India’s TB Crisis: 2.8 Million New Cases, Highest In the World

Every 2 mins, 3 Indians die due to TB. The extent of the problem will delay the UN’s global TB eradication plans.

The WHO has reported that TB cases in India are hugely under-reported, and that six countries accounted for 60 percent of new cases across the world: India, Indonesia, China, Nigeria, Pakistan and South Africa. (Photo courtesy: MSF)

By the time you finish reading this story, somewhere in India, four people would’ve succumbed to tuberculosis.

The World Health Organisation’s Global TB Report 2016 brings the spotlight back on the enormity of the tuberculosis (TB) burden of India and how critically daunting the challenge is going to be.

In a nutshell:

• In 2015, 2.8 million people were diagnosed with TB in India. That’s the highest for a single country in the world and nearly one-third of the global tuberculosis burden.
• In 2015, the number of TB deaths in the country doubled from 2.2 lakhs (in 2014) to a whopping 4.8 lakhs.
• India reported only 56 percent of its TB burden in 2014 and 59 percent in 2015.
• The massive under-reporting by India means that the scourge of this deadly disease is much more serious than previously thought.

Behind closed doors, the Union government has somewhat realised the enormity of the situation. It has called a two-day national level meeting of experts from around the country in the National Capital on 18 and 19 October to overhaul and rejuvenate its end-TB campaign.

Without Success In India, the World Will Never Be Able to Beat TB

The global figures of TB have spiked from 9.6 million in 2014 to 10.4 million in 2015 because of revised figures from (mainly) India. (Photo: The Quint)

We face an uphill battle to reach the global targets for tuberculosis. There must be a massive scale-up of efforts, or countries will continue to run behind this deadly epidemic and these ambitious goals will be missed. 

Dr Margaret Chan, Director General, World Health Organisation

By 2030, the UN has set a target of bringing down TB deaths by 80 percent and the number of cases by 90 percent.

The hurdle? India.

TB defies logic over here. The airborne disease was once a poor man’s illness, easily treatable, curable and on the verge of a decline in the 90s. Fast forward to 2015 and it has metamorphosed into a deadly, multi-drug resistant killer, a silent urban India plague which takes 1,000 lives in the country EVERYDAY.

As the problem of multi-drug resistant TB grows, so does the waiting lists for the expensive and lengthy courses of treatment. (Photo: AP)

The World Health Organisation says that’s primarily because one in five TB patients in India does not complete their long, exhausting treatment, while for one in ten patients the treatment fails.

To say that the treatment of TB is exhausting is an understatement.

Nearly 14,000 pills and 240 injections over a period of two years, with side-effects like nausea, weight loss, possible depression and even deafness. But when a patient drops treatment midway, the disease not only spreads, it also mutates to the harder-to-treat multi-drug resistant TB, curable only 60 percent of the time.

One of India’s top pulmonologists, Dr Zarir Udwadia, based in Mumbai, published a paper in August 2011, which stated that he had found totally drug-resistant strains of TB in four patients. The Union government shunned his research, calling it baseless and alarmist.

Instead they should have put their detection monitoring system in riot gear and immediately tightened regulations around the sale of anti-TB drugs so that no over-the-counter sales could hamper treatment. Only 27 labs are authorised in this giant country to test cases of TB. The government should have increased the number of these sophisticated laboratories and made reporting TB cases mandatory for the private sector as well.

Also Read: Will the New TB Drug For Kids Wipe Out the Deadly Disease?

Need to Mimic the Polio Eradication Programme For Success With TB

Currently, TB experts in Mumbai treat a third of their patients who are incurable with standard medicines. (Photo: iStock)

Doctors fear that one TB patient can infect at least 15 to 20 in a year. 

The economic repercussions of TB are catastrophic – often the patient is the breadwinner of the family.

TB already causes an estimated 100 million workdays’ loss for India. Both diagnosis and treatment of drug resistant TB are difficult. The treatment can cost up to 3 lakh rupees and stretch over two years.

It is a no brainer that the need of the hour is a stringent door-to-door detection programme, combing through the high-risk population, in a way that not a single person goes undetected, undiagnosed or untreated.

In the next five years, if India can screen even 90 percent of high-risk cases and implement a process for isolating infectious cases, the tide can be turned.

The Global Fund to Fight AIDS, Tuberculosis and Malaria, has promised to spend $119 million on TB eradication in the country but without political will and a clear, dedicated roadmap by the government, the disease will continue to haunt urban India for generations.

(Source: RNTCP)

Also Read: Why Does TB Still Kill 2 Indians Every 3 Minutes?