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Five Disease Treatment, Orissa
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Subject Area="Logistics." Objective="Drug supply"
Details for Reform Option "Five Disease Treatment, Orissa"

Background: The Government of Orissa has introduced a strategy to ensure that every patient at a public health institution is guaranteed treatment at government cost for the most common diseases: diarrhoea, Acute Respiratory Infection (ARI), scabies, malaria and leprosy - but not every institution had a regular supply of quality drugs to treat these diseases. Action: To ensure minimum quality standard treatment protocols have been developed, the required medicines have been calculated, ordered and distributed to the facilities and health personnel have been instructed to provide free treatment for these diseases. In addition, if any patient has to buy medicines from the market he is to be reimbursed. The measures are accompanied by clinical audits and deviations from the guidelines result in penalties. Implementation was accompanied by a media campaign to inform the public.

Place Introduced over the whole state of Orissa in 1999.
Time Frame Six months to identify the major diseases prevalent in the population.

Inclusive: Creates a health entitlement as well as a risk protection guarantee for the poor who will receive free treatment. Prescriptive: Forces doctors to prescribe rationally. Time-saving: Patients are informed of their entitlement and can seek care from the right provider. Cost efficient: benefits a large number of people as it addresses the most common diseases affecting the population.


Narrow approach: Focuses resources towards a limited number of diseases at the expense of others. Inflexible: There is no mechanism to change the focus if areas have a different pattern of disease.


Development of treatment guidelines and guidelines for rational use of drugs. Evaluation of disease prevalence to identify most common diseases. System to ensure sufficient supply of essential drugs to facilities.

Who needs to be consulted

State government, medical doctors.



Has been functioning across Orissa since mid 2001.

Chances of Replication



Also known as the Pancha Byadhi Chikitsa scheme.


Submitted By

Matthew Jowett, Former Programme Adviser, European Commission Technical Assistance, New Delhi. July 2002.

Status Active
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