Why Global TB Report a Wake-up Call for India? (Comment: Special to IANS)
The just-released Global Tuberculosis (TB) Report-2016 is a shocker for India. The report reveals the spread of this curable disease is larger than previously projected and moreover, the country accounts for 24 per cent of the global cases.
India’s effort to check the disease is falling far short of what is required. The new figure finds 50 per cent more TB cases in India than previously assessed; so the total cases have gone up from an estimated 9.6 million to 10.4 million cases globally. Six countries — India, China, Indonesia, Nigeria, Pakistan and South Africa — account for 60 per cent of the global total.
The new report is a wake-up call for India to break the status quo on how TB and its drug-resistant forms are being diagnosed and treated. Close to 480,000 people contracted multi-drug resistant TB in 2015 — more than half of them stay in India, China and Russia.
The most critical aspect of the disease unfolding in the new report is quite serious — that many people with multi-drug-resistant (MDR) TB are not able to access proper treatment in their respective countries. The treatment success rate of MDR TB cases was < 50 percent in countries with the largest cohorts: India, the Philippines, the Russian Federation, South Africa and the Ukraine.
This is primarily happening because of high death rate in India, South Africa and the Ukraine; high treatment-failure rates in the Russian Federation and the Ukraine and high rate of loss of follow-up or missing data in India, the Philippines and South Africa.
Globally, 7,234 patients with XDR-TB (extensively drug-resistant TB) were enrolled on treatment (more than twice the level in 2014). Most of these cases in 2015 were notified in India (2,130), the Ukraine (1,206), the Russian Federation (1,205) and South Africa (719). Among six countries with XDR-TB cohorts of more than 100 individuals, mortality was highest (>40 per cent) in India and South Africa.
It is a great worry for the Narendra Modi government as out of 5,000 TB deaths daily at the global level, India accounts for 1,400. The Indian government can no more afford to allow 1,400 of its people, mostly the poor, die every single day because of a disease that is curable and for which treatment is available.
The global pressure on India to act and prioritize TB as a health threat is increasing. With 400 million poor people in the country, who mostly live in crowded small homes with lack of sanitation and poor nutrition, there are fears that TB may take the shape of Ebola on some day if this public health crisis is not taken seriously.
India, on its own economic strength, can diagnose this disease, can treat it with effective anti-micro-bacterial drugs, and cure it with the current drugs that are available. So, the question is what is stopping the government from being serious and allocating the required resources to a disease that has emerged as the No.1 infectious disease killer of poorest of the poor in the country?
There is no other option left before India but to urgently map out where these new infections are coming from, run after them to find those cases, identify them and begin their treatment.
(The author works with the International Union Against Tuberculosis and Lung Diseases — The Union. The views expressed are personal. He can be contacted at firstname.lastname@example.org)