A recent notification by the Union health ministry has made it mandatory for those availing themselves of cash benefits from the government for treatment of tuberculosis, under the Revised National Tuberculosis Control Programme (RNTCP), to register on the Aadhaar database.
The Hindu clarified in a report that diagnosis and treatment of patients wouldn't be affected by Aadhaar, but any claim of monetary entitlement for these purposes by patients, hospitals and healthcare workers will require the number. According to ministry officials, the move is meant to curb duplication and false claims of benefits.
On paper, this may sound like a reasonable step, but it's riddled with problems, the most serious of them being the relative unawareness about the existence of such benefits in the first place. But before getting into the specifics of the decision, it's worth going over the hard facts to set the scale of the epidemic in India in a context.
Killer at large
An op-ed in The New York Times on Wednesday summarises the ground realities by citing shockingly dismal numbers: "Across the globe, 1.8 million patients died from TB in 2015, and almost half a million of them died in India," the authors say, adding that a "staggering number of Indians — over 400 million — are estimated to be infected with TB."
In spite of this alarming scenario and a substantial slash in budgets allocated to TB eradication in the last two years, India still hopes to get rid of the disease by 2025. Now, the feasibility of such a possibility, which is already remote, has come under a serious threat by the government's imposition of Aadhaar for cash benefits disbursed to patients.
TB, an air borne disease, affects populations across the social spectrum, but its victims mostly tend to be the poorest and the most disenfranchised citizens of the country. While the disease can be arrested and eventually cured by aggressive treatment and regular therapy lasting over months, many aren't able to afford the nutritious diet that must supplement regular intake of medication.
The cash benefits, ranging from a few hundred to a few thousand rupees and paid directly to the affected, are expected to help meet these other requirements to combat the killer disease, while the State provides free diagnosis, treatment, medication and regular check-ups.
However, migrant workers, who tend to be majorly vulnerable to the disease, are often unable to secure proper address proofs to get Aadhaar registration. And now, without an Aadhaar number, they won't be able to secure these cash privileges they are entitled to from 31 August 2017.
Even more worrying is response of many health workers who are involved with the welfare of the sufferers of TB. A detailed report in The Wire mentions several healthcare activists saying they were never aware of the cash benefits in the first place.
That such an important aspect of dealing with a deadly disease wasn't adequately made public at the outset is shocking, to say the least. Even in terms of the disbursal of funds, there seems to be a fog of confusion. While the government claims RNTCP is being run through an online portal called Nikshay, many health workers have been operating outside of it so far.
Glitches in the system
Sunil Khaparde, deputy director general for TB in the health ministry, believes since 90% of the country's population is covered by Aadhaar, the same would reflect among those suffering from tuberculosis too. As pointed out above, apart from the practical problems of acquiring an Aadhaar number, even for those who already have it, there are a number glitches to be cleared along the way.
From mismatch of fingerprint to leakage of sensitive data like bank statements to faulty biometrics to poor Internet connectivity, there are multiple impediments along the way for anyone trying to get their rightful claims using Aadhaar.
Stories of people having to climb up trees to get network coverage on their mobile phones so that they can get their ration through PDS or of midday meals for children in schools being linked to Aadhaar are some of the nefarious examples of the imposition of this faulty scheme.
Having made tall promises to conquer TB, India has much to answer for to the international community in the coming few years. And it must not allow the loopholes in its own systems make it lose face.
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