India has the highest number of TB cases globally, according to the World Health Organisation’s 2017 report, and is also among the top five countries that report the highest multi drug resistant cases.
Over the past year, there were more than one million TB cases reported across India, according to health ministry data.
Campaigners argue that the numbers are even higher, as there are gaps in the detection and treatment of TB.
“It affects mainly poor and malnourished people,” Finance Minister Arun Jaitely told parliament in his Feb 1 budget speech - a rare official acknowledgement of the scale and impact of the disease.
The government has promised extra support for those affected, but details of the plan remain unclear.
Tuberculosis patient Yerdodamma Peddeti is hungry, but the wood fire stove outside her home in southern India hasn’t been lit all day.
In pain and battling the side effects of treatment, Peddeti says she hasn’t been able to work for years, and has gone deeply into debt in order to sustain 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 in the southern state of Andhra Pradesh.
Each day, the 40-year-old waits for her sister to stop by with a few vegetables, light the fire, cook a meal, feed her and then help her use the toilet.
“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, for food, to use the toilet and also for death.”
Peddeti’s skeletal frame has been ravaged by multi drug-resistant tuberculosis (TB), which doctors and campaigners say is India’s biggest public health crisis.
Patients like her are resistant to treatment with at least two of the most powerful standard anti-TB drugs, isoniazid and rifampicin.
Adding to the health crisis is the increasing debt burden on patients as they try and stick with the treatment, say public health campaigners.
Expenses such as transportation and the cost of food, combined with the loss of income, push families into debt and are disincentives to continuing treatment, they say.
A study presented at the European Respiratory Society’s 2016 conference in London documented the “catastrophic costs” incurred by TB patients undergoing treatment at private hospitals.
The study showed that patients were spending 235 percent of their income on the 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. (Reuters)