Achievement of a Yaws-Free India and Elimination of Maternal & Neonatal Tetanus

14 July 2016, New Delhi, India

Excellency Shri JP Nadda, Honourable Union Health and Family Welfare Minister

Excellency Smt Anupriya Patel, Minister of State, Ministry of Health and Family Welfare

Shri B P Sharma, Secretary, Health and Family Welfare

Shri C K Mishra, Additional Secretary, Health & Family Welfare

Dr Jagdish Prasad, Director-General of Health Services

Mr James Gitau, Deputy Country Representative, UNICEF

Distinguished Participants, Ladies and Gentlemen

It is a privilege to be here today to acknowledge and celebrate India’s victory over yaws and its elimination of maternal and neonatal tetanus. These achievements build on a series of recent public health gains in India, including the remarkable accomplishment of being certified polio-free in 2014.

Given that India accounts for approximately one-sixth of the world’s population, these victories are not only India’s, but all of humanity’s.

Most striking about the triumphs over yaws and maternal and neonatal tetanus is how a focus on health care access and equity made them possible.

As many of us know, yaws is a neglected tropical disease that commonly affects those who live on society’s fringes, where health services are often found in short supply. As the old saying goes, ‘where the road ends, yaws begins’.

Though the chronic skin disease is easily diagnosed and treated, it has remained a problem in recent decades despite first being targeted for eradication back in 1952. India’s health authorities overcame it by carrying out a highly targeted education and early treatment campaign in vulnerable communities. This campaign was able to treat existing cases and disrupt onward transmission.

Significantly, India is the first country to gain yaws-free status under the 2012 WHO roadmap for the fight against neglected tropical diseases, providing important lessons for countries still struggling under the disease’s burden.

Like yaws, maternal and neonatal tetanus – often referred to as the ‘silent killer’ – is a disease linked to health care inequities. It most commonly occurs among women and their newborns that have limited or no access to health care services. The only way MNT can be overcome is through increasing access to antenatal care and supervised births, as well as through expanding tetanus immunization coverage.

This is exactly what India has done in recent years, and which is responsible for eliminating the disease as a major public health problem.

But unlike yaws, tetanus will continue to be a threat as the bacteria that causes it occurs naturally in the environment. In acknowledging this, both tetanus immunization and safe delivery practices will need to be continued, taking care to ensure that marginalized communities are well-served.

Excellencies and Distinguished Participants, Ladies and Gentlemen,

Beyond the importance of health care access and equity, I would like to draw your attention to a few other lessons that must be heeded. In this regard, I would like to make four points:

First, victories against yaws and MNT were achieved through the existing health system without establishing any vertical elimination programs.

Second, no new groups of health workers were added to the health system; the cadre of existing staff managed it just fine. Of course, regarding the expansion of tetanus immunization we must acknowledge the contribution of the polio eradication experience and infrastructure.

Third, sustained political commitment over an extended period of time was essential to making progress against both diseases.

And finally, programmatic successes were facilitated by clear policies, unified strategies, close supervision and independent technical evaluations.

Each of these lessons must be fully comprehended, and must inform the design and implementation of future disease control programs.

Ladies and Gentlemen,

Before I conclude, I want to commend the Government of India for its foresight and vision, and sustained political and financial commitment to the battles against yaws and MNT.

I particularly commend the efforts of Shri Nadda for leading his team so ably to accomplish these remarkable feats. The achievements made will not only improve the health of marginalized communities, but will also enhance their socio-economic status and contribute to India’s wider development.

I also want to commend and thank the thousands of frontline health workers who, on a daily basis, toil under difficult circumstances to deliver these and other achievements. For their hard work and commitment we must all express our utmost gratitude. I take this opportunity to thank all partners, in particular UNICEF, for their support in making MNTE a reality.

With that Ladies and Gentlemen, I look forward to India’s continued success in controlling diseases and advancing public health.

Thank you.