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2017-11-02

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Developmental Issues
www.thehindu.com

India’s domestic budget for fighting tuberculosis showed a dramatic jump from about Rs. 700 crore in 2015 to Rs. 2,500 crore last year, according to a report from the World Health Organisation (WHO).

Typically most of India’s budget to combat the bacterial infection —that claimed 4.2 lakh last year—used to be dominated by international funding.

But, for the first time this has flipped. Domestic resources accounted for 74% of the $525 million spent in India last year, while it was only 38% in 2015.

“The big difference is that nearly Rs. 1,000 crore of non plan expenditure got added… next year you will see an even bigger spend,” A.K. Jha, Economic Adviser of the Union Health Ministry, said. “The role of the private sector is critical in reducing TB numbers,” he added.

In 2016, India recorded a 12% dip in the number of TB deaths from the previous year though the incidence dipped marginally by 1%.

The number of notified cases of drug-resistant tuberculosis (MDR-TB) jumped from 79,000 to 84,000 in 2016, a government official said, pointing to the deployment of better diagnostics. “Since last year, we’ve scaled up the use of molecular diagnostic tests to detect the infection… even on detection of drug-resistant TB there’s been an improvement,” he told The Hindu on Monday.

However, with 1.7 million new cases in 2016, India still continues to be the largest contributor to the global burden with up to a quarter of the 6.3 million new cases of TB (up from 6.1 million in 2015). In spite of the dip, India accounts for about 32% of the number of people worldwide who succumbed to the disease.

The government has committed to achieve a ‘90-90-90 target’ by 2035 (90% reductions in incidence, mortality and catastrophic health expenditures due to TB). This is premised on improved diagnostics, shorter treatment courses, a better vaccine and comprehensive preventive strategies. In 2016, the WHO said that India had many more deaths and incidence of the disease than had been estimated over the years.

However, several activists say that in spite of the government commitments, TB is still stigmatized and under-reported — especially from the private sector — and top-line drugs are still inadequate to treat people who suffer from the drug-resistant forms of the disease.

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