India urgently needs an intergovernmental organization for the health sector, as many health sectors are rapidly globalizing and the influence of contemporary technologies is increasing, which are transforming health strategies. An organization that can improve coordination between the federal government and the states. Government management of public health outbreaks is hampered by inadequate healthcare infrastructure. Inadequate medical facilities, a shortage of medical personnel, and outdated diagnostic equipment make it challenging to effectively control unexpected disease outbreaks. The World Health Organization recommends a doctor-to-student ratio of 1:1000, but in India, the ratio is currently 1:900. India experienced severe shortages of oxygen cylinders, ventilators, and hospital beds during the COVID-19 pandemic, resulting in delayed treatment and increased deaths. When outbreaks are not promptly identified by inadequate disease surveillance systems, they spread rapidly and cause more cases before corrective action can be taken.
The importance of state and local governments in managing public health is highlighted by the recent Guillain-Barré syndrome outbreak in Pune. In Guillain-Barré syndrome, the immune system targets the peripheral nervous system, a rare autoimmune disease that results in weakness and paralysis. As demonstrated during the COVID-19 pandemic, local governments were empowered to oversee health and sanitation through the 73rd and 74th Constitutional Amendment Acts, making them important partners in outbreak response. Local and state governments have a role in controlling public health outbreaks by ensuring clean water and sanitation. Since these are often the origin of bacterial infections such as Campylobacter jejuni, local governments are in charge of maintaining a clean water supply and adequate sanitation. The need for proper water treatment and safety precautions is highlighted by the likelihood that the Guillain-Barré syndrome outbreak in Pune was caused primarily by water contamination.
Effective surveillance systems should be established by local authorities to promptly detect and track cases of unusual diseases and enable rapid responses. To enable early intervention, Pune’s rapid response teams are already collecting water samples and monitoring the situation to track the spread of Guillain-Barré syndrome. Education of the public about health hazards and protective measures, particularly with regard to food safety and hygiene, is greatly supported by the local government. Local health departments should ensure that the public is aware of safe food and water practices during Guillain-Barré syndrome outbreaks to prevent additional infections. State governments should work with federal health agencies, such as the Ministry of Health and Family Welfare, to exchange information, resources, and experience during outbreaks. Providing plasma exchange and immunoglobulin therapy to Guillain-Barré syndrome patients, which is most effective within two weeks of symptoms, requires close collaboration between local hospitals and health authorities in Pune. Local authorities need to monitor eateries for compliance.
Government management of public health outbreaks is hampered by inadequate healthcare infrastructure. Inadequate medical facilities, a shortage of medical personnel, and outdated diagnostic equipment make it challenging to effectively control unexpected disease outbreaks. The World Health Organization recommends a doctor-to-student ratio of 1:1000, but in India the ratio is currently 1:900. India experienced severe shortages of oxygen cylinders, ventilators, and hospital beds during the COVID-19 pandemic, resulting in delayed treatment and increased deaths. When outbreaks are not promptly identified by inadequate disease surveillance systems, they spread rapidly and cause more cases before corrective action can be taken. The 2018 Nipah virus outbreak in Kerala drew attention to the importance of early identification due to the high mortality caused by initial delays in identifying the source. Management of outbreaks is further worsened by public resistance to health advice due to misinformation and lack of knowledge about diseases and preventive measures. The separate operations of multiple agencies handling urban planning, sanitation, and healthcare lead to inefficient and delayed outbreak response. During Delhi’s 2017 dengue outbreak, poor coordination between health officials and municipal bodies led to a surge in cases and ineffective mosquito control measures. Providing clean drinking water and adequate sanitation is still very difficult, especially in urban areas with high population densities.
To improve urban health surveillance systems, urgent action is needed. Systems for monitoring urban health should include detailed data collection methods that monitor risk behaviors, environmental variables, and disease trends. Detecting new health risks can be aided by a central database that compiles current information on diseases such as Guillain-Barré syndrome, as well as environmental data on sanitation and water quality. The effectiveness of disease surveillance and warning systems in urban areas can be improved by implementing smartphone apps, digital dashboards, and sensor technologies. If residents can use mobile applications to report health symptoms or water contamination, it may be possible to identify potential outbreaks more quickly and implement targeted interventions. Urban health systems should include specialized surveillance networks targeting foodborne diseases, vector-borne diseases, and important diseases such as Guillain-Barré syndrome. Guillain-Barré syndrome outbreaks caused by contaminated food or water can be monitored by a specialized surveillance network for foodborne diseases, just as is done for dengue or malaria.
For a comprehensive approach, urban health surveillance systems should work with community organizations, municipal entities, environmental agencies, and health departments. Joint task forces of sanitation and health departments can monitor food safety and water quality to prevent outbreaks caused by GBS. Effective outbreak management requires local and state governments to prioritize early detection, deploy real-time surveillance, and improve collaboration. Future health emergencies like GBS will be less severe, and public health will be protected by strengthening urban health systems, investing in data analytics, and increasing community awareness.