LUCKNOW, 18 September 2005 — A major outbreak of Japanese encephalitis that has killed hundreds of children in overcrowded northern India has laid bare the inadequacy of the country’s public health programs, experts say.

Some observers in the nation of 1.1 billion blame the failure of ambitious health programs on the government’s determination to become, at all costs, an economic superpower.

In Uttar Pradesh state, encephalitis claims lives among the weakest almost every year, but 2005 has left a terrible toll with nearly 700 people, almost all children, already dead.

Another 3,200 people are fighting for their lives as a hopelessly overloaded medical system struggles to cope. A quarter of encephalitis or “brain fever” survivors in India are disabled for life.

Officials are reduced to trying to fend off a similar disaster from the mosquito-born disease in 2006 since it is already too late for prevention this year.

“We are stocking up on vaccines and will launch an immunization drive in November to prevent a recurrence of the outbreak in 2006,” said Uttar Pradesh public health chief O.P. Singh.

The disease, which first erupted in the state of 180 million people in 1987, struck this year at the end of July as monsoon rains spread.

The alarming death toll led the government to blame Uttar Pradesh state for failing to implement anti-encephalitis vaccination schedules.

Junior Home Minister Shri Prakash Jaiswal rejected the allegations by the provincial administration that New Delhi had not supplied the vaccines.

“Everyone knows that orders for importing such vaccines are placed months in advance because of the procedures drawn up by the World Health Organization (WHO) and we provided the state government with the entire amount of vaccines sought earlier this year,” he said.

He added that a helicopter dispatched to Lucknow for aerial spraying of insecticides was not used to eradicate the culex mosquitoes.

“This was a glaring example of criminal negligence by the state health authorities,” Jaiswal said.

India launched a grand-sounding National Immunization Program in 1985 with the goal of vaccinating 85 percent of children aged 0-15 years against diphtheria, tuberculosis, polio, measles, tetanus and whooping cough by 2000.

“It remains a pipe-dream because India in its unifocal approach to turn into an economic superpower ignored developing its human capital,” said K.P. Kushwaha, chief pediatrician of the largest hospital in Uttar Pradesh’s worst-hit district of Gorakhpur.

Experts believe India, which set a record when 93 million children were immunized against polio on a single day in January 1996, faces entrenched problems with immunization drives in states such as Uttar Pradesh, Rajasthan and Bihar.

“There’s a complete breakdown of the public health infrastructure coupled with grim social neglect in these states,” said Alok Mukhopadhyaya, chief executive of the Voluntary Health Association, India’s largest NGO which works alongside the WHO and United Nations Children Fund UNICEF.

“Bad governance, corruption, poverty and politics have led to this dismal situation which reflects on all reports,” he said, referring in particular to the UNDP’s just-released Human Development Report.

The UNDP warned in its Sept. 7 report that although India’s child mortality rate had shrunk over the past decade, the rate of decline had slowed.

“India is widely off-track for its child mortality target. The annual rate of decline fell from 2.9 percent in the 1980s to 2.3 percent from 1990 — a slowdown of almost one-fifth,” the report said, noting that had it matched Bangladesh’s rate of reduction, 732,000 fewer children would have died this year.

In 2003, the largest number of child deaths was in India with 2.3 million, followed by China with 650,000 and Pakistan with 481,000.

Health experts are calling for India to correct the imbalance in its medical infrastructure.

“We must get rid of random immunization projects and instead ensure the entire country gets an equal share of the resources and we have to prioritize primary health care,” said Kushwaha.

Some 75 percent of India’s health infrastructure is in urban areas where only 27 percent of the population live.