LOS ANGELES, California — According to the World Health Organization’s Global Tuberculosis Report, India has one of the highest tuberculosis incidence rates in the world, with an estimated 2.69 million cases in 2018. The respiratory disease known as tuberculosis or TB has proven time and time again to be one of India’s biggest threat, and with COVID-19 pressuring essential resources in India, increased global support is needed to overcome both TB and the pandemic.
Tuberculosis in India
The WHO reports that 10 million people across the globe contract TB each year, with 1.5 million of those cases resulting in death. Of those 1.5 million deaths, 449,700 are in India alone. To put that figure into perspective, over one-third of all tuberculosis deaths worldwide occur in India.
Tuberculosis is an infectious disease caused by airborne bacteria transmitted from person to person through coughing and sneezing. Although TB is curable, the framework of India’s healthcare system inhibits citizens from receiving proper treatment.
“In India, it’s harder to get a vaccine because it’s really hard to get access to primary care,” said Anjali Kalra, a medical student in Dallas who worked at Jaipur’s Curewell Hospital in Jaipur, India in 2018. “A lot of people don’t have a primary care physician, especially those that live in the slums. And they only go to the doctor when they have conditions that are impairing them so much that they need medical attention, but by then, the doctor isn’t able to give them preventative care.”
Distrust in Medical Personnel and TB strains
While TB is relatively preventable in most regions of the world, it is especially challenging in India due to the houses’ proximity to each other, particularly in the slums. Since the bacteria transmit through the air, buildings clustered together are at a higher risk of contagion. Additionally, skepticism toward doctors and Western medical treatment are considerable barriers to tuberculosis prevention practices.
“A lot of people just don’t trust doctors there, so they might prefer to get herbal remedies,” explained Kalra. “Or a lot of people prefer to go to their priest for medication, especially in rural villages.”
The combined distrust toward medical procedures, clustered communities and a lack of primary healthcare access increases the chances of contracting tuberculosis.
Furthermore, strains of the bacteria are constantly mutating and becoming resistant to existing vaccines, which in turn requires the constant production of new vaccines. Given India’s difficulty in obtaining and distributing vaccines across impoverished communities, the costs for continuous research and reproduction of new vaccines create a more significant challenge.
Although the ever-evolving bacterial strains pose substantial challenges to vaccination distribution, pharmaceutical measures are being taken to combat tuberculosis in India.
Combatting Tuberculosis in India
Last month, the Indian government permitted Mylan N.V., a Pennsylvania-based pharmaceutical company, to distribute a drug called pretomanid in India. Pretomanid is an antibiotic drug recently developed to treat resistant strains of tuberculosis and legalized in 150 countries. Due to its widespread approval and its promotion by organizations like the World Health Organization (WHO) and the United Nations, the drug is seen as a viable option in mitigating tuberculosis cases in India.
In addition to India’s medical advancements, the country has also received considerable support from international organizations in its fight against tuberculosis. For example, the United States Agency for International Development (USAID) contributed an additional $1 million in 2019 to their continued effort to fight tuberculosis since 1998, and in the same year, the World Bank agreed to a $400 million loan agreement for the Program Towards Elimination of Tuberculosis.
India’s tuberculosis epidemic could agreeably be one of the most significant threats the country is facing today, and its struggle to eradicate the disease has mostly been an uphill battle. Yet, despite these challenges, with continued global support and funding, the goal of eliminating tuberculosis in India grows nearer.
– Joey Patton