Tuberculosis has 'profound financial implications' for India: Health Minister JP Nadda

India’s Health Minister J P Nadda’s authored a comment in the international medical journal The Lancet, where he says that tuberculosis “not only exacts a terrible mortality toll in India, it also has profound financial implications.” India has the highest number of tuberculosis (TB) patients of any country in the world:  27 percent of the global total. One of the financial implication of the infection is poverty. The Minister’s comments were part of 62-page Lancet Commission report  Building a TB free world. Quoting a recent analysis from The Lancet, Nadda says that TB in India is part of what continues to keep people in poverty for several years after they completed their treatment. And while the individual financial losses are not as easy to estimate or tally, the analysis reported that the loss to India’s economy – her general public – is “at least $32 billion every year over the next 30 years.” [caption id=“attachment_6309701” align=“alignnone” width=“1280”] A 36-year-old Tuberculosis patient Kallu, who also suffers from HIV, gives his fingerprint as part of a verification program to Operation ASHA program counselor Shammo Khan. AP[/caption] Of the 10 million new tuberculosis (TB) cases reported worldwide in 2017 by the World Health Organisation, 2.74 million were from India – marginally lower than the 2.79 million in 2016. According to The Lancet Global Health article based on modelling for three high-burden countries, including India, compared with 2015 data, 57 percent reduction in incidence and 72 percent reduction in mortality will be seen only by 2035. However,  one of the papers in the Lancet Commission report claims it will take until 2100 to reach India’s “End TB” goals, even with “extreme measures.” Interestingly, India’s report card had only one parameter in which it received a top score: political will, which was assessed as “high”. Seven other parameters “needs improvement”, three parameters are “approaching target” and one is “on target.” The government has pledged to eliminate TB by 2025, while the global goal has been set for 2030. This is being taken as Prime Minister Narendra Modi’s “high” political will, intent and claim towards the TB epidemic. [caption id=“attachment_6308671” align=“alignnone” width=“1280”] New research holds the promise of shorter treatment courses for people with drug-resistant- TB. Image courtesy: Daniel Irungu/EPA[/caption] The National Strategic Plan for TB 2017-2025 is now a “fully funded and operational” project with a budget of $2 billion. In addition, India also allocates $100 million annually to provide nutrition to TB patients. The Lancet Commission has paid special attention to the role the private sector players in India’s TB crisis. A study from 2016 showed India having underestimated TB cases by over a million. Thus TB patients in the private sector were not being counted in the government’s official data. Optimising how the private sector engages with patients alone could avert eight million TB deaths by 2045, The Lancet says. Nadda also flagged other issues driving tuberculosis that the government needs to pay mind to – overcrowding, rapid urbanisation, diabetes and malnutrition.