The TB Scourge: Where India Stands

Every year March 24 marks World Tuberculosis Day. On this very day in 1882, the TB bacillus was discovered by Dr Robert Koch. However, till date, Tuberculosis remains an epidemic in most developing nations. Let’s have a look where we in India stand in terms of TB.

What we know so far

According to WHO data, India accounts for 27 per cent of the world’s 10.4 million new cases of TB, and reports 29 per cent of the 1.8 million deaths from it every year.

Women and girls make up nearly 1 million of the estimated 2.8 million new TB cases in India each year; it is the fifth leading cause of mortality among women. And the maximum fatalities are in women aged 30–69

TB is a disease that remains deeply stigmatized in our country, more so for women.  It is often seen as divine punishment for disreputable actions. Therefore, the suffering woman is isolated from society. They are forced to eat and sleep separately. Married women are rejected by the husband and his family, and substituted by a second marriage.

A highly contagious disease, TB affects the fates of entire families. Girls with tuberculosis are not considered fit for the “marriage market”. Hence, TB provokes fear and secrecy, leading to delays in seeking medical attention. Women who have been diagnosed sometimes prioritise privacy over the quality of care; despite the higher cost, women often use the private health sector to keep their diagnosis confidential. In turn, delays in beginning the treatment of TB and failure to keep to prescribed treatments going because of the costs involved. Often drug-resistant tuberculosis is often misdiagnosed.

While men do face stigma, they continue to receive the much-needed support of their wives and loved ones. They do fear their masculinity is threatened as they no longer are able to be the breadwinner but are not held culpable for the diagnosis. They are excused from routine obligations.

How can we mitigate the negative impact of TB on girls and women?

Counselling women with the disease and offering them social support during treatment will be helpful in strengthening their ability to resist internalizing the exclusions they experience. While an individual-level approach is helpful and necessary, it calls for a big shift in mindset at the societal level.

Mass educational and literacy campaigns such as social media messaging; television; creating venues for communities to come into direct contact with the people battling the illness and learn about their challenges and needs will help create the awareness, especially in low-income areas.

There is a need for new legislative and policy changes, whereby prejudices are stifled through legal and human rights-based approaches.

Steps by the Government to address the situation

India plans to eliminate TB by 2025, and the Union Cabinet has also approved the National Health Policy 2017 that proposes to increase public health expenditure to 2.5 per cent of GDP.  However, provisions of quality care that is gender-sensitive and clear plans to counter the stigma and address the barriers that patients with TB face -- especially women and girls -- are much needed.

Also Read: Patna Girl Fights For Right To TB Drug