This is in response to the article, (’Being page’ – “TB time bomb: the price of policy inertia”, March 26). I would like to acknowledge the efforts of The Hindu in highlighting the cause of TB, but I am restricting myself to certain points.
The title is misleading as TB is one of the oldest diseases and there is no case of it being a time bomb. The incidence of TB has started falling; so too is the case of MDR-/XDR-TB. e.
Second, there is no policy inertia as there are enough diagnostic centres, specialised TB centres, DOTS centres, quality drugs. Even the latest machines such as CB-NAAT are available at the district level. Social stigma is to blame for patients not discussing the issue openly. The real problem lies in the non-reporting of a large number of patients by private practitioners as these patients are not generally counselled well enough to avail of free drugs from public health service centres. It doesn’t matter whether private doctors continue to provide consultancy and charge a fee. Such patients are not treated and sometimes become victims of MDR-/XDR-TB.
Bedaquilline is a new drug and has still not been finalised for general treatment in India. The World Health Organization is also on board. There are six centres where Bedaquilline is provided to about 600 selected patients who are also under constant monitoring. It is also available for “compassionate access”, meaning a doctor can provide it to patient(s) on compassionate grounds. That is why the question of the court’s intervention doesn’t arise. Therefore, approaching court in order to capture media attention shows what the intent is. The media should have a look at the court judgment.
India has successfully reached, and on time, the Millennium Development Goals (MDG) target. The government of India has taken upon itself to address the task of elimination of TB by 2025, five years ahead of the Sustainable Development Goals (SDG) target of 2030. The National Health Policy, 2017 has also mentioned the commitment of the government in defeating TB and also the 2.5% of GDP expenditure in the health sector.
Arun Kumar Jha,
Economic Adviser
Ministry of Health & Family Welfare,
New Delhi
