India leads 11 Asian nations for a trillion dollars TB-fighting bill: World Bank

India leads 11 Asian nations for a trillion dollars TB-fighting bill: World Bank

India is leading the list of the eleven Asian nations facing the biggest tuberculosis burden. The new World Bank report, The Economic Benefit of Global Investments in Tuberculosis Control, estimates that these countries will be paying an astronomical amount of a trillion dollars over next ten years if they don’t invest and respond to TB control effectively.

TB continues to be the leading infectious killer of adults in Asia. The worst affected nations are China, India and Indonesia with two-thirds of world’s TB burden. It is also the biggest cause of death for people living with HIV (PLHIV).

TB high-burden countries like India could gain more from the money they spend on diagnosis and treatment of the disease if they invest in the Global Plan to Stop TB, to sharply reduce the numbers of TB-related deaths, said this World Bank report.

However India’s Union Minister of Health and Family Welfare, Dr Anbumani Ramadoss, while speaking at the recent 62nd National Conference on TB and Chest Diseases (NATCON) in New Delhi, didn’t talk about India’s contribution to The Global Plan to Stop TB – a timed and costed strategy to fight TB globally over the coming ten years (2006 – 2015).

Dr Ramadoss termed drug-resistant TB as a major challenge, and discouraged health practitioners from irrational use of first and second line anti-TB drugs. He emphasized on quality of TB treatment. The most effective means of preventing further resistance was by maintaining and improving the quality of treatment and, more importantly promoting rational use of anti-TB drugs, said Dr Ramadoss.

DOTS (the Directly Observed Treatment Short-course) strategy as per the Government of India’s Revised National Tuberculosis Control Programme (RNTCP) has not been sufficient to reduce the TB incidence, particularly in people living with HIV (PLHIV), and also due to emerging crisis of drug resistant TB.

Dr Ramadoss made no mention of how is India going to fight TB differently to improve the TB control efforts. He instead emphasised on the need to do more of DOTS. It is beyond doubt that poor programme performance of DOTS resulted in increase of drug resistance.

The economic impact of TB deaths and the benefits of TB control among 22 high-burden countries are greatest in China and India, where the combination of growing incomes and a relatively high number of TB deaths translates into a significant economic effect, according to this World Bank report.

Every additional US$1 spent on diagnosis and treatment in 14 of the 22 countries would generate more than US$5 in economic benefits from people who would be able to stay in the workforce, the World Bank study found. In Indonesia, the investment would result in a benefit of US$61 per US$1 spent, while in Thailand the investment would lead to a gain of US$53.

Despite recent gains in fighting TB, there were still 8.8 million new cases and 1.6 million deaths from the disease in 2005. Without treatment, two-thirds of smear-positive TB cases die within five to eight years, with most dying within 18 months of being infected.

Published in:
The Statesman, India
20 December 2007