TB News from India: July-August 2002
Issue
(TB News from India is published by Health and Development Initiative-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:
An article published in June 2002 issue of Bulletin of World Health
Organization, entitled ' Response to a major disease of poverty: the Global Partnership to Stop TB' enlists the challenges that lie ahead in order to implement the global plan to Stop TB. Nearly two million people died of TB in 2000, and TB morbidity contributed to the impoverishment of millions of families in a number of nations. With sufficient resources the Stop TB Partnership will reach its targets for the years 2005 and 2010 and pave the way for elimination of TB as a public health problem. This is not only a public health undertaking but is imperative for development, human rights, and poverty alleviation.
"Finding the necessary resources is finally a question of political values. The rapid establishment of the global fund to fight AIDS, TB and Malaria is a promising expression of these values. However, it will not provide a quick and easy success for the STOP TB Partnership or for the world. Marshalling resources for TB is a test of political will for nations, communities, and organizations around the world. It is major challenge they will have to decide about day by day as they debate their own values and purposes, and their relation to communities beyond their own" the article concludes.
It is high time that political and administrative leadership of high-TB- burden country like India rise to the challenge and ensure that funds to run TB control programme are not only adequate but are also utilized prudently.
Rapid DOTS expansion in India:
A theme paper published in the June 2002 issue of Bulletin of World Health Organization describes the progress of DOTS expansion in India. Since 1998 the coverage of the DOTS strategy has been expanded rapidly. In both 2000 and 2001 the country probably accounted for more than half the increase in number of patients treated under DOTS and by early 2002 more than a million patients were being treated in this way in India. As a result nearly 200,000 lives were saved. The lessons learnt relate to the importance of the following elements of the programme:
1. Getting the science right and ensuring technical excellence
2. Building commitment and ensuring the provision of funds and flexibility in their utilization
3. Maintaining focus and priorities
4. Systematically appraising each area before starting service delivery
5. Ensuring an uninterrupted drug supply
6. Strengthening the established infrastructure and providing support for staff
7. Supporting the infrastructure required in urban areas
8. Ensuring full time independent technical support and supervision, particularly during the initial phases of implementation
9. Intensive monitoring and giving timely feedback
10. Continuous supervision.
Tuberculosis (TB) control still faces major challenges in India. To reach its full potential, the control programme needs to: expand so as to cover the remaining half of the country; much of which has a weak health infrastructure than the areas already covered; increase its reach in the areas already covered so that a greater proportion of patients are treated; ensure sustainability; improve patient friendliness of services and confront TB associated with Human Immunodeficiency Virus (HIV) infection. It is expected that HIV will increase the number of TB cases by at least 10% and by a considerably higher percentage, If HIV becomes much more widespread.
India's experience shows that DOTS can achieve high case detection and cure rates even with imperfect technology and often with an inadequate public health infrastructure. However, this can only happen if the delivery programme is appropriately designed and effectively managed.
You can read the full text of paper written by Dr. Thomas R. Frieden and Dr. G R Khatri at:
http://www.who.int/bulletin/pdf/2002/bul-6-E-2002/80(6)457-463.pdf
Railway hospital TB ward needs help more than patients
A Times News Network story by Kumod Verma says that While the World Health Organization has emphasized the need of providing better medicare to tuberculosis patients all over the world; it is, however, a sealed fate for the TB patients undergoing treatment at the Danapur Railway Hospital.
Lallan, 60, who is a railway gangman posted at Buxar, has been undergoing treatment in the TB Ward since April 10 this year. He said that he had to purchase medicines worth over Rs 1,000 from his pocket.
Faujdar Mandal, 50, an employee of the Patna railway canteen, was admitted to the TB Ward on April 16 with constant bouts of cough and pain in the chest. He also complained that the doctor did not visit the ward daily and that routine medicines were being given to the patients.
Sources said while the affluent railway employees prefer treatment of the disease in private clinics, the poor employees, who cannot afford expenses of private clinics, have no alternative but to bank on the railway hospital's TB center.
You can read the full text of story at:
http://timesofindia.indiatimes.com/articleshow.asp?art_id=9106079&sType=1
(Danapur district of Bihar state is currently not implementing DOTS: Editor)
Government neglects anti-TB society
A news item published in The Tribune published from Chandigarh says that the Multi-Drug Resistant Tuberculosis Treatment Society (MDRTTS), formed under the Chairmanship of the Deputy Commissioner, Solan, at the Dharampur TB Sanatorium, 4 km from here, has failed to get the desired support from the state government.
The society was primarily formed to provide financial help to multi-drug resistant TB cases that have become a potential health threat in the country, says Dr R.P. Kaushal, Medical Superintendent of the Himachal Pradesh Government sanatorium. Between July, 2000, and July 2001, as many as 29 patients were treated here.
Dr Kaushal, who was instrumental in the formation of the MDRTTS in October last, says around Rs 1.50 lakh (US $ 3000) is required for the full course of treatment of an MDRTB patient. Most of the patients, who come from poorer sections, cannot afford it.
You can read the full text of story at:
http://www.tribuneindia.com/2002/20020309/himachal.htm#4
60 STD clinics in state not functional
A Times News Network Story published from Hyderabad reports that as many as 60 sexually transmitted disease (STD) clinics established in the area hospitals and seven district hospitals in the state to reduce prevalence of HIV and AIDS, are yet to be fully functional. According to a health department official, though doctors have been trained in association with the Andhra Pradesh State AIDS Control Society (APSACS), no doctor is made available at these clinics, and STD patients are referred to the outpatient unit.
As any STD has a social stigma attached to it, patients are reluctant to seek outpatient treatment. The behavioral surveillance study report published by the National AIDS Control Organization (NACO) revealed that seven per cent of both the male and female population in Andhra Pradesh had an STD symptom.
You can read the full text of story at:
http://timesofindia.indiatimes.com/articleshow.asp?art_id=13404414&sType=1
Web call: Web based information on tuberculosis
Given the magnitude of the tuberculosis epidemic worldwide there is a relative dearth of TB-related information to be found on the Internet, in comparison with HIV/AIDS. There is also a large gap between the countries producing most of the web-based TB information and the countries most affected by TB. A large proportion of web-based information relating to TB is produced by western academic institutions and is not necessarily aimed at audiences in the south, in terms of relevant content or language. Nonetheless there still many web sources that provide excellent information for the general public, TB patients, researchers, and health care professionals.
For a first port of call query, the best sources of online information are the STOP TB Partnership and Centers for Disease Control and Prevention (CDC) websites. Because these are both large, well-resourced, technically- oriented umbrella organizations, their websites contain comprehensive, accurate and up-to-date information regarding TB. CDC has a large online catalogue of educational materials and guidelines for clinicians, the general public and patients, which can be ordered, free of charge: https://www2.cdc.gov/nchstp_od/PIWeb/TBorderform.asp
For patients who want to find out about TB, a nicely laid out "frequently asked Questions" page covers most of the basics and can be found at the American Lung Association's website: http://www.lungusa.org/diseases/lungtb.html.
There are number of websites, though not nearly enough, that offer the viewer a feel for the TB situation in a given country. An India -based website named Health and Development Initiative has a lively and frequently updated website, which gives an insight into the TB situation in India, through fact sheets, news updates, articles and relevant links.
(http://www.healthinitiative.org/html/index.htm).
One can hope that over time more and more locally driven websites relating to TB will arise with locally generated content news.
You can read the full text of this article written by Ms. Louise Berry at:
http://www.who.int/bulletin/pdf/2002/bul-6-E-2002/80(6)514-516.pdf
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