DOTS X-rayed
In India, about 19 lakh people need to be treated for TB. The lives of these patients is dependent on the free medicines provided by the government under its Revised National TB Control Programme—RNTCP. The pillar of this programme is the uninterrupted supply of medicine to the patients. But this is not happening everywhere. In states like Bihar, the ground reality of the programme is very different. The shortage of medicines is a common refrain in these areas.
"The central government asks state governments to purchase the essential drugs. The state governments in turn ask district authorities to buy it, but many districts don't spend a single penny on purchase of the medicines," says Dr Muhammed Shaffi, former World Health Organization consultant to RNTCP in Bihar.
The biggest problem with shortage of drugs is that it leads to a more serious form of TB: multidrug-resistant (MDR) TB. "People are losing faith in the system. Why will they come to get themselves treated?" says Dr Shaffi.
The attitude of the medical authorities is that of apathy and negligence. The district reports a cure rate of 85% whereas the actual rate must be 60-65%. The lab reports are fudged to show that patients have been cured. But ultimately who is responsible? "This is not the neglect of any one individual alone, it is a problem of the system and everyone, from top to bottom, is responsible for this. The greatest responsibility is that of Central TB Division," says Dr Shaffi.