The audacious, yet doable dream: End TB

What do India’s Mathematical genius Ramanujam, Former First Lady of the United States Eleanor Roosevelt, the lovely Vivian Leigh, who played Scarlet-O- Hara in the film ‘Gone with the Wind’, music composer Chopin, influential authors George Orwell, Franz Kafka or Henry Thoreau all have in common? They all died of Tuberculosis.

Isn’t it really eerie that this gruesome killer disease, Tuberculosis (TB), took a toll of some of the best minds, from the fields of literature, music and art? This glamour quotient is also being leveraged, today, with Big B featuring in the effective quickies for awareness and action against TB.

Twenty-five years ago, the WHO declared TB an emergency. The silver lining is that this terrible, infectious disease is completely curable. Yet, even today, this is a killer on the rampage, killing 750 times the people killed by Malaria and 6 times the people killed by HIV-AIDs, in India. The Disability Adjusted Life Years (DALY) is also 520, 287, and 1258 respectively for HIV-AIDs, Malaria and TB. India has the dubious distinction of housing 27% of the total TB patients across the world and 26% of the total deaths due to TB, globally.

136 years ago, Robert Koch, a German physician and scientist, discovered the bacterium that causes Tuberculosis (TB). That day has, over the years, come to be known as World TB Day, which was observed yesterday. The real breakthrough in treatment came with the rollout of the Directly Observed Treatment Short course or DOTS treatment regime. A few days ago I interacted with an ASHA, grassroots community health worker, Parshanba Solanki of Hatipura village in Ahmedabad. In spite of being severely disabled since birth, her commitment to eliminate TB, was very impressive. She diligently ensured that the 35 identified TB patients of her village, underwent DOTS, without break, over the years. There is no instance of the more persistent ‘Drug-Resistant’ (DR) TB or the even more stubborn ‘Multi-Drug Resistant’ (MDR) TB in her village. This is in addition to all her health services for the 1000 people of her village.

Under the ‘Make in India’ effort, a special gift for TB has been the True NAT machine that helps identify the disease type immediately after identifying a patient. Research and innovations are also on to address this disease in various dimensions and aspects.

On the 13 th of this month, the clarion call of the Prime Minister to end TB was received with great enthusiasm. As he declared the goal of a TB Free India with zero deaths, disease and poverty due to tuberculosis, the entire packed auditorium of Vigyan Bhavan rose up to express solidarity with this audacious target of ending TB in India by 2025. To my mind, 2025 seems more doable than 2030! Close on the heels of the fairly palpable success of the Swachch Bharat Mission, I have come to realize that a mission mode works very effectively, giving dramatic results. Had medicine for TB been available then, Ramanujan and Chopin, Vivian Leigh and Eleanor Roosevelt would have lived longer. We may have had the legacy of more classy movies, music compositions, mathematical works and philosophical, literary and political interventions that the longer lives of these geniuses could have given to mankind. We have the complete cure now. It would be a shame to let people die, in spite of this.

A persistent cough for over two weeks, continuous low-grade fever, with co-morbid conditions like use of Tobacco or occupational diseases, need careful scrutiny for TB. Good nutritious food, better lifestyle with greater ventilation, sunlight and sanitation would also help address the rot at the root of this scourge. A greater awareness, identification of all cases, full coverage under treatment leading to complete cure is the simple mantra for eliminating the terrible killer looming large. The theme for this year’s TB Day is “Wanted: Leaders for a TB-free world.” Can each of us take a few steps in this direction to contribute our bit to end TB by 2025 in India?

The author is a Harvard-educated civil servant & writer, and has worked in the education sector
jayanti.ravi.dna@gmail.com