Union budget 2018: ‘Will vulnerable TB patients get benefit?’
According to the World Health Organisation Global TB report 2016, India accounts for 2.8 million of the 10.3 million new TB cases globally
More than half of all cases of TB every year — two-thirds of new cases in people 15-19 years old — can be prevented by ensuring people get enough to eat in terms of calories and proteins, studies have shown. So, there was a general cheer when the Budget made an allocation of Rs 600 crore towards nutritional support for TB patients. But experts were not sure whether this was enough.
Prof Madhukar Pai, Associated Director, McGill International TB Centre, Canada, told The Indian Express that under-nutrition is a major risk factor for TB and TB mortality in the country. “So while this move is welcome, what I am worrying about is the implementation,” Dr Pai said. “Will the most vulnerable TB patients get this benefit? Will there be hassles related to Aadhaar card that might exclude the poorest? Will the cash benefit of Rs 500 per month get used for food or go elsewhere. If the entire family is poor, will the cash be enough,” asked Dr Pai. He said there should be more clarity on whether India’s ambitious national strategic plan for TB elimination 2017-2025 will get the full budget that was asked for.
Under-nutrition is endemic in India, with 34 per cent of men and 36 per cent of women (15-49 years) undernourished, according to National Family Health Survey NFHS-3 estimates. These people are up to four times more likely to develop TB than healthy people as under-nutrition, the leading cause of immunodeficiency globally, weakens resistance to the TB bacillus, experts point out.
While surveys are being conducted towards finding active TB cases among vulnerable groups, according to the World Health Organisation Global TB report 2016, India accounts for 2.8 million of the 10.3 million new TB cases globally. Extremely drug resistant TB (XDR-TB) constitutes 10 per cent of the total multi drug resistant TB cases.
While activists like Chapal Mehra, convenor of NGO Survivors against TB, has termed the budgetary allocation as a patient-centric and empathetic move, others have raised questions about the inadequate cash incentive. Blessina Kumar, CEO of Global Coalition of TB Activists, said recently they set up the Northeast unit and interaction with members raised the issue of what happens after the duration of treatment was over. “Also, how will the government ensure people who need it the most get the benefit,” Kumar asked.
According to Central TB division health officials, not all drug resistant TB patients want “ready to eat” food packets. Pilot studies in Mumbai showed patients with multi-drug resistant TB were unhappy with the quality of food. According to sources, a decision was taken to provide Rs 500 in cash per month for the newly detected TB cases for a period of six months. A re-treatment patient would get Rs 4,000 for eight months (Rs 500 per month) and similarly the drug resistant patient would get Rs 12,000 for the duration of treatment that could last for nearly two years.
Source: The Indian Express
