National One Health Mission: An Integrated Ecosystem for Augmenting India’s Pandemic Preparedness

Abstract

Over the past two decades, outbreaks such as Nipah virus infection, Severe acute respiratory syndrome, Avian influenza, Middle East respiratory syndrome, Zika virus disease, COVID-19 and Monkeypox have highlighted the growing threat of zoonotic spillovers and the need for proactive pandemic preparedness through a One Health approach integrating human, animal, and environmental health. In India, the National One Health Mission (NOHM), launched under the aegis of the Principal Scientific Adviser to Government of India, provides an integrated framework involving 16 Ministries and Departments for coordinated pandemic preparedness and response. NOHM is anchored on six strategic pillars: intersectoral R&D, integrated surveillance & multisectoral outbreak response, 23 BSL-3 laboratories, medical countermeasure development, data integration and capacity building. Key initiatives include sentinel syndromic surveillance for acute febrile, respiratory, encephalitic, and diarrhoeal illnesses, integrated surveillance at high-risk animal–human interfaces (slaughterhouses, bird sanctuaries, wetlands, and zoos) to strengthen early zoonotic spillover detection, genomic and metagenomic surveillance, support pathogen sequencing, variant tracking, and preparedness for “Disease X”. Wastewater surveillance serves a population-level early warning system for priority pathogens. The National Joint Outbreak Response Team (NJORT) and national mock drills operationalize multisectoral rapid response. The proposed integration of Integrated Disease Surveillance Program (IDSP), National Digital Livestock Mission (NDLM), Department of Animal Husbandry & Dairying (DAHD), and Ministry of Environment, Forest & Climate Change (MoEFCC) data platforms will enable real-time intelligence sharing. Together with accelerated vaccine, therapeutic, and monoclonal antibody platforms aligned to the 100 Days Mission, and strong global collaborations, NOHM is building a resilient, future-ready pandemic preparedness ecosystem for India.