India must fight TB harder as disease claims 1400 every day

The TB epidemic now is "at a crossroads", Dr. David W. Dowdy, of Johns Hopkins Bloomberg School of Public Health, wrote in In an accompanying editorial.

About 450‚000 people contract TB each year in SA, of which about 20‚000 get multi-drug resistant TB (MDR-TB).

They are calling for accurate diagnostic tests to deliver individually targeted treatments, clear prescription guidelines, and improved control measures to prevent infection spread. Because of the adverse side-effects of TB medications, patients tend to leave treatment midway and risk developing drug resistant TB.

In 2015, there were some 480,000 MDR cases, about half of them in India, China and Russian Federation.

There was a decades-long lull in TB drug development after the last major antibiotic, rifampicin, was licenced in the 1970s.

United States expert Dr David Dowdy, from Johns Hopkins Bloomberg School of Public Health, said the global TB epidemic was "at a crossroads". As the main victim of the disease, Africa certainly deserves worldwide support, but it should also aim at proving it can lead the struggle for a world freed from TB.

World Health Organization is now also working with NTP on drafting the protocol for a drug resistance survey (DRS) planned for this year.

Compounding Africa's response to TB is the proliferation of Multidrug-resistant tuberculosis (MDR TB), which may be even more prevalent than previously appreciated. Particularly, students living in hostels sharing space with others, travelling daily in crowded public transport, living in houses with inadequate ventilation and congested cities are all highly prone to catch the TB infection. XDR-TB was first widely publicised in 2006 following an outbreak in the rural hospital of Tugela Ferry when 53 patients were found to have XDR-TB, of which 52 died within 16 days of the sputum specimen collection. Speaking to TOI, Dr. M.S. Faujdar, district tuberculosis officer, said, "It is true that it is hard to control the spread of tuberculosis because it is an air-borne disease and spreads very quickly". The mortality rate is extremely high at around 40 percent for patients with MDR-TB, and 60 percent for patients with XDR-TB.

The Commission sets out key priority actions for the next two, five and 10 years for the research and policy communities, and outlines key treatment recommendations and procedures for doctors treating patients with MDR- or XDR-TB. In India, it is estimated that 2.5% of all new TB cases are MDR-TB. Ending tuberculosis (TB) by 2030 is a target of the SDGs and the goal of the WHO End TB Strategy.

Health authorities will continue to support areas with higher reported cases of TB, it said. "According to Stats SA, TB is the leading cause of death in South Africa", Klazinga adds.

I am now the Secretary, Department of Health Research, Ministry of Health & Family Welfare, Government of India, as well as the Director General of the Indian Council of Medical Research (ICMR). The focus must be on how to respond to the emerging complexities that TB presents.

  • Lila Blake