What India learned, and what it still needs to do
Epidemiology is related to unanswered questions, but also to unquestioned answers.
International Day of Epidemic Preparedness emphasizes the importance of prevention, early detection, and collaborative efforts to combat epidemics.
In India, a nation of 1.4 billion people characterized by densely populated cities, the ability to collect weekly district-level reports and support early outbreak detection is crucial. Given the country’s porous borders and significant burden of climate-sensitive infectious diseases, the question becomes urgent: How prepared are we to identify an outbreak early, contain it locally, and prevent it from escalating into a national or global disaster?
While the past five years have seen meaningful reforms, they also remind us that preparedness is a systemic property rather than just a singular program.
Strengths: Surveillance, Labs, and Human Resources
One of India’s core strengths lies in the Integrated Disease Surveillance Program (IDSP), which gathers weekly district-level reports to facilitate early outbreak detection. The program also enables the deployment of Rapid Response Teams at the local level. The use of the digital Integrated Health Information Platform within the IDSP has accelerated reporting and provided public health managers with a more profound understanding of issues requiring further investigation.
The National Centre for Disease Control (NCDC) has bolstered its capabilities in laboratory confirmation, field epidemiology, and public health preparedness planning. Initiatives such as India’s Epidemic Intelligence Service (EIS) training are enhancing the field epidemiology workforce, equipping professionals to investigate clusters, trace contacts, and inform decisions regarding containment and treatment.
On the international front, India actively engages with the World Health Organization’s frameworks and adheres to the National Action Plan for Health Security model. This alignment of national strategies with global standards for prevention and response is crucial, as epidemics do not recognize borders. Coordinated approaches facilitate quicker access to technical assistance, diagnostics, and vaccines when necessary.
Gaps persist in decentralization, financing, and the One Health approach. Capacity varies significantly across the country; surveillance and laboratory networks are more robust in urban and well-resourced areas, while rural districts often rely on slow sample transport and have limited diagnostic options. Although the IDSP portal’s weekly reports provide a solid foundation, they depend on trained personnel at district surveillance units—staff members who are frequently overburdened by routine health tasks and seasonal outbreaks.
Ongoing financing for public health initiatives—covering prevention, community outreach, and laboratory maintenance—remains a critical shortfall. Funding typically spikes during emergencies but rapidly declines afterward. Preparedness necessitates consistent funding for stockpiles, cold chains, training, and drills; without this support, the nation risks falling into a familiar pattern of panic, inadequate response, and eventual neglect.
Additionally, modern epidemic threats increasingly emerge at the intersection of human, animal, and environmental health. While India’s developing One Health initiatives—a multi-sectoral approach linking these areas—are making strides, institutional coordination still lacks the necessary legal, budgetary, and operational capacity to prevent and investigate zoonotic spillovers effectively. Recent expert recommendations have highlighted the importance of accelerating the institutionalization of One Health within mainstream planning.
Recent examples: what went right, what warned us
Recent events have produced both successful outcomes and cautionary tales.
Seasonal flu and dengue outbreaks, along with localized threats such as drug safety issues and contamination-related clusters, have repeatedly tested India’s surveillance system. The Integrated Disease Surveillance Programme continues to report numerous outbreaks weekly, enabling quicker alerts to state and central agencies than was possible two decades ago. However, recent experiences indicate that early problem detection relies on rapid laboratory testing, timely risk communication, and robust supply chains for critical medicines and tests.
The COVID-19 pandemic underscored and subsequently reinforced various components of the health system. As diagnostic capacities expanded, genomic sequencing networks were established, emergency operations centers were activated, and risk communication systems evolved. If we successfully preserve and scale these advancements for future challenges, they will become invaluable assets.
Practical priorities for India—a checklist
On this International Day of Epidemic Preparedness, policymakers and public health leaders should concentrate on a concise, actionable checklist:
- Sustain and secure funding for the Integrated Disease Surveillance Program (IDSP), laboratories, and Rapid Response Teams to ensure that preparedness is not dependent on emergency budgets.
- Address local-to-national gaps by investing in district public health laboratories and sample transport systems; swift confirmation can help prevent panic.
- Expand field epidemiology training, such as Epidemic Intelligence Service programs, to guarantee that every state has trained outbreak investigators available on short notice
- Institutionalize the One Health approach with a designated coordinating body, shared surveillance across human and animal sectors, and collaborative outbreak simulation exercises
- Maintain supply chains and stockpiles of diagnostics, personal protective equipment (PPE), and essential medicines, and clearly define protocols for rotation and replenishment
- Engage local communities and improve risk communication—preparedness is ineffective without public trust; clear and consistent messaging, along with local health worker networks, are crucial
- Conduct regular drills and after-action reviews to convert exercises into actionable policy and budgetary changes.
Role of technology and data—but with human oversight
Human oversight must complement the vital role of technology and data.
Digital platforms, genomic surveillance, and AI-assisted analytics have the potential to reduce detection timelines. The Integrated Health Information Platform (IHIP), the IDSP, and genomic sequencing projects show how technology can help India grow. However, data systems require human interpretation; while algorithms can identify signals, trained epidemiologists and local health workers are essential for translating these signals into public health action. Ensuring data quality, interoperability, and privacy must be central to any technological advancements.
A citizen’s role
Preparedness is not solely the responsibility of the government. Citizens, community leaders, and private healthcare providers must actively engage in vaccination drives, vector control initiatives, hygiene campaigns, and the timely reporting of cases. Social media and local news outlets can be valuable allies in disseminating verified public health guidance and combating misinformation, which can be as harmful as the pathogens themselves.
Looking ahead
The International Day of Epidemic Preparedness serves as a reminder that essential preparedness work occurs daily and is not merely symbolic. Since the pandemic began, India has developed robust resources, including surveillance systems, laboratory networks, field epidemiology training programs, and international partnerships. The next crucial step is to convert these resources into adequate protection by ensuring stable funding, equitable access across sectors, improved coordination of health efforts, and sustained community involvement.
As the world confronts constantly evolving biological threats, preparedness will be India’s most effective insurance policy. It is more cost-effective than treatment and vital for safeguarding lives, protecting livelihoods, and maintaining national stability. On December 27—and every day thereafter—ongoing focus, rather than sporadic alarm, will determine whether the next outbreak is contained at its source or escalates into another significant crisis.
Disclaimer
Views expressed above are the author’s own.
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