NEW DELHI – India has the highest number of TB cases globally, according tothe World Health Organisation’s 2017 report, and is also among the top fivecountries that report the highest multi drug resistant cases.

Over the past year, there were more than one million TB cases reportedacross India, according to health ministry data.

Campaigners argue that the numbers are even higher, as there are gaps inthe detection and treatment of TB.

“It affects mainly poor and malnourished people,” Finance Minister ArunJaitely told parliament in his Feb 1 budget speech – a rare officialacknowledgement of the scale and impact of the disease.

The government has promised extra support for those affected, but detailsof the plan remain unclear.

Tuberculosis patient Yerdodamma Peddeti is hungry, but the wood fire stoveoutside her home in southern India hasn’t been lit all day.

In pain and battling the side effects of treatment, Peddeti says she hasn’tbeen able to work for years, and has gone deeply into debt in order tosustain herself and her 12-year-old son.

“I don’t have the money to buy food or the energy to cook,” she said,sitting at the doorstep of her one-room home in Mutyalacheruvu village inthe southern state of Andhra Pradesh.

Each day, the 40-year-old waits for her sister to stop by with a fewvegetables, light the fire, cook a meal, feed her and then help her use thetoilet.

“I also don’t eat much because I am scared I might need to use the toilet.I can’t walk to it unless my sister comes and supports me. So I wait, forfood, to use the toilet and also for death.”

Peddeti’s skeletal frame has been ravaged by multi drug-resistanttuberculosis (TB), which doctors and campaigners say is India’s biggestpublic health crisis.

Patients like her are resistant to treatment with at least two of the mostpowerful standard anti-TB drugs, isoniazid and rifampicin.

Adding to the health crisis is the increasing debt burden on patients asthey try and stick with the treatment, say public health campaigners.

Expenses such as transportation and the cost of food, combined with theloss of income, push families into debt and are disincentives to continuingtreatment, they say.

A study presented at the European Respiratory Society’s 2016 conference inLondon documented the “catastrophic costs” incurred by TB patientsundergoing treatment at private hospitals.

The study showed that patients were spending 235 percent of their income onthe disease – meaning they had to borrow money to support their treatment.

“Not only is TB a disease of poverty, it also causes poverty,” said Dr.Zarir F. Udwadia, a leading chest physician and co-author of the study.