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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
INDIA: Indian Bureaucracy Slows Treatment of Tuberculosis
Geeta Anand, Shreya Shah
October 12, 2012
Wall Street Journal (10.11.12)

A tuberculosis (TB) patient in India was one of 16 patients identified by Mumbai doctors to be resistant to all traditional TB treatments. Now the patient is perilously close to running out of life-saving medicines. The patient returned home to Uttar Pradesh, a thousand miles from the Mumbai treatment center, expecting to die, only to find that the experimental treatment prescribed by a Mumbai TB expert has held the disease in check—but the patient must continue the treatments for 18 more months for a chance of being cured. The latest twist in the patient’s story exposes the bureaucratic tangle that can hinder treatment for India’s TB patients. India now has 42 labs that can make the diagnosis, but the patient’s home state of Uttar Pradesh—India’s most populous state—does not have a lab yet. India’s incomplete national network for treating the most virulent forms of TB has complicated this patient’s treatment. National health officials have pledged free treatment to the patient; however, on October 8, Dr. Mini Khetrapal, Mumbai’s top TB official, said that the city would stop providing the medicines because the patient no longer resides in Mumbai. Dr. Khetrapal further stated that if the patient wants more medicines, the patient must return to Mumbai so that Mumbai doctors can monitor the side effects of the medicines administered. The patient is too poor to return to Mumbai, and does not wish to be homeless and living on the streets in such a weak condition. The patient's family already sold all their land and spent their life savings to pay for treatment during the past six years. On October 10, Dr. Ashok Kumar, head of India’s national TB program, reiterated that the government would keep providing the patient’s medication and would courier the medicines to the patient’s home state until Uttar Pradesh is able to take over the treatment. However in the past, medicines from Mumbai have arrived several weeks late. TB affects approximately 2.3 million Indians per year. Although in 1977, India began to build a national program to diagnose and treat TB, India was slow to diagnose and treat patients with multidrug-resistant TB. Thus, there are now signs of an epidemic in some parts of the country, especially in Mumbai.

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