How India can put an end to tuberculosis
The untapped power of millions
India is home to the world's largest youth population. According to the United Nations Population Fund, 28 per cent of India's population lie between 10-24 years of age. India has a huge potential for rapid economic and social progress by tapping into the potential of this young demographic.
The youth is the driving force of the present and a glimpse into the future of the nation. We, therefore, need to increase investments in their future through social services such as health and education, which are the building blocks of any society. Health and education do not exist in isolation; rather they are dependent on each other. To tap the potential of these 356 million 10-24 year-olds, it is essential that this young population is equipped with proper health and education.
It is unfortunate and troubling to note that children and young adults in India suffer multiple health challenges such as high rates of maternal mortality, under-five mortality, undernutrition, anaemia, tuberculosis (TB) and HIV. Significant progress has been made toward controlling these diseases but the burden still remains at epidemic proportions. TB is a case in point. It is an alarming fact that India has the highest number of TB cases in the world, with almost one-fourth of the global burden. In spite of being both preventable and treatable, TB continues to plague the country. It is a matter of grave concern that the disease is affecting more young adults during their productive and formative years - an estimated 70 per cent of TB patients are aged 15-54 in India . Hence, a disease such as TB results in the youth being trapped in a cycle where low health decreases productivity and income, and reduced income leads to low health.
Lifting the veil of stigma and lack of awareness from TB
TB is a preventable and curable disease. However, stigmatisation and myths associated with the disease have led it to be considered an illness of the poor. It is essential to note that anyone can get infected with TB. The likelihood of developing active TB may increase due to various risk factors which reduce a person's immunity like malnutrition, HIV/AIDS, diabetes and poor sanitation practices amongst others.
The lack of awareness about the disease and gaps in correct and prompt diagnosis and treatment are major hurdles for TB control and prevention in India. A communicable disease, TB primarily spreads through the air; if left untreated and without timely diagnosis a person with active TB can infect 10-15 people every year .
The classic symptoms of pulmonary (lung) TB are - coughing, with sputum production with or without blood, low-grade fever and significant weight loss in a short span of time. One should consult a doctor in case any cough lasts for more than two weeks. Due to lack of education and awareness about the importance of completing the treatment, TB patients could become cases of multi-drug resistant (MDR) - TB, which is more difficult and expensive to treat.
Bihar exemplifies the challenge of India's TB epidemic. Bihar has more than 100 million people and is one of the most densely populated states of the country. The majority of the state's population resides in rural areas , which lack well-equipped public health facilities. In urban environments, factors such as overcrowding, lack of sanitation and unhygienic living conditions too pose a distinct challenge to TB control. In 2014, the state had 67,991 TB patients registered for anti-TB treatment.
A major impediment to TB control has been the lack of awareness about the disease. However, the "TB Harega Desh Jeetega" campaign launched in December, 2014 with Mr Amitabh Bachchan as its ambassador has the potential to influence and increase public awareness about the disease - its symptoms, spread and the need for early diagnosis. The sustained dissemination of the campaign can make a far-reaching impact in building awareness.
Another barrier to improve TB control is the lack of engagement with the private sector. For the majority of the patients, the first point-of-contact is a private practitioner. Thus, both public and private sectors need to institute holistic measures to ensure appropriate diagnosis and treatment to the patients.
One such innovative approach to engage with private providers is the Private Providers Interface Agency (PPIA) launched in urban Patna by the government of Bihar. In the past one year of the programme's launch, it has strengthened TB control efforts by engaging qualified formal providers, informal providers, chemists, and diagnostic facilities - through a technology-based reporting platform and an inclusive financial- and service-based incentive structure. I applaud this development and congratulate the government for its unwavering commitment.
I believe collaborative efforts are important to fight TB. To lift the veil of stigma and lack of awareness covering this disease, we must supplement the government's effort for its care and control and harness the power of the young to spread awareness. For India to stem the spread of TB and continue on its path to inclusive development, it needs to prioritise the health concerns hindering the youth of the country.
We must all work together to coordinate a holistic response to be able to tap the untapped potential of the 356 million youth of the country because it is the quality of the youth that determines the future of the nation.