which a person can get vaccination for all notified communicable diseases?”

All the different departments of Ministry of Health and Family Welfare stated that there is no law, policy or data available and it is quite astonishing that there is no law/policy/scheme under which a person can get vaccination for all notified communicable diseases.

Further, it is surprising that none of the departments of Ministry of Health and Family Welfare have data of any vaccination notified for such communicable diseases in India.

Also, vide RTI application dated 27.11.2018, HCFI had asked “Is this UIP operating in all private as well as government hospitals?” The Immunisation Division of Ministry of Health and Family Welfare does not have any information relating to the same. 

Vide reply dated 28.12.2018, the Immunisation Division of Ministry of Health and Family Welfare gave following answer to the question “Does government apply these vaccines to the people living on street and beggars under this UIP?”: “It is to state that, the RTI Act, 2005 and guidelines issued there under make it clear that, only such information is required to be given which already exists and, it is not required to create information or to interpret information or to solve the problems raised by the applicant/appellant of to furnish replies to hypothetical question.

Instead of just giving reply in Yes or No to the query raised by HCFI, the Immunisation Division stated that it is required to give only such information which already exists. 

We are talking about ONE INDIA. But from the reply given by different departments, the dream of achieving ONE INDIA is quite impossible. The Cabinet Secretariat needs to work out some stringent and effective measures for ensuring better Inter-Ministerial coordination and also among various departments of same Ministry. Till the time, the different departments of single ministries have coordination and better data availability, the Ministry as a whole will not be able to work effectively.

The new Cabinet is requested to ensure better coordination not just at the Inter-Ministerial level but also among various departments of the same ministry.

Analysis of Communicable Diseases RTI

Sr. No.

RTI application dated 27.08.2018

Reply by Ministry of Health and Family Welfare, Immunisation Division dated 15.10.2018 & reply By DGHS dated 17.10.2018

Reply by PH (IH) Section of Ministry of Health and Family Welfare, dated 23.10.2018

Reply by National Centre for Disease Control, Integrated Disease Surveillance Programme (IDSP)

1.

Is there any notified list of communicable diseases in India?

Vide reply dated 15.10.2018, the Immunisation Division of Ministry of Health and Family Welfare, Government of India has stated:

in this regard, the matter regarding list of notifiable communicable diseases doesn’t pertain to Immunisation section hence your RTI application is being transferred under Section 6(3) of RTI Act, 2005 to DGHS for providing information directly to you. However, the list of diseases against which vaccination provided under UIP is enclosed herewith.”

List of vaccines under Universal Immunisation Programme and Diseases prevented:

Vaccine

Disease prevented

Bacillus Calmette-Guerin (BCG)

Severe form of childhood tuberculosis

Oral Polio vaccine (OPV)

Poliomyelitis

Hepatitis B vaccine

Hepatitis B

The PH (IH) Division deals with implementation of International Health Regulations (IHR) at Points of Entry and Public Health Emergencies of International Concern (PHEIC). This division does not have any information pertaining to notified diseases and their vaccinations in India.

IDSP is a disease surveillance programme which is routinely collecting data of 22 communicable diseases. Health is a state subject and each State has its own list of notifiable diseases.

2.

If answer to query no. 1 is “Yes”, then please provide the said notified list of communicable diseases in India?

Pentavalent Vaccine

Diphtheria, pertussis, tetanus, hepatitis B, pneumonia and meningitis caused by H. influenzae type b

Rotavirus vaccine

Rotavirus diarrhea

Inactivated Polio vaccine

Poliomyelitis

Pneumococcal conjugate vaccine

Pneumococcal pneumonia

Measles vaccine

Measles

Measles & Rubella (MR) vaccine

Measles and Rubella

Japanese encephalitis (JE) vaccine

Japanese encephalitis

DPT vaccine

Diphtheria, pertussis and tetanus

Tetanus toxoid

Tetanus

‘Nil’ keeping in view of information on point one above.

List of notifiable diseases for each State may be obtained from respective State

3.

Is there any vaccination notified for such communicable diseases in India?

Information not available with IDSP

4.

If answer to query no. 3 is Yes, then please provide the details of all vaccinations notified for all notified communicable diseases in India?

5.

Is there any policy or law or scheme under which a person can get vaccination for all notified communicable diseases?

6.

If answer to query no. 5 is “Yes”, then please provide the details of all policies or law or scheme under which the person can get vaccination for all notified communicable diseases?

 

Analysis of Communicable Diseases RTI

Sr. No.

RTI application dated 27.08.2018

Reply by Immunisation Division of Ministry of Health and Family Welfare dated 28.12.2018

1.

How many states in the country have adopted the UIP?

UIP is implemented across the country

State-wise details of vaccines is provided in the enclosed schedule.

2.

Are all vaccines under UIP available free of cost for the poor patients?

Yes

3.

If answer to query no. 2 is “No”, then provide the details of the vaccines which are available free of cost for the poor patients?

Question does not arise.

4.

Is this UIP operating in all private as well as government hospitals?

No such information available.

5.

Does government apply these vaccines to the people living on street and beggars under this UIP?

It is to state that, the RTI Act, 2005 and guidelines issued there under make it clear that, only such information is required to be given which already exists and, it is not required to create information or to interpret information or to solve the problems raised by the applicant/appellant of to furnish replies to hypothetical question.

6.

If answer to query no. 5 is “No”, then under which programme or policy or law, the government provides immunisation vaccine to the people living on street and beggars?

As per the reply given on point no. 5 question does not arise.

   

National Immunisation Schedule (Age-wise)

Age

Vaccines given

Birth

Bacillus Calmette-Guerin (BCG), Oral Polio vaccine (OPV)-0 dose, Hepatitis B birth dose

6 weeks

OPV-1, Pentavalent-1, Rotavirus vaccine (RVV)-1***, Fractional dose of inactivated Polio vaccine (fIPV)-1, Pneumococcal conjugate vaccine (PCV)-1***

10 weeks

OPV-2, Pentavalent-2, RVV-2***

14 weeks

OPV-3, Pentavalent-3, fIPV-2, RVV-3***, PCV-2***

9-12 months

Measles-1 or Measles & Rubella (MR)-1***, JE-1*, PCV-Booster***

16-24 months

Measles-2 or MR-2***, JE-2*, Diphtheria, Pertussis & Tetanus (DPT)-Booster-1, OPV-Booster

5-6 years

DPT-Booster-2

10 years

Tetanus Toxoid (TT)/Tetanus & adult Diphtheria (Td)

16 years

TT/Td

Pregnant mother

TT/Td1, 2 or TT/Td Booster**

*JE in 231 endemic districts.

**One dose if previously vaccinated within 3 years.

***Rotavirus vaccine: MR/Measles vaccine and PCV in selected states/districts as per details below:

Rotavirus: Andhra Pradesh, Assam, Haryana, Himachal Pradesh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Tamil Nadu, Tripura and Uttar Pradesh.

MR vaccine: Andhra Pradesh, Andaman & Nicobar Islands, Arunachal Pradesh, Chandigarh, Daman & Diu, Dadra & Nagar Haveli, Goa, Haryana, Himachal Pradesh, Karnataka, Kerala, Lakshadweep, Manipur, Mizoram, Punjab, Odisha, Puducherry, Tamil Nadu, Telangana and Uttarakhand.

PCV: Bihar, Himachal Pradesh, Madhya Pradesh, Uttar Pradesh (12 districts) and Rajasthan (9 districts).