The death of more than 60 children in the span of a few days in a major referral hospital in Uttar Pradesh has jolted the conscience of the nation. This was an entirely preventable tragedy. It will take an independent inquiry to establish why children perished at the BRD Medical College in Gorakhpur between August 7 and 11. Such an inquiry should examine whether and to what extent the disruption of oxygen supply to those who were extremely sick was a cause for the deaths. That the two events were not entirely unrelated seemed to be indirectly confirmed with the frantic requisitioning of emergency oxygen supplies and the State government suspending the principal of the college. Chief Minister Yogi Adityanath’s immediate assertion that no deaths took place due to lack of oxygen was inappropriate as it would prejudice any administrative probe. After all, the company that supplied the oxygen had issued notice to the hospital on large unpaid bills, warning of a crisis. Only a high-level judicial inquiry will have credibility. That no lessons have been learned by the State government and the Centre is evident from the unremitting annual peaks of disease and death in U.P., particularly in the eastern districts: data show that Japanese encephalitis, which afflicted many of the children who died last week, has claimed more than 10,000 lives in the State between 1978, the year of the first major outbreak, and 2005. High mortality has been witnessed in subsequent years as well. As a parliamentarian representing Gorakhpur for almost two decades, Mr. Adityanath was only too familiar with the epidemics that wracked his constituency frequently. Previous State governments have done little to address this problem, but that cannot be Mr. Adityanath’s response to the tragedy.
Reducing the incidence of fatal or crippling disease calls for robust medical infrastructure, which governments can create quickly, if they have the will. In the case of U.P., the epidemics have their roots in weak social determinants such as housing and sanitation, coupled with ecological changes. Encephalitis is correlated with expansion of irrigation and construction of dams four decades ago, resulting in an increase in disease-transmitting mosquitoes. Proximity to pigs and birds created viral transmission pathways. The Centre has a vaccination programme in place and a stated commitment to build paediatric intensive care units in priority districts, but these have not had significant impact. The way forward would be for the Indian Council of Medical Research to launch a special commission for U.P., treating it as a public health emergency. It is also an appropriate moment for the Centre and the States to consider their poor record. They trail even other developing economies, such as neighbouring Thailand and some African countries, in moving to universal health care. Such a system should be non-commercial and regulated to contain costs, giving everyone affordable access to doctors, diagnostics and treatment.