India's death census

[Guest guest]

He conducts India's death census

June 17, 2004

Dr Prabhat Jha and his 16-member team are conducting the world's

largest study on the causes of death in India.

Jha, from the Centre for Global Health Research of the University of

Toronto, is this year's winner of 'Top 40 under 40' award, sponsored

by The Globe and Mail Business Magazine, Air Canada, Birks and

Caldwell Partners, and is given each year to 40 most successful

people in different fields who are under 40.

Jha's study is examining the cause of deaths among 150,000 people in

India.

" It's the world's largest study as we are contacting six million

people in one million households all across India, " Jha told

rediff.com

" There are 800 surveyors, 100 physicians, 17 collaborators, " he added.

They have already done the necessary field work on 40,000 deaths. " We

need to do field work on 110,000 more, " he said.

India first started studying death in 1972, though not the

causes. " That is helpful but we have to study why people die, and

what are the underlying causes, " said Jha.

The scope of the study was amplified two years ago, when Jha became

the lead investigator with 16 other collaborators.

" The (Indian) government is committed to reducing child mortality and

improving public health. This study should enable representative,

reliable, routine, low-cost, and long-term measurement of child,

maternal and adult mortality in India, " said Indian Census

Commissioner J K Banthia.

" This is a landmark study, and will transform public health in

India, " said India's Health Secretary J R V Prasada Rao. " The

registrar general of India has shown great vision in mounting this

study. They have successfully completed the 2001 census of the

living, and will now successfully tackle the census of the dead. "

Their two departments are co-sponsoring the study and funding is from

several sources, Jha said.

" The study will really have a big impact on public health in India, "

he said. " The study will bring to light important diseases like

tuberculosis and where they are, what populations they occur in and

what we can do about them. From there we will build public health

programmes, which areas we should place an emphasis on, how important

is child morality, and how important smoking-related deaths and

tuberculosis are. "

If seen " as an honest accounting of the state of health of India in a

way that you have financial audit, it is going to have a really big

impact, " he said.

Jha said diseases like AIDS, tuberculosis, etc " all have specific

contributions. " However, he declined to reveal the findings and

conclusions so far. " I am not at liberty to release the details

because they will be released officially when the study is completed

next year. "

Another piece of information Jha shared with this reporter was that

two million children die each year in India. Describing India as a

nation with " the world's largest child deaths, " he said " these deaths

are related to infectious diseases, malnutrition, diarrhea and chest

infections. "

" Our surveyors are going to the one million households, spread all

across the country, and will ask them what deaths have occurred in

the family in the last few years. We gather information on how they

die so we can understand not just the cause of deaths but also the

determinants such as smoking, etc. "

Jha, who is also conducting another study, about the spread of HIV in

Tamil Nadu and Maharashtra, said, " We found in Tamil Nadu that half

the tuberculosis related male deaths are attributed to smoking. So,

what comes out of our study will be relevant to all of India. "

The spread of HIV, particularly in Tamil Nadu and Maharashtra, has

taken an epidemic form and " it could really be a disaster, " said Jha.

About 4.5 million people are currently infected but " we really don't

know. One of the things our

study will do is to get much better information of the spreading of

HIV through the population. "

" Think of it as a road map to prevent HIV, " he said.

" This study has just started as we were awaiting permission from the

governments to proceed. Those clearances have now come and we will

have some results ready by the end of the year, " he said.

The study, Jha said, is being funded by the Canadian Institute of

Health Research, World Health Organisation, and others.

Jha is the founding director of the Centre for Global Health

Research, St 's Hospital in Toronto and associate professor in

the department of public health sciences, University of Toronto. He's

also professeur extraordinaire at the Universite de Lausanne

(Switzerland).

He has also worked as a senior scientist at WHO in Geneva (1999 to

2002) where he co-chaired the working group on Improving Health

Outcomes for the Global Poor for the Commission on Macroeconomics and

Health.

He is lead author of Curbing the Epidemic: Governments and the

Economics of Tobacco Control (World Bank, 1999) and lead editor of

Tobacco Control in Developing Countries (Oxford University Press).

Curbing the Epidemic is said to be one of the most influential books

on tobacco control.

Jha holds an MD from the University of Manitoba and a DPhil in

epidemiology and public health from Oxford University where he

studied as a Canadian Scholar.

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