Demands Dengue Budget from Manipur Government

MNP (Meitei Nationalist Party) *

Fogging underway in areas identified as prone to Dengue in Churachandpur district on October 04 2015 :: Pix - TSE

MNP (Meitei Nationalist Party) demands Dengue Budget to be allocated for matters related to Dengue in the annual budget of Manipur from Manipur Government, and if the state government has already allocated such budget, then the party asks how much of it has been spent so far in tackling Dengue in Manipur and the total amount year wise allocated so far on Dengue from January 2007 (Government of India sent Long Term Action Plan for Dengue to the states for implementation on January 2007) to 2015.

1) MNP outlines reported cases of dengue in Manipur since 2007 as follows;

(i) November 2007 (Moreh, Chandel): According to a research published in WHO (World Health Organisation)’s Dengue Bulletin, 2008; 32: 219-21, An outbreak of dengue in Moreh, dengue is endemic in most countries of south-east Asia. Thailand, Indonesia and Myanmar continue to be hyper endemic countries in the region (Source: WHO-SEARO, New Delhi, 2007). The research confirmed, in November 2007, dengue and also reported the death of an 11 year old girl due to dengue haemorrhagic fever in Moreh town of Manipur’s Chandel district.

(ii) November 2011 (Churachandpur): According to the then district’s Deputy Commissioner/Collector, 33 (thirty three) cases of dengue were reported.

(iii) October 2012 (Chengkhonpang village, Churachandpur): According to the district malaria officials, 2 (two) confirmed dengue cases were reported.

(iv) October 2015 (Rengkai, Churachandpur): According to Manipur’s Health Department, out of the 6 (six) positive cases of dengue in Manipur, 5 (five) are from Rengkai of Churachandpur.

2) MNP is seriously concerned about the prevailing dengue in Manipur because of the following reasons;

(a) According to 2014 study by Government of India’s National Institute of Health and Family Welfare, New Delhi, it was found that India could have had an annual average of 5,778,406 clinically diagnosed dengue cases, or 282 times the reported number per year between 2006 and 2012. The study reported that the National Vector Borne Disease Control Programme captures only 0.35 per cent of the annual number of clinically diagnosed dengue cases in India. According to Dr. Soumya, Director General of the Indian Medical Council of Medical Research (ICMR), the government numbers are just the tip of the iceberg. Therefore, MNP worries and doubts the Manipur Government’s statistics on dengue cases.

(b) According to Myanmar’s Ministry of Health records of dengue, as reported on Myanmar Times, it recorded 35,993 cases from January to September 27 of 2015, almost three times as high as last year, and 78 per cent higher than the previous outbreak – deemed record breaking – in 2013. The ministry said that the year-to-date infections are the highest since the government began counting in 1965.

According to MSF (Medecins Sans Frontieres/ Doctors Without Borders), as reported on 17 August, 2015, Myanmar flood victims vulnerable to dengue fever, dengue is endemic to Rakhine state and Sagaing region, and in Sagaing region, Kalay is the most impacted town by the recent floods. Kalay is a town on 165 kilometres Tamu-Kalayamyo road connecting Myanmar and India’s Manipur and is also drained by Manipur river which is perennially linked with Manipur’s Imphal river. MNP is concerned about the rising dengue cases in Manipur’s districts (Chandel and Churachandpur) that border with Myanmar’s Sagaing which is dengue endemic region.

3) MNP lists out some steps taken by Government of India for dengue;

(a) As PIB (Press Information Bureau), GoI (Government of India) reported on 21 September, 2015, Cabinet Secretary Shri P. K. Sinha, in his review on preventive and clinical management measures to deal with Dengue in the states and the Capital Region of Delhi, directed that each hospital should be advised to set up a 24/7 separate unit manned by a senior doctor to attend to all fever related cases.

(b) As PIB, GoI reported on 14 September, 2015, ‘Union Health Minister reviews preparedness on Dengue’, around 12 (twelve) advisories have been issued from March to August this year (2015) regarding Dengue by the Union Health Ministry. This includes an advisory by the Union Health Minister to all the state Chief Ministers in April 2015. The Union Health Secretary has also issued an advisory to the Chief Secretaries in March 2015.

(c ) From NVBDCP ( National Vector Borne Disease Control Programme), Directorate General of Health Services, Ministry of Health & Family Welfare, India, in the List of Sentinel Surveillance Hospitals for Dengue and Chikungunya, Manipur has two hospitals ( Regional Institute of Medical Sciences, Imphal and J.N. Hospital Porompat, Imphal ).

(d ) From NVBDCP, DGHS, Ministry of Health & Family Welfare, India, in the List of Apex Referral Laboratories, the North East India has only one which is Regional Medical Research Centre (ICMR), Dibrugarh, Assam.

(e) From NVBDCP, DGHS, MoH&FW, India, in the Tentative State Wise Allocation for Dengue, Chikungunya and Japanese Encephalitis during 2015, Manipur has been allocated with 10 tool kits for Dengue, 1 (one) for Chikungunya and 2 (two) for JE (Japanese Encephalitis). In the Tentative month wise/state wise allocation breakup of Dengue kits [ to be supplied by NIV (National Institute of Virology), Pune], 2010, Manipur was allocated with 1 (one) in August and 1 (one) in September, or in total 2 (two) Dengue tool kits for the whole state.

(f) From NVBDCP, DGHS, MoH&FW, India, Government of India has;

(i) Developed a Long Term Action Plan for Prevention and Control of Dengue in the country and sent to the States on January 2007 for implementation.
(ii) National guidelines for clinical management of Dengue Fever, Dengue Hemorrhagic Fever, Dengue Shock Syndrome has been sent to the States April 2007 for circulation in all hospitals.
(iii) Established 110 Sentinel Surveillance Hospitals with laboratory support for augmentation of diagnostic facility for Dengue in endemic States in 2007 which has been increased to 170 in 2009. All these are linked with 13 Apex Referral Laboratories with advanced diagnostic facilities for back up support.
(iv) To maintain the uniformity and standard of diagnostics in these laboratories IgM MAC ELISA test kits are provided through National Institute of Virology (NIV), Pune. Cost is borne by GoI.
(v) Diagnosis of Dengue and Chikungunya is provided to the community at free of cost.
(vi) Since 2007, every year in the 1st quarter, Directorate of NVBDCP prepares the tentative allocation of test kits based on the previous epidemiological situation of Dengue and Chikungunya in the states and communicate to both NIV, Pune and States.
(vii) Kits are supplied by NIV, Pune on receipt of requirement from the respective states.
(viii) Buffer stocks are also maintained to meet any exigency.
(ix) State wise allocation of Dengue and Chikungunya during 2010 was communicated to the states on 15th February 2010.
(x) Ensuring the diagnostic facility and availability of kits is the responsibility of the respective State Programme Officers, NVBDCP.

4) Questions MNP ask to Manipur Congress Government on Dengue in Manipur are given below;

(a) What has the Manipur Government done in terms of
(i) Integrated Vector Management,
(ii) Clinical Management of Dengue,
(iii) Research on tackling Dengue from 2007 to 2015?
(b) How much amount has been sanctioned in an annual budget year wise from 2007 to 2015 on Dengue?
(c ) How much amount has been utilised in the sanctioned amount on Dengue year wise from 2007 to 2015?
(d) Whether the unutilised amount on Dengue fund of a year was added to the new Dengue fund of the succeeding year or not? If so, then provide the breakup of unutilised Dengue fund year wise from 2007 to 2015?
(e ) What steps has the Manipur Government taken to make all the district hospitals of Manipur to be listed in the List of Sentinel Surveillance Hospitals for Dengue and Chikungunya, as mentioned in 3(c)?
(f) What steps has the Manipur Government taken to have at least 1 (one) laboratory of Manipur in the List of Apex Referral Laboratories, as mentioned in 3(d)?
(g) Are the fund meant to tackle malaria and the fund meant to tackle dengue from the same pool of sanctioned amount in the annual budget or are the two funds recorded separately from each other?
(h) What steps has the Manipur Government taken to stop its spread to other districts of Manipur?
(i ) Has the Manipur Government initiated any scientific research or fact finding technical team on why the dengue cases are prevalent in the two hill districts, Churachandpur and Chandel, that border with Myanmar?
(j) Can the Manipur Government clarify that there is no threat of Dengue in the rest of Manipur other than the few pockets of the two hill districts, Churachandpur and Chandel, of Manipur?
(k) Can the Manipur Government clarify in terms of demarcating Manipur in areas such as Dengue risk area, Dengue prone area, Dengue critical area, Dengue free area, Dengue suspected area, Dengue confirmed area, Dengue never affected area, etc.?
(l) Has the Manipur Government notified a directive to cap the maximum cost of laboratory tests for Dengue in private hospitals of Manipur? If so, then, how much the government has charged for (i) NS1 antigen and dengue antibody tests, and (ii) Platelet count tests to the private hospitals or laboratories in Manipur?
(m) Has the Manipur Government notified and publicised the name and contact details of Manipur State Programme Officers, NVBDCP, as mentioned in f(x), and the name and contact details of the subordinates of the State Programme Officers?
(n) Has the Manipur Government appointed Malaria Inspectors so far? If so, then whether the work to check and fumigate an area to tackle Dengue is to be done by Malaria Inspector or not? If the work is not done by Malaria Inspector or if the government has not appointed a Malaria Inspector, then whether the government will appoint Dengue Inspector or not? Which lowest official of the government in a district is assigned the sole responsibility on Dengue?

(o) Has the Manipur Government, according to Cabinet Secretary’s directive mentioned in 3(a), directed that each hospital of Manipur should set up a 24/7 separate unit manned by a senior doctor to attend to all fever related cases?
(p) Has the Manipur Government taken any step as a response to the advisory by the Union Health Minister to all the state Chief Ministers in April 2015 and the advisory by the Union Health Secretary to the Chief Secretaries in March 2015 as mentioned in 3(b)? If so, then what steps have been taken thereof?

If the Manipur Government is not in a position to reply to 16 questions from (a) to (p) already mentioned, then whether the state government will seek support and coordination from Union Government of India or not to do so?

MNP stands for a scientific oriented healthy society where technology and economy unite to bring a healthy Manipur, India and the world. MNP, being inspired by Mother Nature, also calls for community based eco-bio-social approach to tackle Dengue in Manipur besides the support from both the state and central governments.

HEALTHY MANIPUR, HEALTHY INDIA, HEALTHY WORLD