Vellakal et al must be commended for a very useful study on a large sample which has raised the probability of equal or higher prevalence of non communicable diseases in India. This finding definitely has huge policy implications in terms of resource allocations by both government as well as donor agencies for the future. There would be expectedly as in the past be other studies published soon which refute the findings of this study.

This debate is also aligned to a similar debate in India from the infectious diseases arena regarding the actual disease load or incidence of vaccine preventable diseases for which new vaccines are being proposed for introduction. This also has huge policy implications in terms of resource allocations.

Both these debates can only be settled if India prioritizes the establishment of a sensitive disease surveillance network across the country which provides complete and truly representative data for both communicable and non communicable diseases. This is not an aspirational suggestion but based on an already existing sensitive surveillance network in the country which reports data on poliomyelitis cases from across the country confirmed by virus culture isolation!. The academics and many policy makers in India unfortunately dismiss any achievements by the polio eradication initiative including its surveillance system as a non replicable " Vertical system". India needs to learn from this surveillance network to design a sustainable and sensitive network for selected priority communicable and non communicable diseases. Till such action is taken, we will have depend on data from surveys and studies for information and the debate will continue.
Bidyut K Sarkar M.D E mail: bidyutk.sarkar@gmail.com