This Article is From Nov 27, 2014

India, Emerging World Power, Grappling With TB

Anurag Thakur is a BJP MP (Lok Sabha). He is also the National President of the Bharatiya Janata Yuva Morcha, the youth wing of the BJP and Chairman of the Parliamentary Standing Committee on Information Technology.

India is a country of many paradoxes. On one hand, its mastery of cost-effective technological innovation has made it a leading global example and its massive pool of human resource is second to no other, giving the world some of its best scholars, scientists, doctors, leaders, sportsmen and innovators. On the other hand, it is a country where a large proportion of its population lives under the poverty line.

It is a country where preventable and treatable diseases kill millions every year, and push hundreds of thousands of families into gut-wrenching poverty.

Tuberculosis (TB) is one such disease that many do not perceive as a public health threat, when in fact it is among the leading causes of death among Indian adults. Annually, India witnesses 300,000 TB deaths, 2.3 million new cases and additionally, a million missing patients languishing in the unorganized private sector.

October 2014 was a big month for India's battle against tuberculosis - a widespread yet neglected disease in a country that accounts for one-fourth of the global TB burden alone.
On home turf, Aamir Khan and his team on Satyamev Jayate brought the issue of TB and its drug resistant strains to the fore, calling the disease a "Ticking Time Bomb" and generating much needed public awareness nationwide like never before.

Internationally, a delegation of Indian MPs (that I was part of) attended the 45th Union World Conference on Lung Health in Barcelona, Spain under the leadership of the then Union Health Minister Dr. Harsh Vardhan. This was a landmark event for TB in India, as it is here that Dr. Harsh Vardhan announced the TB-Mission 2020 to eliminate TB from the country.

These developments promise to bring TB out of the shadows, paving the way for concrete action to address the several challenges that are perpetuating disease transmission and the rise of drug resistant strains. Awareness generation is a critical tool to capture this building momentum - the general public must be educated about existing benefits and hazards in the TB landscape, while systemic issues and bottlenecks must be brought to the attention of policy-makers. Therefore, the time to act is now but first we must understand the major issues at hand.

Although the Revised National Tuberculosis Programme (RNTCP) has made good progress over the years, the sheer scale of India's TB epidemic is challenging. The national TB control program provides free TB diagnosis and treatment but a concerted effort must be made to increase awareness about these services.

To make matters worse, mismanagement of TB care in the private sector is fuelling drug resistant TB due to the inaccurate diagnostic tests and prescription of incorrect drug regimens. The limitations of currently-available TB diagnostics also drive home the point that innovation in diagnostic technology is the need of the hour, especially in high-risk cases such as HIV-TB co-infections.  

In India, widespread malnutrition drives the TB epidemic. It decreases immunity, thus increasing the risk of contracting TB infection. Therefore, we must address the issue of malnutrition on a war footing. Policy initiatives should focus on providing requisite nutritional value to TB patients as part of their TB care packages, for instance, in the form of daily meals at TB directly observed treatment short-course (DOTS) centers. Efforts can also be made to provide free meals to the needy in impoverished localities, particularly in those areas where TB is a known threat.  

We have already talked about the daunting magnitude of India's TB epidemic, which cannot be fought by the public sector alone. An inclusive approach focused on private sector engagement in TB control is imperative, together with stringent measures to mitigate malpractices and ensure mandatory notification of TB cases. Information and communications technology can be a powerful tool to achieve the latter, the foundation for which has already been laid by the RNTCP's innovative NIKSHAY platform, which is a web-based solution for disease surveillance and case management of TB in India.

Today, a lot depends on the attention the media throws at a particular problem. The recent focus on the Ebola outbreak, for example, ensured that funds were pumped in for its prevention, diagnosis and control. Unfortunately, this may not always be the case for diseases which are sometimes capable of even greater damage to the health of our society.

As an emerging world power, it is unacceptable for a country like ours to turn a blind eye to the perpetuating vicious cycle of human tragedy caused by diseases that are other otherwise preventable and treatable. We have a multitude of resources at our disposal that we can channel towards the wellbeing of our people. The Union World Conference on Lung Health was an eye opening experience that highlighted this potential and I urge our leaders and the general public to realize India's vision of eliminating TB by 2020.

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