Need political will to tackle TB: Lancet

It notes that a national survey to measure the magnitude of drug-resistant tuberculosis in India has never been undertaken.

A global series on tuberculosis published by the Lancet Journal of Infectious Diseases,released on the occasion of World TB Day that falls on March 24,has called for strong political leadership to fight the very real threat of drug resistant tuberculosis.

Commenting on efforts to control the disease in China and India,which account for the highest number of multi-drug-resistant TB cases in the world,the fifth part in the series notes that in 2000,the Chinese government started to revitalise its tuberculosis programme; its acceptance of tuberculosis as a major health issue,and the subsequent strong political commitment,have led to major successes in control of the disease. In Indias private sector,the national surveillance programme does not detect tuberculosis in many patients,and the quality of diagnostic and treatment services by family doctors is a major issue.

The fifth part in the Lancet series,titled Drug-resistant tuberculosis: time for visionary political leadership,however,commends the fact that TB has been made a notifiable disease in India now.

It notes that a national survey to measure the magnitude of drug-resistant tuberculosis in India has never been undertaken. Surveys in Andhra Pradesh,Gujarat,and Tamil Nadu states showed that up to 3 per cent of new cases,and 13-17 per cent of previously treated cases,were of MDR tuberculosis.

In the series,experts,including Professor Alimuddin Zumla,Director of the Centre for Infectious Diseases and International Health at University College London Medical School,and Dr Marco Schito from the National Institute of Allergy and Infectious Diseases,USA,warn that the emergence of extremely drug resistant TB in the past eight years heralds the possibility of virtually untreatable TB,and without visionary political leadership and a radical shift in policymakers perceptions,global efforts to control the disease will be threatened.

A major conceptual change and visionary global leadership are needed to move away from the conventional view that tuberculosis is only a disease of poor nations, the authors say.

According to a 2012 WHO report,India has the highest cases of MDR TB in South East Asia,at around 62,000 in 2010. India,China,Russia and South Africa account for about 60 per cent of the global MDR TB load.