India failing to tackle 'massive TB crisis'

24 March 2015
India failing to tackle 'massive TB crisis'
A drug-resistant TB patient receives treatment at a clinic in Lashio, Shan state, Myanmar. Photo: C Eddy McCall/MSF

India is failing to tackle a tuberculosis epidemic because of chronic shortages of funds and the government's inability to regulate an "exploitive" private health sector, an article in the British Medical Journal said.
The article, published ahead of March 24, World Tuberculosis Day, called for a massive investment in public health infrastructure to diagnose and treat what it called India's biggest health crisis.
India accounts for an estimated 2.2 million of the 8.6 million new cases of tuberculosis that occur globally each year and harbours more than twice as many cases as any other country, according to the World Health Organization. Some 300,000 people die in India every year from the disease.
The article by Zarir F Udwadia, a doctor at one of Mumbai's biggest private hospitals, said the government's TB programme was failing to monitor the country's burgeoning private health sector.
"This is where most patients with TB seek initial care despite extensive evidence of inaccurate diagnostics and inappropriate treatment," said Udwadia, from the P.D. Hinduja National Hospital and Medical Research Centre. 
"Patients with TB in India typically flit between an unsympathetic public sector and an exploitative private sector until they are too sick or impoverished to do so, all the while continuing to transmit and spread tuberculosis in crowded home and work environments."
India's anti-TB programme has spent a "derisory" five billion rupees ($80 million) annually on tackling the disease, the least among the BRICS group of developing nations, he said.
Udwadia's comments, published online by the BMJ on Monday, come as India Health Minister Jagat Prakash Nadda is due to release an annual report later Tuesday on his government's efforts to combat the disease. 
Udwadia said government efforts have improved in recent years, including better laboratory and hospital facilities, after the number of drug-resistant TB cases soared.
"Despite these positive developments, the general perception remains that India's TB programme has failed to control disease and to reach out to poor and marginalised people who need its help most," said Udwadia, a public health specialist. 
A group of experts recently wrote to Prime Minister Narendra Modi urging him to treat TB as a national emergency, including by increasing public awareness of the disease and tackling drug resistance, he added.