: In spite of India carrying the major burden of tuberculosis in the world, there is little presence of top-level policymakers at the 43r{+d}Union World Conference on Lung Diseases that has a focus on TB.

Talking to The Hindu , Blessina Kumar, public health consultant and vice-chair, Stop TB Partnership, said the lack of Indian presence was most noticeable. Most of the African countries had their top- level officials in the national TB programme management presenting their cases.

Out of the total 90 lakh cases the world over, India accounted for 20 lakh cases in the WHO estimates in 2009. Of the 13 lakh people who died, India had accounted for nearly 3 lakh.

Global Funds, which is looking for new funding model, requires that countries present their perspective on strategic planning and funding on TB control activities. Mukund Uplekar, working for the World Health Organisation’s Stop TB department on policy, innovations and strategies, said it depends on how good strategies each country has to get the Global Fund to support their programme.

Knowing your own programme and its performance is essential, he added. It is the intense interaction and dialogues backed by good evidence that will provide the basic framework for TB funding.

TB scourge

Speaking on the TB scourge in India, Ms. Kumar said with the bottlenecks of diagnosis and treatment seen as major hurdles, the government should have a relook at the Directly Observed Treatment Short course (DOTS) under the Renewed National Tuberculosis Control Programme. It is over 12 years that the scheme has been running and the government, instead of being defensive about the programme, should review it for the sake of better implementation practices.

Certain aspects of TB control can be enforced without delay, said Ms. Kumar. Controlling the availability of TB drugs over-the-counter is the first step and it will bring down the number of multi-drug resistant TB. The statistics on multi-drug resistant TB in the country could be much higher than what the government figures reveal, she added.

A lot of funds made available through the National Rural Health Mission that is lying unutilised can be channelled for TB control, she said.

Two important steps that the government did recently was to make TB a notifiable disease and to ban the serological tests for TB. But the follow-up programmes for both require more than the guidelines put forth by the Health Ministry.

The lack of information on TB control programmes, like the ones on polio and HIV, should bring it on the radar of people as well as all the stakeholders on TB control programme to have an active participation in controlling the disease. No one on ground zero knows what programme the government has on controlling TB, she added.

(Shyama Rajagopal is attending the conference at the invitation of the organizers.)