The COVID-19 pandemic has profoundly impacted India, marking it as one of the worst public health emergencies in history. With an official death toll exceeding 5,30,000, the country faced unprecedented challenges as the virus rapidly spread, overwhelming healthcare systems and leading to widespread loss and suffering. In light of this, NITI Aayog established an Expert Group to develop a ‘Framework for Action for Future Pandemic Preparedness and Emergency Response’.
The COVID-19 pandemic has profoundly impacted India, marking it as one of the worst public health emergencies in history. With an official death toll exceeding 5,30,000, the country faced unprecedented challenges as the virus rapidly spread, overwhelming healthcare systems and leading to widespread loss and suffering. In response, the government implemented stringent nationwide lockdowns—an unprecedented situation that had never been witnessed before in India—disrupting daily life, the economy, and education. These measures, while necessary to curb the virus’s transmission, revealed critical vulnerabilities in the public health infrastructure and exposed systemic issues that need urgent attention. The chaos and uncertainty experienced during this time underscored the fragility of health systems and the pressing need for a more resilient response framework to tackle future health crises.
Several studies and researchers have warned that the COVID-19 pandemic is unlikely to be the last health crisis humanity faces. In fact, between 2009 to 2022, WHO has declared six Public Health Emergency of International Concern apart from COVID-19. These include Influenza A in 2009, poliomyelitis in 2014, Ebola West Africa in 2014, Zika in 2016, Ebola Democratic Republic of Congo in 2018, and Monkey-Pox in 2022.
Pandemics are likely to emerge more frequently in the coming years
With the planet’s shifting ecology, and climate, and the complex interactions between humans, animals, and plants, new infectious threats to human health are almost certain to emerge. The WHO in 2014 had warned that 75% of future public health risks are expected to originate from zoonotic sources, stemming from emerging, re-emerging, or novel pathogens. An expert report from the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) warned in 2020 that future pandemics are likely to emerge more frequently, spread more rapidly, cause greater economic damage, and result in more fatalities than COVID-19 unless there is a transformative shift in the global strategy for managing infectious diseases—from a reactive approach to one focused on prevention.
NITI Aayog Expert Group makes a slew of recommendations for Action Plan to deal with pandemics
In light of this, NITI Aayog established an Expert Group to develop a Framework for Action for Future Pandemic Preparedness and Emergency Response. The group’s Terms of Reference encompass a comprehensive evaluation of how COVID-19 was managed at both national and global levels. This includes identifying key lessons learned from successes and challenges alike, as well as assessing critical gaps that must be addressed to improve preparedness and response for future public health crises. The expert group recently released a report that provides an action plan for a 100-day response to any outbreak or pandemic.
The Expert Group, after fourteen consultations with over sixty national and international experts, proposed a Pandemic Preparedness and Emergency Response (PPER) framework which outlines a roadmap and Action Plan for responding to Public Health Emergencies within 100 days, identifying gaps and enhancing existing frameworks for effective implementation. It has proposed measures for better pandemic preparedness across various aspects, including enhancing research and development, strengthening warning systems, improving surveillance, and optimizing data management. Some of the key recommendations in this report are discussed below.
PHEM Act and EGoS have been recommended
A new legislation namely the ‘Public Health Emergency Management Act (PHEMA)’, has been proposed which aims to enhance public health emergency preparedness and response at central and state levels. It focuses on developing expertise, repositioning personnel, regulating travellers and goods, improving communication, accelerating the development of diagnostics and vaccines, establishing emergency procurement processes, and coordinating with international organizations.
During the COVID-19 pandemic, several Indian states invoked the Epidemic Diseases Act to implement measures such as quarantine, isolation, and social distancing to control the spread of infectious diseases. However, COVID-19 exposed the limitations of this colonial-era legislation and the Law Commission of India in its 286th report recommended a complete overhaul of this legislation.
A Standing Empowered Group of Secretaries (EGoS) for ‘Pandemic Preparedness and Emergency Response’ has been proposed to prepare and monitor readiness during peacetime. Chaired by the Cabinet Secretary and co-chaired by the Member, Health of NITI Aayog, this group will oversee governance, finance, R&D, surveillance, and partnerships, ensuring a coordinated response during public health emergencies. EGoS will also create specialized working groups for each area of focus during emergencies like the Empowered Groups established during COVID-19.
Report stresses on measures for boosting data collection, management and transparency
The proposal advocates for a unified data platform to integrate existing data portals, improving sharing and analysis. It aims to utilize the ‘Integrated Health Information Platform (IHIP)’ and ‘Integrated Disease Surveillance Programme (IDSP)’ data for an outbreak module, enhance data collection and management, and implement training for effective integration with modelling systems.
Enhancement of the surveillance system for early warning by integrating public and private sectors through a One Health approach has also been recommended. It focuses on community surveillance in hotspots, real-time monitoring using AI, strengthening genome sequencing, and establishing a Regional Surveillance Network for transboundary pathogen tracking.
Measures to boost research in vaccines and outbreak modelling suggested
The proposals include establishing an Epidemiology Forecasting and Modelling Network for Indian prediction models, supported by an innovation fund for pandemic preparedness. It aims to create a Vaccine Science & Development Institute, launch a National Mission on Therapeutics, develop novel diagnostics and vaccines, and set up a Network of Centres of Excellence for research on priority pathogens.
A new regulatory system is proposed to be set up to work with global regulators for easier data sharing. This is to include faster approval processes and stronger expert committees. A solid Clinical Trial network is also to be created, involving key hospitals. The Central Drugs Standard Control Organization is to be made an independent authority with a Chief Regulator who can quickly approve new products.
Group calls for better communication, and partnership for dealing with pandemics
The group recommends setting up a Risk Communication Unit at the NCDC, led by a senior officer, to share updates with the stakeholders. They recommend formulating a plan to build public trust, improve communication skills in the scientific community, manage misinformation, and partner with UNICEF and social science groups for a strong communication framework during pandemics.
Further, the group recommended setting up agreements for sharing data, samples, and funding. They suggested encouraging teamwork during peacetime and strengthening partnerships between ICMR and NCDC to speed up testing. Additionally, the report recommends building international connections for information sharing and technology transfer, promoting South-South cooperation, and collaborating with WHO and CDC.
Legislations to deal with pandemic outbreaks already exist in US, UK, and Australia
The recommendations put forth by the group highlight essential measures for enhancing India’s pandemic preparedness and response. Coming up with such a framework is a significant step forward. India can take inspiration from other countries that have successfully implemented similar policies.
For instance, in the US, the Public Health Service Act, 1944, laid the groundwork for federal public health services, granting the government authority for quarantine and disease prevention. The Pandemic and All-Hazards Preparedness Reauthorization Act, 2013 updated this framework, enhancing programs for pandemic preparedness and clarifying the roles of officials in emergencies. This Act also streamlined processes for reassigning personnel and developing medical countermeasures, focusing on improving overall readiness for public health threats.
In the UK, the primary legislation for public health emergencies is the Public Health (Control of Disease) Act, 1984. This Act provides a legal framework for the control of communicable diseases and enables health authorities to respond to outbreaks.
Similarly, the Biosecurity Act 2015 in Australia establishes a framework for managing biosecurity threats, including infectious diseases, by allowing the government to implement control measures, declare emergencies, assess risks, and promote cooperation among different levels of government.
WHO and Member States are coming up with an international accord for pandemic prevention
At the international level, the WHO and its member states are actively engaged in ongoing negotiations to develop a new international accord aimed at strengthening pandemic prevention, preparedness, and response. This effort is often referred to as the “pandemic treaty” or “pandemic accord.” The World Health Assembly established the Intergovernmental Negotiating Body (INB) to draft the WHO convention. The efforts began in December 2021 between 194 of the world’s 196 nations. As of now, the pandemic accord is in the negotiation phase, with member states working diligently to address complex global health challenges revealed by the COVID-19 pandemic which, officially, claimed 7 million lives and cost 2 trillion USD at the global level, even though a deadline of May 2024 was not reached.
