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India: Renewing the Pledge Against Tuberculosis on World TB Day

Today, 24th March is World Tuberculosis (TB) Day – observed across the world in order to raise public awareness about TB and to support TB-control efforts globally. This year's theme is ‘Stop TB in my lifetime: Call for a world free of TB'.

World TB Day Poster 2012 by Centers for Disease Control and Prevention

In India, where TB is one of the biggest health challenges, the day was observed in various parts of the country. Given that every year nearly 2million Indians develop TB and that one fifth of the world's tuberculosis cases are in India, this day allowed health activists, practitioners and other stakeholders to spread awareness regarding the various challenges faced in their fight against TB and also to renew their pledge to fight the disease and find/implement better methods of control and treatment.

India also has one of the highest cases of multi-drug resistant TB. In January this year, Global Voices author Christine Mehta had reported how the health community had locked horns over whether a drug resistant TB strain that had been found in Mumbai should be labeled ‘totally drug resistant’ or ‘extremely drug resistant'. In her post, Christine had pointed out that

…the #tuberculosis Twitter stream and TB online advocacy community are adamant that tuberculosis needs to remain a high-priority for donor governments and international donor organizations like the Global Fund and the United Nations.

The task of generating public awareness is also critical and it is no secret that a lot still needs to be done in this area, as this tweet points out:

@pushpdeep: Yes, #Tuberculosis is very much neglected in india.. Poor awareness in the communities “@TBVI_EU (cont) http://tl.gd/ggkg1a

Due to poor awareness, not only do people tend to ignore the symptoms of the disease but also often face problems within the family and community at a later stage; there is a stigma associated with the disease, especially among Indians belonging to the lower socioeconomic classes. Women are particularly vulnerable and a media report indicates that over a hundred thousand women are thrown out of their homes each year because they have TB.

Superhero Bulgam Bhai

However, it is heartening to note that recently a nationwide communication campaign has been launched in India, giving her a new superhero, Bulgam Bhai (who also has his own Facebook page), to help fight the TB battle. On his blog Between the Lines, blogger BhavnoorSB talks about the innovative campaign that launched Bulgam Bhai:

As part of Global Fund Round 9 (Project Axshya) funded by The International Union Against Tuberculosis and Lung Diseases and implemented by Population Services International, BBCWST (BBC World Service Trust) has designed and produced a 360 degree communication campaign to improve case detections of TB, which means increased sputum testing at the nearest Designated Microscopy Centers (DMC); for people having persistent cough for 2 weeks or more.

Here's the campaign, uploaded on YouTube by BBCWST, with the following introduction:

The world has a new superhero from India.

He's not muscular and doesn't wear a cape. He has a den with a cough-detecting gadget. When someone coughs, wherever they are, he appears out of nowhere and asks if they have been coughing for two weeks. He's Bulgam Bhai (whose Hindi name translates into ‘Mr Sputum’ in English). He's joined the war against tuberculosis, the biggest single infectious cause of death in the world. Bulgam Bhai is the star of the TB control multi-media campaign created by the BBC Media Action for Project Axshya.

Watch him in action…

In a note sent via email, Karishma Saran, Program Assistant, Global Health Strategies, New Delhi, commented on India's TB strategy. She wrote:

The Revised National Tuberculosis Control Programme (RNTCP) under the Ministry of Health is the primary body coordinating TB prevention, control and treatment in India. The strategy of Directly Observed Treatment, Short-course (DOTS), recommended by the World Health Organisation (WHO) based largely on research done in India, has been successfully implemented under the RNTCP, leading to approximately 9 out of 10 patients being cured. For the past four years, the programme has consistently achieved the global benchmark of 70% case detection and 85% cure of new smear positive patients.

However, despite these successes, TB continues to affect people at an alarming rate in India. For more effective TB control, India must ensure universal access to high quality TB diagnosis and treatment for all.

According to a January 2012 update [pdf] by the RNTCP, some of the key challenges facing the country with respect to tackling tuberculosis were as follows:

  • Insufficient public sector MDR and XDR TB diagnosis and treatment services
  • Poor quality of TB and MDR (multi drug resistant) TB laboratory diagnosis in the private sector
  • Lack of information about patients diagnosed with TB and MDR TB in the private sector
  • Anti-TB drugs available without prescription and subsequent widespread irrational and irresponsible use

India is now taking innovative steps to aggressively build public awareness and combat the TB menace in the country. While the government is enlisting the help of chemists to check the rampant misuse of TB medication, advocacy groups are exploring newer communication spaces, encouraging public participation and engagement. Engaging youngsters has been part of this strategy and programs and rallies were held with school children to build awareness from a young age.

Student’s in Dimapur in an awareness rally on the occasion of World Tubercolosis Day. Image by Caisii Mao. Copyright Demotix (24/3/2012)

Also, a Stop TB flash mob dance by children was organized in New Delhi on the occasion of World TB Day. Here is a video of the Flash Mob Dance by Children in India – World TB Day 2012

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