Although it still has the world’s highest tuberculosis burden. New infections, as well as deaths due to TB are falling in India. However, evidence has shown the number of drug resistant cases of TB in India are rising rapidly.
These drug resistant strains of TB are significantly harder to treat, with some areas not having the necessary second line therapies to deal with outbreaks. Despite falling numbers of TB cases, India may, in the future, see a rising tide of far more deadly, untreatable TB.
The World Health Organization has released its Global Tuberculosis Report 2017, which shows mixed results in India. Deaths due to TB were estimated to have fallen 12 percent, from 480,000 in 2015 to 423,000 in 2016. However, over the same period, drug resistant TB cases rose by 13 percent, from 130,000 to 147,000.
“The 2017 Global TB Report by WHO shows little improvement since the last year, globally, and in India” says Dr Madhukar Pai, Associate Director, McGill International TB Centre and Canada Research Chair in Epidemiology & Global Health in exclusive comments to Health Issues India. “TB continues to rank as the leading infectious killer, and India continues to bear the highest burden among all countries.”
Funding is an essential factor in combating the spread of drug resistant TB. The WHO report notes that between 2015 and 2016 the amount of funding issued by the Indian government doubled. While this marks an initial commitment from the government, the funding must not only be sustained, but increased to handle the growing threat.
“TB continues to suffer from limited financing by high burden countries, including India. So, unless there is serious political commitment, funding and execution, it will be impossible to meet the End TB targets.” says Dr Pai. TB is endemic in many low and middle income countries. This may mean that aid from wealthier nations may be a vital component of any sustained efforts in curbing the disease.
The report adds that even including international aid donations, India currently falls short of the expected funding to have a sustained effect in reducing rates of TB. Projected funding levels over the course of 2017 are estimated at $388.5 million USD in domestic funding, with a further $136.5 million USD in international aid. This figure falls short of the $680 million USD per year over the next five years the report claims will be needed to have an impact on cutting down levels of TB.
Professor Madhu Pai remains optimistic that countries will do more to address the situation. “Hopefully, the Ministerial meeting in Moscow (16-17 Nov) will galvanize countries to wake up and do more to end the TB epidemic. I hope India will step and show leadership, and fully fund and execute its ambitious National Strategic Plan to Eliminate TB.”
The Global Ministerial Conference on Ending TB in the Sustainable Development Era will bring together many of the countries most affected by the disease. Alongside health ministers from a number of nations, NGO’s, academic and research institutions as well as UN organisations are expected to attend, hoping to find a solution to the emerging crisis of drug resistant TB.