Integrated Disease Surveillance Programme

The Integrated Disease Surveillance Programme (IDSP) is a nationwide public health initiative in India established to strengthen and maintain an effective surveillance system for epidemic-prone diseases. Designed to enable early detection of outbreaks, enhance laboratory capacity and ensure prompt response, it forms a crucial part of India’s health infrastructure for epidemic preparedness and control.

Background

The IDSP was launched in 2004 by the Ministry of Health and Family Welfare (MoHFW), Government of India, with technical and financial assistance from the World Bank. Initially known as the Integrated Disease Surveillance Project, it was later converted into a programme under the National Health Mission (NHM) to ensure long-term sustainability.
The programme operates through a decentralised network of surveillance units functioning at three administrative levels—Central, State, and District. The Central Surveillance Unit (CSU) at the National Centre for Disease Control (NCDC), New Delhi, oversees the national operations, while State Surveillance Units (SSUs) and District Surveillance Units (DSUs) manage data collection and response activities at their respective levels.

Objectives

The major objectives of the IDSP are to:

• Strengthen and maintain a decentralised, IT-enabled, laboratory-based surveillance system for epidemic-prone diseases.
• Detect and respond promptly to outbreaks in their early stages through trained Rapid Response Teams (RRTs).
• Monitor disease trends and provide essential data for evaluating and guiding disease-control programmes.
• Integrate surveillance activities across health, environmental, and veterinary sectors to promote a “One Health” approach.

Key Components and Strategy

1. Decentralised Structure: The surveillance network is designed for efficient coordination between central and local levels. The CSU at NCDC manages national data and policy; SSUs coordinate reporting from districts; and DSUs collect and analyse data from healthcare facilities within their jurisdictions.
2. Human Resource Development: Training programmes are regularly conducted for epidemiologists, microbiologists, laboratory technicians, and health officers. The objective is to develop skilled personnel capable of investigating outbreaks, analysing trends, and implementing effective response measures.
3. Information and Communication Technology (ICT): The IDSP utilises digital platforms for timely reporting and analysis. The Integrated Health Information Platform (IHIP), a cloud-based system, allows near real-time data entry and mapping of cases. It also enables early warning notifications to health authorities.
4. Laboratory Strengthening: Public health laboratories have been equipped and upgraded to ensure rapid confirmation of suspected disease cases. These laboratories play an integral role in linking clinical data with laboratory results for effective surveillance.
5. Surveillance Mechanism: Weekly reporting is the backbone of the programme, using three standard formats:

• S Form: Suspected cases reported by health workers.
• P Form: Presumptive cases from clinicians.
• L Form: Laboratory-confirmed cases.Data collected through these forms are analysed at the district level and then uploaded to the national portal for further evaluation.

6. Event-Based Surveillance: In addition to routine data collection, the programme includes Media Scanning and Verification Cells (MSVCs) to monitor news and digital sources for potential outbreaks. This proactive system enables authorities to respond quickly to unusual health events.

Diseases under Surveillance

The IDSP primarily focuses on epidemic-prone communicable diseases such as malaria, dengue, chikungunya, acute diarrhoeal diseases, viral hepatitis, influenza, and Japanese encephalitis. However, in recent years, it has expanded its scope to include emerging and re-emerging infectious diseases and to support surveillance of non-communicable diseases in collaboration with other national health programmes.

Achievements and Impact

Since its inception, the IDSP has established surveillance units in nearly all districts of India, achieving nationwide coverage. The weekly data reporting system has enabled continuous monitoring of disease trends and quicker outbreak detection.
The introduction of the IHIP platform has transformed the traditional paper-based reporting into a digital and geospatially enabled system, improving data accuracy and accessibility. Additionally, the establishment of RRTs at the district level has strengthened outbreak investigation and containment efforts.
The Media Scanning and Verification Cell has successfully identified numerous outbreaks that may otherwise have gone unnoticed, demonstrating the importance of event-based surveillance. Through its structured training programmes, IDSP has also built a significant cadre of trained public health professionals across the country.

Challenges and Criticism

Despite its accomplishments, several challenges persist:

• Delayed Reporting: Some districts experience delays in data submission and laboratory confirmation, affecting the timeliness of response.
• Infrastructure Gaps: Limited laboratory infrastructure and uneven IT connectivity hinder effective data management in remote areas.
• Inter-sectoral Coordination: Coordination between human health, veterinary, and environmental sectors remains inconsistent, reducing the effectiveness of a unified “One Health” strategy.
• Human Resource Shortage: Vacant positions for epidemiologists and microbiologists at state and district levels often weaken data analysis and outbreak response capacities.
• Data Quality: Issues such as incomplete entries and inconsistent classification of diseases affect data reliability and interpretation.

Significance and Applications

The IDSP serves as a cornerstone of India’s health security system. Its early warning and rapid response mechanisms help control outbreaks before they spread widely. Data generated through the programme assist policymakers in disease trend analysis, planning vaccination drives, and implementing preventive strategies.
The system’s design also supports India’s obligations under the International Health Regulations (IHR-2005) by improving its capacity for surveillance, assessment, and reporting of public health emergencies. Furthermore, the IDSP model has been recognised as a framework for developing digital health surveillance systems in other low- and middle-income countries.

Recent Developments and Future Directions

Recent upgrades to the programme focus on real-time, geospatial data integration through the IHIP, linking health data across states and facilities. Efforts are also underway to include climate-sensitive diseases, zoonotic infections, and environmental data within the surveillance system to anticipate health impacts of climate change.