Strengthening of Vaccine-Preventable Disease (VPD) Surveillance to Enhance National Health Capacity and Security: Perspective from India.

The Government of India, in collaboration with the World Health Organization (WHO), established the National Polio Surveillance Project (NPSP) in 1997 and initiated acute flaccid paralysis (AFP) surveillance to achieve the goal of polio eradication. The WHO South-East Asia Region, comprising of 11 countries, including India, was certified as polio-free in March 2014. India was also validated to have eliminated maternal and neonatal tetanus in May 2015. Over the years, the surveillance of other vaccine-preventable diseases (VPDs) was integrated with AFP surveillance in the country. Outbreak-based measles-rubella (MR) surveillance was initiated in 2005 using AFP surveillance as a platform, case-based fever-rash (FR) surveillance started in 2021 as one of the strategies to achieve measles and rubella elimination in the country. The surveillance of diphtheria, pertussis, and neonatal tetanus was integrated with AFP surveillance in a phased manner during 2015-2022. The surveillance system for VPDs in India, supported by a laboratory network of 10 polio laboratories, 28 measles-rubella laboratories, and 20 diphtheria-pertussis laboratories, has enhanced the national health capacity and security. The setting up and expansion of the surveillance system in the country involved the important component of capacity building of personnel on various components of surveillance, including case identification, case investigation, sample collection and shipment, data analysis and public health response. These capacities have been used effectively during other emergencies, such as the recent COVID-19 pandemic, as well as during outbreaks of other diseases and natural calamities.