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T.B.???

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By Dr CSRaju
Salient points about the story of T.B. in India:
  • HIV,DIABETES,MALNUTRITION are major fueling factors for T.B.
  • Poverty leads to TB and TB worsens poverty.
  • Treating childhood TB has no role in TB control.
  • BCG vaccine stops progression of infection into childhood T.B.
  •  Childhood TB is not infectious;
  • Govt loosing about $25 billions annually.
  • BCG vaccine has no protection against infection by TB bacilli.
  • DOTS saves lives from TB mortality, but has failed to control TB.
  • in our country,RNTCP’s budget is only $200 million. 



Is the BCG vaccine is effective?
No. as per the report published in the Indian Journal of Medical Research, that the TB control project had lost the tool of primary prevention.
Since 1978, the Expanded Programme on Immunisation took over BCG vaccination.
But In 1979, even though the  preliminary results of a 15-year-long BCG trial showed no protection against infection by TB bacilli, the MOH ignored it .
Why BCG is included in universal vaccination program?
 BCG fails to protect against infection by TB bacilli, but protects against infection progressing to childhood TB. Thus, universal neonatal BCG vaccination saves thousands of lives and huge costs for diagnosis and treatment.
What about the RNTCP ?
RNTCP) using DOTS was launched in 1993, the year WHO declared TB a global emergency. Nationwide expansion of RNTCP took 13 years as the government saw no TB emergency in India.

How the T.B. burdens the country?
Poverty alleviation requires TB control. The annual economic loss to India on account of uncontrolled TB was assessed by the government at $23.7 billion, while RNTCP’s budget is only $200 million. A redesigned RNTCP deserves at least $1 billion. TB control is at once a humanitarian service, human rights entitlement and investment in socio-economic development. The RNTCP leadership has to get back to the drawing board to redesign TB control.

What happened further to control T.B. in our country?
·         In 2000, the Indian Academy of Pediatrics called for a major redesign of TB control, with alternative tactics to prevent infection and treat infection before it caused disease.
·         WHO’s 2012 Annual Report on TB confirmed India’s failure.

·         DOTS saves lives from TB mortality, but has failed to control TB.

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