TB in times of corona

Jayeeta Chowdhury | Updated on March 25, 2020 Published on March 25, 2020

We are in the grip of the fear that the coronavirus pandemic may engulf the nation. We indeed need to be, given our experience with a long pervading infectious disease and mortality related to it in India. That disease is tuberculosis (TB). As per the Global TB Report, every year, TB claims 4,40,000 lives in the country; even as you are reading this article, there are 1,205 deaths a day. What is even more worrying is that approximately 52 crores people inof India’s population carry latent TB infection.

India accounts for 27 per cent of the global burden with an estimated 2.69 million cases annually. Furthermore, in 2019, Eric P Goosby, UN’s special envoy on TB, observed that unavoidable TB deaths could have an adverse effect on the Indian economy and cost at least $32 billion each year for the next 30 years.

Worldwide, TB is the leading cause of death from a single infectious disease agent. The report estimated that globally, 10 million people fell ill with TB and 15 per cent succumbed to it.

The government adopted a stringent target to eliminate TB by 2025. But are we ready? The Joint Monitoring Mission Report 2019 highlighted achievements in TB management, including increased case notification and treatment completion rate. However, there are areas that need change.

A large section of population needs access to rapid diagnostic tools and screening services, the absence of which contributes to the “missing millions” of presumptive patients. Unfortunately, 1,30,000 cases were estimated to have multidrug-resistant TB, as per the Report, while at the same time, effective drugs are not widely available. Poor nutritional status, immuno-compromised bodies, congested habitations and persisting stigma lingers on alongside the need for a well-oiled data management system and access to data for wider public good.

TB affects the socially marginalised communities enormously, owing to the inequitable distribution of healthcare. While individuals from privileged communities may also contract TB, catastrophic socio-economic consequences are faced by the former. TB-affected individuals await patient-centric care, advent of a new vaccine, superior drugs with lesser adverse reactions, prevention strategies, reduced turnaround time for test results, appropriate non-invasive diagnostics for children, novel diagnostic assays for extra pulmonary TB — accounting for about 20 per cent of all TB cases — a high-quality surveillance and decision support platform, and efficient logistics and supply chain management.

Recent outbreaks of infectious diseases — SARS, Ebola, and Nipah — point to the struggle to beat these like never before. It is imperative, now more than ever, that comprehensive and novel approaches and tools are developed to control infectious maladies like TB with the same sincerity and urgency that we are witnessing in combating the coronavirus, globally.

Learning and drawing lessons from the radical measures adopted by Taiwan, Singapore, and Hong Kong in coping with SARS and in the initial phase of the coronavirus control will be a progressive step. These countries embraced trail-blazing approaches like technology-enabled rapid decision support system and screening; artificial intelligence and big data analysis in testing and tracking; universal coverage through health insurance; accelerated supplies; protected health workforce with personal protection equipments; and scaled-up effective communication.

India needs context-specific processes and tools. India Health Fund, seeded by Tata Trusts, is India’s only aggregator platform founded to pool-in philanthropic, public and private sector capital to foster innovations in infectious ailments like tuberculosis.

The writer is Program Director, India Health Fund. March 24 was World TB Day

Published on March 25, 2020
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