‘TB elimination cannot be just a political slogan’

MUMBAI: Less than two years before India’s tuberculosis (TB) elimination target of 2025, noted pulmonologist and tuberculosis expert Dr Zarir Udwadia, on the eve of World TB Day, said the country would not achieve freedom from the infectious disease so long as there were problems with drug stockouts and access to regimens. Dr Udwadia was speaking at the Tuberculosis Oration 2024 organised by Hinduja Hospital and Lupin on Saturday.

“There is no access to many TB drugs and regimens,” stated the doctor who is attached to PD Hinduja and Breach Candy hospitals. “Large numbers of Indians (as much as 60% of the population by some estimates) are latently infected, a state that can get activated at any stage in life. The Indian TB program is doing little to treat these patients, overwhelmed as it is treating the millions with active disease. While we are making the right moves to eliminate TB, there are miles to go and there cannot be a target year.”

Speaking on ‘The problems accessing MDR-TB treatment in India: A Physician’s Perspective’, Udwadia said there was a need for government commitment and action to speed up the supply of generic TB drugs as well as establish more public private clinics to dispense Bedaquiline and Delamanid, which are vital to treat multidrug-resistant TB.

Professor Jennifer Furin, infectious disease clinician with Harvard Medical School who has been working closely with organisations, hospitals, research organisations and NGOs in Mumbai, Chennai, Delhi and Bihar, said that while the world was amazed with India’s 2025 TB elimination target, it was unachievable and meant little.

Furin, who was speaking on ‘Turning promises into progress: What India can achieve in tuberculosis by 2025’, pointed out that two million Indians are diagnosed with TB every year as per World Health Organisation statistics.

“Though 2025 is an ambitious target, the attainable goals for India by 2025 are to stop drug stockouts with political will, universal access to first- and second-line drug susceptibility testing and rapid roll-out of shorter oral regimen for drug resistant TB,” said Furin, who is also director of Clinical Capacity Building for the Sentinel Project on Pediatric Drug-Resistant Tuberculosis.

But of all the aspects, she said, person-centred TB care must become the norm. “Once a TB patient is placed at the centre, policies will be robust, which will push India to continue to do a better job with diagnosis, treatment and prevention,” she said. “Things may be better in metros such as Mumbai but not in other parts of India. TB control or elimination cannot be just a political slogan.”