On March 24, 1882, Robert Koch, German physician and microbiologist, was at the University of Berlin’s Institute of Hygiene presenting evidence to a group of scientists that tuberculosis was not an inherited disease, as was widely believed at that time, but an infection caused by a bacterium.
This marked a turning point in history and laid the way for diagnosis and treatment of this scourge, which at that time was ravaging populations across Europe, the Americas and Asia, killing one out of every seven people. A hundred years later in 1982, the International Union Against TB and Lung Disease proposed that March 24 be observed as World TB Day. A decade later, World TB Day was given official recognition and since then, every year, the TB community jointly commemorates this day, reviews the progress made and reinvigorates its commitment.
World TB Day this year is different as 2015 is a landmark year of transition from Millennium Development Goals to Sustainable Development Goals, which propose ambitious and holistic targets to address poverty and hunger; ensure education, health, gender equality, human rights, environmental sustainability, global partnerships and economic development; and provide a framework for countries to develop their agendas and policies for the next 15 years.
TB remains an important component of this agenda, and the post-2015 global framework, aptly named the “End TB strategy”, aims for a world free of TB, aligning with the ambitious SDGs.
The new strategy hinges on three key pillars. First and the most fundamental is a patient-centred approach. The interventions for TB care and prevention should be sensitive and responsive to patients’ educational, emotional and material needs, which should be understood, and the interventions customised accordingly, and not the other way round.
The second pillar encourages the institution of bold policies and support systems which will enable implementation of interventions through coordinated efforts of the national TB programme with other stakeholders, including public and private health-care providers, social support programmes, non-governmental and civil society organisations, communities and patient associations. The policies to treat and prevent tuberculosis should extend beyond the health sector and address underlying social determinants such as poverty, food insecurity, poor living and working conditions as well as interventions to address direct risk factors such as tobacco use, HIV and diabetes care and prevention.
The third pillar underscores the importance of research and innovation directed at development of novel diagnostic, treatment and prevention tools and strategies and their rapid uptake.
For India, with the highest TB burden globally, World TB Day 2015, is momentous. It could well be the beginning of the end of this deadly epidemic, which affects nearly two million Indians and kills 1,50,000 of them every year, causing an economic loss of over $40 billion annually. The global TB community now looks at India for its commitment and efforts to banish TB in the next couple of decades. Setting local targets, developing a work plan, mobilising resources and implementing the plan with strict monitoring of progress will be critical to India’s success, which will actually be a global victory.
(Dr. Sarabjit Chadha is Project Director with the International Union Against TB and Lung Disease)
