TB lurks in the shadow of Hepatitis-B

MUMBAI, SEPT 20: Amid the hype and hoopla that cloaks campaigns to combat Hepatitis-B, a killer disease has been silently and steadily cre...

MUMBAI, SEPT 20: Amid the hype and hoopla that cloaks campaigns to combat Hepatitis-B, a killer disease has been silently and steadily creeping into Mumbai without so much as being noticed. Tuberculosis, which carries a stigma as being predominant among the economically backward classes, in fact now afflicts 30 per cent of the city’s 1.4 crore residents. This, experts say, is the result of a four-fold increase in recent years.

Still, while politicians continue to trip over each other to launch anti-Hepatitis-B campaigns and the Brihanmumbai Municipal Corporation (BMC) has made it compulsory for each student to pay Rs 25 for a Hepatitis-B vaccination, not a single tuberculosis check-up camp has been organised in schools in the last decade. The state government too has kept aloof from holding such camps.

However, doctors say it is precisely such apathy — and ironically its stigma as well — that gives the tuberculosis bacterium its longevity, making it a bigger health hazard than AIDS and Hepatitis-B. In fact, while an estimated 30 per cent of Mumbai’s population is afflicated by tuberculosis (Mumbai is the TB capital of the state), only an estimated 3-4 per cent of the city’s residents are afflicted by AIDS (Mumbai is the AIDS capital of the country). Hepatitis-B afflicts a miniscule 0.1 per cent of the population.

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Experts point out that funding too follows a similar pattern. While seven foreign organisations (including the World health Organisation) are involved in funding Hepatitis-B and HIV/AIDS programmes in the country, funds for tuberculosis come from the World Health Organisation (WHO) only. The allocation of funds through government and non-governmental organisations for AIDS programmes is an estimated Rs 1,450 crore, for Hepatitis-B an estimated Rs 500 crore while the budget for tuberculosis is a mere Rs 194 crore.

“Unlike both AIDS and Hepatitis-B, tuberculosis is not a glamour disease. Initially, it was considered to be a disease that affected the lower strata of society. Today, due to migration and overcrowding, it has become an urban disease, with an extremely high incidence. It is there in the air and anyone can get it,” says Dr Sulabha Akarte, associate professor (Preventive and Social Medicine), Grant Medical College. “The speed with which it is spreading is a reason for alarm. Unlike Hepatitis-B and AIDS, though, there are no preventive measures to stop the disease, which spreads through air,” she said.

“The hype and publicity attached to Hepatitis-B is not called for as it affects only 0.1 per cent of the total population and that too only high-risk groups (through blood transfusion, injectible drug abuse and sexual transmission). Tuberculosis strikes anyone. There is a dire need to increase awareness about the disease. It is a silent killer and affects more people than can be counted,” said Dr Akarte.

Experts point out that the heightened publicity about Hepatitis-B is also sending wrong signals to the people, with the resultant fear seeing serpentine queues at Hepatitis-B vaccination camps.

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They also point out that tuberculosis treatment is inexpensive compared to that for Hepatitis-B. While anti-tuberculosis drugs are indigenously manufactured and are easily available over the counter, treatment could cost as little as Rs 200-250 per month. The drugs are also distributed free to patients at government hospitals. In contrast, of the 19 manufacturers that make the Hepatitis-B vaccine, only three are Indian companies. Treatment too is extremely expensive.