On the opening day of the World Lung Conference, the global public health community expressed concern over the gaps in tuberculosis reporting in India. Earlier this month, the World Health Organization (WHO) stated that the global TB burden was actually higher than previously estimated, mainly because of new data from India.
The Philippines health minister, Paulyn Ubial said that she was concerned that the India was not ‘doing enough’ to mitigate the crisis. “In our country we look at TB as a public health problem and we expect other countries to do the same. This is the only way to make sure no country is left behind. It is a concern of the Philippines and WHO that India is not doing its part in trying to detect all TB cases and putting all detected cases under treatment immediately,” Ms. Ubial said, addressing the opening press conference.
According to the latest Global TB Report 2016, an estimated 10.4 million new cases were reported in 2015 but only 6.1 million out of these were detected and officially notified — leaving a significant gap of 4.3 million cases that are "missing" globally. These cases are either undiagnosed, or managed in large unregulated private sectors and not notified to TB programs. Of the 10.4 million cases, India accounts for 2.4 million but the annual report notes that the country had reported only 56 per cent of its TB burden in 2014 and 59 per cent in 2015.
“We have had some very disturbing news from WHO this month. We now know that the global burden of TB is much higher than we previously thought. If we carry on with business as usual, we will fail miserably to meet the global targets agreed upon under the End TB Strategy. We need to make better investments,” said José Luis Castro was appointed Executive Director of the International Union Against Tuberculosis and Lung Disease. Responding to the issue of gaps in Tuberculosis data from India, Mr Castro added that, “we need to work to improve the quality of data. Due to the sheer size, India has a major impact on the rest of the world.”
The substantial increase in reporting from India was due to the policy of mandatory TB notification. The government made TB a notifiable disease in 2012, resulting in this 34% increase in the number of cases — most of them being treated in the private sector that would have otherwise not been reported. “Despite the alarming report, Indian government is laid back. The gravity of the situation has not dawned on them. We are losing people every day. Earlier, we thought we were losing 1000 people a day and now it is 1400 a day. We need to be on a war footing because there is really no time to lose. If our borders were being encroached we would act with so much force. This is killing our citizens. Where is the urgency? Where are the forces?” said Blessina Kumar, Chair of The Global Coalition of Tuberculosis Activists (GCTA).
