Bold and audacious steps needed for TB control

Diana E Wangari, CNS Special Correspondent
Photo credit: Diana Wangari/CNS
When the Indian Minister of Health and Family Welfare Dr. Harsh Vardhan made a speech at the WHO Global Tuberculosis Symposium held just prior to  the 45th Union World Conference on Lung Health in Barcelona, he was greeted with a roaring applause. I could not help but wonder whether it was in recognition for the inspirational speech just delivered or it was an appreciative gesture for a step long overdue.

The battle against TB is one that has been waged over years but we can hardly claim victory. Could it be that the reason behind it was that we have not given TB control the efforts it demands? Could it be that we did not realize that we are no longer fighting a battle--we are actually at war? A war necessitates that we pull our resources together if we are to mount a proper attack; if we are to be truly prepared. In the same regard, TB control is no longer a matter to be left to health care workers and experts in the field. It requires the co operation of different professionals and members of the community at large. Echoing this sentiment, Dr. Harsh Vardhan said, "We need to stop thinking in biomedical terms only. TB control includes a social aspect and  even politics has a part to play. It is not only medical and health care workers who should be involved."
Photo credit: Diana E Wangari/ CNS

He said that he recognized that the challenge with TB is great and that the solutions are equally complicated and tedious, but we cannot continue doing what we are doing as that is unlikely to let us reach our least not in our lifetime. He raised a question that has remained unuttered, but deserves consideration, "We have made great technological advancements in terms of research, why then are the results of it not being reflected in equal proportion?"

Citing some bold steps taken by India in the realm of TB care and control, he said that India is moving its health campaigns from the state to district levels to involve more and more of the community. Also free TB diagnosis and treatment is available for all those who are in need of it, irrespective of who their healthcare provider is. India has also banned serological tests to diagnose TB, enforced mandatory electronic case notification through a modern e-health system, and is also working towards ensuring that all anti TB drugs are registered in the appropriate Drug Registry. There is also a plan to ban the sale of TB drugs in the open market in future to control irrational drug use.
Photo credit: Diana Wangari/ CNS

He rightly said that even as annual meetings and conferences are held all around the globe on TB and Lung Health, people go back to their homes they also return to their comfort zones.This just would not do. There is need for a new approach. There is need for integration. There is need for fresh and different thinking. And as the 45th Lung Health Conference theme "Community driven solutions for the next generation" reflects, the change begins now. Certainly, the face of TB epidemic is changing as we fight TB-HIV co infections, TB-Diabetes co infections, drug resistant TB--the list seems to go on and on.

This calls for thinking out of the box.  We have the knowledge, we need to apply it and we should not just be willing but we must do it. More importantly, we must be able to take risks. We have to remember that TB control is no longer a battle, it is a war.

"Let us be bold, let us be audacious," the Minister said in his closing remarks. The challenge has been issued and we need to take it up with all the resources at our disposal.

Diana Esther Wangari, Citizen News Service - CNS
28 October 2014
(The author is reporting from 45th Union World Conference on Lung Health in Barcelona, Spain for CNS, with support from Lilly MDR TB Partnership. Email: