dna edit: In the grip of tuberculosis

The World Health Organization’s 2013 global tuberculosis report paints a grim picture for India. Once a pioneer in TB treatment among developing nations, the government’s resolution to fight the disease has  developed cracks over the years. According to the report, the country has 2-2.5 million TB cases — a conservative figure, given that worldwide three million cases go undetected each year. The other depressing fact is that 33 per cent of the total population suffering from TB worldwide does not have access to treatment. Imagine then the condition in India where there is no reason to repose faith in government efforts to detect and treat such cases at the grassroots, the section most vulnerable to tuberculosis.

Poverty, lack of nutrition and unhygienic living conditions are the three main reasons for the wide spread of this highly infectious airborne disease. What makes matters worse is the miserable condition of the country’s health-care system, which is incapable of tackling the disease. A vast section of the population living in villages and urban slums does not have access to doctors and medicines even when the government has taken it upon itself to provide free medicines to the poor through community centres.

The fight against TB is getting progressively tougher as drug-resistant TB increasingly makes its  presence felt.  According to the WHO, around 450,000 people are victims of multi-drug resistant (MDR) type of TB with China, India and Russia together accounting for most cases. MDR occurs when people stop taking medicines midway, making subsequent treatments more difficult and complicated. It has forced the WHO to change its earlier stand when it dissuaded countries like India from diverting resources for treating ordinary TB to boost drug-resistant TB programmes. Now, it has urged countries to make MDR TB part of the national programme as it requires urgent attention.

The other reason for a thriving MDR is that most pharma companies do not want to invest resources to research and design new drugs to combat this menace. TB is essentially a poor man’s disease, hence, there is little scope for profit for these corporates.

Though global funding for TB is pegged at US$2 billion per year —  essential for poor countries —  it is inadequate since TB cannot be wiped out in the near future. Moreover, it is important to monitor how that money is spent in the treatment of the patients and launching campaigns to raise awareness. This includes not just India, but Afghanistan and the sub-Saharan countries lacking in basic amenities.

The WHO states that it is confident of meeting Millennium Development Goals, but at this point it seems unlikely that India can bring about a radical change in such a short span to control and curb the ever-increasing incidence of TB. The political will evident in nationwide polio programmes is sadly missing in the case of TB. That makes the struggle even more acute.