12 November 2016
Challenge and response
Source: The Statesman
The 2016 Global Tuberculosis Report, released a fortnight back by the World Health Organisation, has few bouquets to offer to the public health authorities in India. Sad to reflect, the data furnished is yet to get the response that it deserves in the season of killings and skirmishes across the frontier and coups in rarefied boardrooms.
For all the trumpeted growth in GDP figures, the country still leads the unflattering league of six nations that account for 60 per cent of the global tuberculosis burden. India is followed by Indonesia, China, Nigeria, Pakistan and South Africa. The figures and the inference drawn by WHO are testament to the sclerotic state of public health and negligent nonchalance. Though the surveillance and survey data from India is believed to be more comprehensive than what it used to be, the report is emphatic that “India’s TB data are far from flattering by most counts”.
A major impediment relates to diagnosis and detection, and India’s record on both counts has been painfully dismal. This is palpable from the WHO report’s assertion that “some people living with TB are in fact, never diagnosed.
So, you don’t even know what the story is”. It is the lament as well as the message from Dr Mario Raviglione, director of Global TB Programme at WHO. In the net, India has incurred a dubious distinction -- the largest gap between new and relapsed notified cases. In a word, the nationwide feedback on a potential killer remains ever so fogbound despite the chilling reality that contagious TB is almost endemic across rural and urban India. Surprisingly, it remained for WHO to inform the Government of India that the country has a 74 per cent success rate in terms of TB treatment.
More accurately, this is much less than the global average of 83 per cent, and is behind the BRICS group and other poorer countries of the world. China has a success rate of 94 per cent. Even Mozambique (89 per cent), Pakistan (93 per cent), Tanzania (90 per cent) and Vietnam (91 per cent) showed better results than India... where medical treatment is only for those who can afford it.
The risk of patients dying because of inaccurate diagnosis and ineffective treatment is dangerously real. Despite the glaring figures furnished by WHO, India relies heavily on international funding for dealing with this public health challenge. Most importantly, the country’s national health budget is much lower than the levels recommended by WHO. There ought to be no dumbing down either of dengue in West Bengal or of tuberculosis in India.