Covid has shown that healthcare communication needs to be linked across public health programs. Separate communication strategies do not help to create overall awareness which experts say is crucial for, ‘health seeking behavior’.

With this backdrop, Pulse Talk, Episode 2 spoke with a series of experts on the issue of linking communication for large public health diseases such as TB, tobacco use and Covid.

Speakers included: Sharmistha Ghosh, Vice President, Avian WE, Prof Amir Ullah Khan, Research Director, CDPP and Adjunct faculty at ISB, Shibu Vijayan, Global TB Technical Director, PATH, Vaishakhi Mallik, Associate Director, South Asia, Policy Advocacy and Communication, Vital Strategies, Dr. Rachana Acharya, Associate Director, IDV and Global Public Health India, Janssen, Neelam Makhijani, Country Director at ChildFund International in India, and L M Singh, MD, Vital Strategies India.

The urgency to link TB and Covid Communications

Speaking exclusively on the PRmoment-Avian WE Pulse Talk podcast, Dr. Rajendra P Joshi, DDG, Central TB Division, MOHFW commented on how integrating the communication for the two can help to save lives.

He also outlined on the need for better TB awareness, saying, ” Awareness about tuberculosis is unfortunately not up to the mark. Even though we are in an information age, the awareness about symptoms of tuberculosis, which are very simple, like cough more than two weeks, blood in the sputum, weight loss, mild fever, night sweats, loss of appetite, these things are very easy, but unfortunately, there are many people who don’t link it to tuberculosis who don’t seek facilities, whether it is private or government. So, unless the health seeking behaviour is improved, we cannot achieve the goal of elimination.”

Sharmistha Ghosh, Vice President, Avian WE outlined the urgency for linking awareness of TB and Covid and upping investment in TB treatment, “This is especially more important in the light of COVID 19 epidemic, which has halted years of progress in the fight against TB.”

L M Singh, MD, Vital Strategies India, said, “COVID has taught us this lesson that we cannot really underestimate both the social and economic impact a disease has, I’m glad to see that we’ve interlinked public health challenges like TB with the need to make that investment, whether it’s the investment of awareness, investment over time, and clearly the investment of financial money, which can actually help us to meet these goals.

Adding how health-seeking behaviour matters, Singh stated, “Studies have estimated that preventing any epidemic would require billions of dollars, four to $5 billion a year. And if we look at TB itself within India, and look at the disease burden we carry, clearly the amount of investment required and the kind of innovation required, needs to be stepped up.”

Dr. Rachana Acharya, Associate Director, IDV and Global Public Health India, Janssen, said, ” If I have to call out some of the top benefits of horizontal communication, I think any communication which integrates is better in terms of the responsiveness to the user If you’re targeting to, it has an amplifying impact. It is also a very nuanced innovation by itself, which may not be there at the start of your strategy. Because there are insights which get generated within each cycle. And I think most importantly, it just helps for very rapid diffusion of knowledge, especially if your communication is related to awareness. And that, in turn, then gets translated into better adoption, and leveraging and optimising of resources.”

Agreeing Vaishakhi Mallik, Associate Director, South Asia, Policy Advocacy and Communication, Vital Strategie said, “The COVID pandemic has shown us clearly that we cannot look at public health, in isolation, the different public health issues in isolation. That is why we advocate for mass media campaigns, because, they have the highest impact and reach. And the lessons that you learn from one programme those could be employed in another closest programme.”

Economic Impact of disease

Prof Amir Ullah Khan, Research Director, CDPP and Adjunct faculty at ISB talked about the long term health impact of diseases and major global events like the pandemic.

Khan said, “The most famous case that is talked about is the impact of World War 2 on on Dutch pregnant mothers. Due to the World War, we saw how that that the health was adversely impacted, of not only the children who were in the wombs at that time, but their children later on.”

Khan added, “Exactly the same case is with COVID. Just to make it even more explicit. You see what one of the things during wave one and wave two when we shut down everything,- we had the most draconian lockdown that we saw anywhere in the world.

And one of the repercussions of that was that we closed down all our medical centres, the antenatal care, and, and you had pregnant women, not availing of antenatal facilities of iron infusion for example infusion. And you can see that you know, those 12 million or so children that would have been born during that time must have must have been affected adversely.”

Funding instruments to support integrated healthcare and its impact on economic return

Neelam Makhijani, Country Director at ChildFund International in India said, “Innovative financing is very important because as NGOs, I think, you know, we have those very traditional way of getting grants and we still need them. But as a leapfrog strategy in terms of getting paid only when you show the change, but also show the impact.

So how, as NGOs, we will be more conscious that we have to give results to get paid. Plus, how do we therefore ensure that we have very robust measurement system in place. And, you know, it raises your accountability standards to the highest.”

Shibu Vijayan, Global TB technical Director, PATH, pointed out that, “For every $1 invested in tuberculosis is actually a return of $43. So, just be clear that we need more investments and then we will get more returns.

Commenting on how poor nutrition can deeply impact the disease burden Vijayan said, “So, tuberculosis is actually an indicator of household poverty. And, and we need to intervene into the household not at the patients but at the household level. Targeting the families is the best vaccine, and this vaccine is actually nutrition.”