India on the frontline of the fight against tuberculosis

NEW DELHI: All the symptoms were there but it still took four doctors and several months of waiting before Bharti Kapar’s cough and stomach pains were diagnosed as tuberculosis. Hailing from a poor town outside the smog-choked capital of New Delhi, Bharti, 24, was one of the 2.7 million new cases of tuberculosis last year in India — home to more than a quarter of the world’s cases of the deadly disease.

After five months of rigorous medical treatment and taking several pills a day, she was declared cured in April but still has to force herself to venture out of the small home she shares with her mother, two brothers and a sister-in-law. “Sometimes I feel that my breathing is difficult, it’s not normal. I do not have any energy, I do not want to go out, I do not want to do anything,” she said. A major killer in the West until the mid-twentieth century, tuberculosis remains a menace in developing countries and killed 421,000 in India in 2017 according to the World Health Organization — more than AIDS and malaria combined. The Global Fund will meet in France on 9-10 October hoping to raise $14 billion for the worldwide fight against TB, malaria and AIDS. For its part, the government of Narendra Modi, which came to power promising development for India’s 1.3 billion people, has set an ambitious target of overcoming India’s TB “epidemic” — the world’s largest — by 2025. It has created new patient monitoring systems and recently enlisted artificial intelligence to help screen for the disease. The government’s call to arms “is not just rhetoric,” said Dr Jamhoih Tonsing of the International Union Against Tuberculosis and Lung Disease, noting that the budget for TB in India has doubled between 2016 and 2018. But its timetable may be too ambitious. TB incidence in India is currently declining by about two percent each year, Tonsing said. “To reach the 2025 target, we need to make this decline at least 10 per cent per year. A big jump has to happen.

Transmitted by droplets of saliva when a contaminated person speaks or coughs, TB spreads easily in India’s crowded cities, where immune systems are often already weakened by air pollution or poor sanitary conditions.