Only with political will and commitment, backed by sufficient resources, can India effectively control tuberculosis (TB) that kills over three lakh people every year, says a Mumbai-based senior doctor.
Unless this happens, TB will continue to be India's silent epidemic and a death sentence for poor people, Zarir Udwadia, consultant physician at P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, warned.
Twenty years ago, it was widely believed that India was successfully on its way to controlling its alarming TB epidemic.
Yet, each year, India has 22 lakh new cases, more than three lakh deaths, and economic losses of $23 billion (Rs. 143,123 crore) from TB, making it India's biggest health crisis, Udwadia wrote in the article published in the journal The BMJ (formerly the British Medical Journal).
At the heart of this crisis is the failure of India's Revised National Tuberculosis Control Program (RNTCP) to engage and monitor the country's large and unregulated private sector, he pointed out.
According to him, considering India's massive TB crisis, the RNTCP's annual budget of Rs.500 crore remains derisory. The RNTCP spends the least on each TB patient among the BRICS countries (Brazil, Russia, India, China, and South Africa) - $28 (Rs.1,741.32), compared with $107 (Rs.6,654.32) in China and $264 (Rs.16,418) in Brazil.
"India needs to do much more if it seriously wants to control its TB epidemic," he said.
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," Udwadia said.
India must work at providing every TB patient with free and accurate diagnosis and the right treatment, whether in the public or the private sector. When TB is diagnosed, patients and their families must receive counselling, nutrition, and economic support, Udwadia said.
He also added that India desperately needs new drugs for the growing population of patients with more extreme forms of drug resistant TB, who have nearly exhausted the available first and second line drugs.