Boston.com reported that approximately 100,000 people in poor villages in the Lohata area of India’s Uttar Pradesh state have TB. Dr. J.N. Banavalikar, vice chair of the TB Association of India, attributed the high TB prevalence to poverty, malnutrition, and the occupational hazard of silk weaving.
Banavalikar noted that thousands of Lohata sari weavers breathed in minute silk threads, which weakened their lungs. The workers labored in cramped rooms with poor ventilation, where TB spread easily. The sari industry recently declined, due to changing fashions and lack of raw materials. Weavers who once turned out five saris each week now produced only two. The average monthly income in Lohata was approximately $48. Lower income resulted in poor nutrition, and children were particularly vulnerable to TB when malnourished. Dr. S.P. Dubey, an Uttar Pradesh health official, reported 12,900 TB deaths in Lohata in 2011 and 13,700 in 2012.
The World Health Organization Global TB Report 2013 estimated that India had up to 2.4 million TB cases, the highest incidence in the world. India also experienced the highest increase in multidrug-resistant TB (MDR TB) cases from 2011 to 2012. Although India’s government offered free TB medication programs, many barriers to success existed. Pharmacists and unqualified providers “routinely” gave out antibiotics without prescriptions, which gave short-term relief but led to drug-resistant strains. Some people stopped taking TB medications because of side effects. One federal program paid providers to observe patients taking TB medications—but only if patients completed the six-month course—giving providers an incentive to lie if patients dropped out. Some local officials did not make TB drugs available to people, according to Banavalikar.
According to Uttar Pradesh Health Minister Ahmad Hasan, the Indian government failed to supply enough free drugs. Treatment for MDR TB could cost $160 per month.