Health and Development Initiative-India, (www.healthinitiative.org), publishes 'TB News from India' once every two months. The objective of newsletter is to highlight issues related to Tuberculosis and HIV/AIDS control in India and enlist political, public, professional and administrative support for its cause. Health and Development Initiative-India is a not-for-profit organization and the news items have been quoted from various sources for fair use and in public interest. Reproduction of the material published is welcome provided a reference is made to the original source of the news item and TB News from India.

Editorial note: Celebrating the spirit of World TB Day

A couple of months from now we will be observing World TB Day (WTBD). The theme of WTBD 2003 is 'People with TB' and rightly so. Even in these modern times the life of a patient of tuberculosis is riddled with multiple problems. In addition to the physical agony and hardships that tuberculosis inflicts on its victims; it also renders them personally, socially and economically handicapped. The marriage of an unwed girl may get delayed; a married woman may be expelled from the household, the bread earner of the family may lose his job, once a person gets stigmatized. In resource poor countries like India difficulties in access to treatment add to their woes.

TB patients do not need our sympathies. They need a timely and correct diagnosis of their ailment and treatment facilities that are within their reach.

Directly Observed Treatment Short-course (DOTS) is the most appropriate instrument in our hands to help these hapless victims of TB. The slogan of WTBD 2003 'DOTS cured me- it will cure you too' is a reassuring message for a new TB patient. The spirit of this message is 'DOTS for all'. In India only fifty percent population has an access to Revised National Tuberculosis Programme (RNTCP), which provides DOTS services. Even in areas where DOTS is available the poor and vulnerable are being missed out. 

The best way to celebrate the spirit of WTBD is to rapidly extend DOTS to un-served territories without delay. 

Where TB becomes self-cure

The Magsasay Award Winnner Aruna Roy and Nikhil Dev of the Mazdoor Kisan Shakti Sangathan (MKSS) have asked for a more transparent approach to the implementation of the World Bank supported tuberculosis programme, RNTCP, following detection of irregularities in the use of funds earmarked for cause at district level.

A serious case of diversion of funds has been unearthed in Jalore District in Rajsthan in which the then Collector, in May 2001, had purchased an air-conditioned car and a laptop computer for his use with the precious money meant to treat TB patients under DOTS. Aruna Roy and Nikhil Dev, who used the provisions of the Right to information in Rajsthan to procure audit reports of TB Clinic Jalore found than an amount of Rs. 5,66,799 ($ 11500) was diverted for two items which did not have any thing to do with TB cure. The Collector was also Chairman of the District TB Society Jalore. 

The MKSS team which brought the issue to the notice of the Rajsthan Chief Minister, Ashok Gehlot, demanded immediate action against the then Collector and return of the money to the District TB Society. They also asked for a special campaign to assess TB programme in the rest of districts of Rajsthan.

"TB is a disease which is linked to poverty. For years the poor people have been falling victim to the disease in the absence of treatment. When the funds for meant for treating the disease like TB are misused it should be taken seriously by the State Government" Ms. Roy and Mr. Dey wrote in their letter.

The Hindu, New Delhi 2nd November 2002

34000 tuberculosis patients under treatment in Punjab

About thirty four thousand tuberculosis patients are currently under treatment in North Indian State of Punjab. Dr. D P S Sandhu Director, Health Services Punjab stated this while participating in a seminar on 'Role of Medical Colleges in Revised National Tuberculosis Program (RNTCP)' held at Amritsar in December 2002. He said that preparations to launch DOTS in eight districts of Ropar, Hoshiarpur, Sangrur, Nawanshahar, Ludhiana, Amritsar and Fatehgarh Sahib have been completed. He said that DOTS services would be available soon in these districts. Seven more districts of the State will launch DOTS in second phase of RNTCP expansion.

Mr. Iqbal Singh Sidhu, Deputy Commissioner of Amritsar, who is also Chairman of District TB Control Society, said that so far 6410 tuberculosis patients have been detected in the district; of these 2610 patients need intensive care. 

Source Dainik Jagran, Jalandhar 18th December 2002

Karnataka to extned DOTS to 12 more districts

South Indian State Karnataka has decided to extend the Revised National Tuberculosis Control Programme (RNTCP), which implements Directly Observed Treatment Short-course (DOTS), to 12, more districts. Announcing this the Minister for Health and Family Welfare, Kagodu Thimmappa, said the programme would be extended to Belgaum, Bidar, Chikmagalur, Dharwad, Gadag, Gulbarga, Kolar, Tumkur, Mysore Shimoga, Hassan, and Dakshina Kannada districts, covering a population of 25.6 million.

Districts such as Bangalore Urban, Raichur, Bijapur, Bagalkot, Bangalore Rural, Koppal, Bellary, Chitradurga, Mandya, and Davangere have already been covered under the programme. Other districts would be covered by next year, he said. As many as 41,588 people were under treatment under RNTCP of which, 18,612 were sputum-smear positive patients and the cure rate was 80 per cent. Of the 15.32 million TB cases in the country, 900,000 were from Karnataka.

However, the existing National TB Control Programme was in operation in the districts where the revised programme was yet to be extended. But the programme had faced many setbacks and had had little impact on the patients, less than 30 per cent of the patients under the programme had completed treatment and not much progress could be achieved in controlling the disease, Mr. Thimmappa said. 

Read full text of the story at: 
http://www.thehindu.com/2002/10/03/200210034640400.htm 

Successful efforts in India to curb epidemic of Tuberculosis
A discussion on National Public Radio (November 4, 2002)

…India is a huge country with more than a billion people. Each year, two million become infected with tuberculosis. It has a quarter of all the world's tuberculosis cases, and until 1993 had no effective system for controlling it. Dr. Richard Chaisson of Johns Hopkins' Center for Tuberculosis Research says that the vast majority of the people with tuberculosis in India relied on private doctors who didn't properly diagnose TB, supervise treatment and had multiple and non-standardized drug treatment regimens. And the result was that they had a high rate of treatment failure, a high rate of drug resistance, and half a million patients a year dying of tuberculosis, many unnecessarily…

Read the full text of the discussion at: 
http://www.massiveeffort.org/html/nprnov4.html 

A deadly passage to India

More than 20 million people could be infected with the AIDS virus by 2010. A journey to heart of suffering nation 

… AIDS has varied faces in a country this vast, but those of the women stand out. As I discovered in the Tamil town of Namakkal, a monogamous woman can earn her in-laws' contempt by getting infected by her husband. With their bright saris, almond eyes and shiny black hair, Chitra, Selvi, Suganda, Selvamani and Vanilla look more like college girls than widows. When the girls were in their late teens or early 20s, all five married truck drivers and, in keeping with tradition, stayed home to care for babies or in-laws while their husbands plied the highways. All five are now HIV-positive, and all but one have nursed their mates through their own illness and death. The women still wear their wedding necklaces, still care for their young children. Yet each is now reviled by her in-laws. "The family always blames the wife," Suganda explains matter-of-factly. "Very few husbands will admit their own responsibility."…

Read the full text of this eye-opening story at: 
http://stacks.msnbc.com/news/835539.asp 

A booklet in Hindi on FAQ's about Tuberculosis

Health and Development Initiative has produced a booklet in Hindi on Frequently Asked Questions about Tuberculosis. This booklet meets the need of health educators and TB programme Managers both in India and abroad. You can place an order for the booklets by sending E-mail to webmaster@healthinitiative.org 

Web Call - A visit to 'The Ramakrishna Mission TB Sanitorium Website

The Ramakrishna Mission in India has been at the forefront of philanthropic and charitable activities especially in remote, inaccessible areas of the less developed parts of the country. The medical services provided by the mission are illustrative of providing the best with the minimal of resources and at the doorsteps of people who actually need them. 

The Ramakrishna Mission TB Sanatorium has been in existence since 1948 and is providing medical care of patients with Tuberculosis. In keeping with the times it has made its activities known through its simple yet informative website, http://www.rkmtbs.org

The website, through its different pages, provides a comprehensive view about the working of the sanatorium, the area that it sub-serves and the facilities that are available. A link leads on to three well-written and interesting comments on the experience of the centre on TB treatment. The first, on DOTS implementation goes on to prove the superiority of once daily regime of TB treatment in preventing relapses, the second, examine the role of nutrition in TB and the third is a case archive, which contains success stories of people who have been treated at the centre, the section is well organized and provides motivation for people working for TB treatment in resource poor settings and in the face of abject poverty.

The website forms an example of people coming together to work for a common cause with success.