The World Health Organisation’s (WHO) global report on tuberculosis has a patch of good news but there are areas of serious concern, especially for India. One sign of progress in the fight against the disease is that the number of deaths caused by it and the rate of incidence of the disease have conti-nued to fall everywhere, including in India. But TB remains one of the top 10 causes of death worldwide. The rate of decline is low at 1.5% and the global programme to eliminate TB will start showing good results only if the rate of annual decline goes up to 4-5% by 2020. Six countries in Asia and Africa account for 60% of the new TB cases. The absolute numbers of new patients are increasing. India accounts for
one in four tuberculosis patients worldwide.
The fight against TB is one of the oldest public health programmes in India but it still has to go a long way to become a success. It is estimated that the number of new TB patients was about 2.8 million in 2015. The actual number may be much more because the figure does not include most of those who receive treatment in the private sector. The problems related to diagnosis of the disease and treatment are serious. Very often the disease is detected and diagnosed late. Because of lack of awareness and education, many patients stop the treatment before the course is completed. This makes the patient vulnerable to a virulent strain of virus which is resistant to the multi-drug therapy that is in use now. There are about 79,000 multi-drug resistant TB cases in the country currently. Treatment of TB and the medicines are free under the Revised National Tuberculosis Control Programme. But since the state of the public healthcare system is poor, many patients do not go to it, and those who go to it, do not always get the best treatment.
Tuberculosis is completely curable but the country has not been able to eradicate it even after decades of campaigns and programmes. There is a socio-economic dimension to the disease as well because it is generally people from the lower economic strata who are more affected by the disease. Nutrition, lifestyle and environment are also factors and the programmes to fight the disease should take these into consideration. About 40% of the Indian population is considered to be infected by the tuberculosis virus, though that does not mean that all of them suffer from the disease. But that makes the fight against the disease very important.