India has the highest Tuberculosis burden in the world. Of the 10 million TB cases reported worldwide, over 2 million are from India. Maximum drug-resistant TB patients are also found in India. The government aims to eliminate tuberculosis by 2025, ahead of the WHO targets. Experts, however, opine that the target is devoid of any understanding of the ground realities.
India, with its high tuberculosis (TB) and multi- drug resistant tuberculosis (MDR-TB) burden, has long been looking for an affordable, high sensitivity tests to be used in the most peripheral health facilities.
Dr Madhukar Pai, TB expert and Associate Director of the McGill International TB Centre told NDTV, “India can help the world eliminate TB. India plays a huge role in global health platform by producing drugs and vaccines.”
Despite her eloquent voice and enthusiasm, deep down under, 7-year-old Shrishti is still braving survival scars. The young girl, a survivor of tuberculosis, which has put her off the school scene, is all set to ace her academic work.
Shrishti’s parents are daily wage workers moved from Patna to Delhi in search of better opportunities but have not managed to secure a permanent job. In June this year, she was diagnosed with pulmonary tuberculosis.
“It began with a sharp pain in her leg and spent 4 months visiting 2 hospitals but neither did the pain subside nor did we have a diagnosis. We were then referred to Kalawati Saran Children Hospital and it is here that the doctors after a few tests told us she has TB,” said Preeti, Shrishti’s mother.
The road to recovery for Shrishti has not been easy. Shrishti had to drop out of the school and was isolated by her peers.
Dr Varinder Singh, Pediatrician, Kalawati Hospital said, “Children present with common symptoms make it harder to diagnose. Samples for a sputum test are difficult to collect and even if collected, the sensitivity of the tests are low.”
“Diagnosis is the weakest link. In the public sector in India, we lose almost 40% of all patients when a diagnosis is made. We are still relying on the sputum test diagnostic. India needs to improve its diagnostic tools in the public sector,” added Dr Pai.
Almost 200,000 children under the age of 5 died of TB globally in 2015, a number that was enough to place TB among the top 10 causes of child mortality worldwide, according to the September 2017 issue of the Lancet.
As though the fight against TB was not difficult enough, Shrishti’s grandmother recounts the social stigmas.
“My elder daughter used to teach but now no one visits our home because they call it the TB home. Shrishti dropped out of school due to ill health but the Principal has suggested we look for a different school once she recovers. She is a child who gets upset not only because of the medication but also when her friends refuse to play with her.”
Dr Pai warns that unchecked social determinants like poverty, malnourishment and tobacco smoking add to India’s tuberculosis burden.
“India has made a strategic plan to end TB by 2025. There is an increasing political will but it is a massive disease burden to end in 8 years. Will India follow up on the National Stretegic Plan? The plan is great but the budget required is several folds greater than what the India is spending on TB,” he added.