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Stop TB-Fight poverty : An Indian Perspective
Conclusion
India carries a third of global TB burden. Every year two million people develop active TB. TB accounts for nearly 4,50000 deaths every year and more than 1000 persons die of the disease every day. TB is inflicting enormous economic and social costs on the country. The estimated economic cost of TB is US $ 3 billion per year.
In India 240 million people live below the poverty line. Poverty alleviation remains a pronounced challenge before the government. Surveys reveal that almost 59% of households accounting for 526 million people have an annual abysmally low income of less than Rs 12500 (US $260)
Income poverty leads to ill health and ill health contributes to income poverty. The cost to the Indian patient for successful treatment of TB averages US $ 100 to US $150. Research shows that 20% of rural and 40% urban patients borrow money to pay for expenses due to TB.
Indian women have to pay much higher social and personal costs if suffering from TB. Besides poverty the shame and stigma associated with the disease, early marriage and social pressures to start a family early on and limited access to treatment facilities makes them more vulnerable to disease more so during the reproductive age group of 15 – 45 years.
The nation has not risen adequately to meet the twin challenge of TB and HIV/AIDS. The number of HIV positive persons has risen above 3.86 million. Nearly 60% of AIDS cases are reported to be opportunistic TB infection. This is going to add to the national load of 14 million TB cases.
Effective TB control can help break the cycle of poverty and disease. It cures people and returns them to active, productive life, which in turn benefits their children and contributes to the economic and social development of their country. A cost-effective health intervention exists for TB control and treatment: DOTS. Increasing public awareness about proven, effective interventions like DOTS and providing greater access and benefit to treatment for those with TB, will help put billions back into the economy. Projected incremental costs to the government for successful DOTS implementation throughout India are of the order of US $ 200 million per year, compared to the tangible economic benefits of at least US $ 750
million per year. The expenditure on health has declined in last decade and stood at 1.11% of GDP in 1998-99. Indian government will have to increase its expenditure on TB control.
The three aims associated with World TB Day 2002 theme viz DOTS expansion, efforts to raise awareness among political leaders, decision makers and opinion leaders and mobilization of TB sufferers for demanding greater access to treatment are more relevant to India than any other country in the world.
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