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India you go! You have signed up to yet another declaration!

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The Hon’ble Minister of Health and Family Welfare,

Government of India

Dear Dr Nadda,

We the people of India cannot thank you enough for attending the ‘First WHO Global Ministerial Conference – Ending Tuberculosis in the sustainable development era: a multi-sectoral response’ and reiterating your commitment to TB elimination in India by 2025.

I was particularly heartened by your strong  and decisive message at the conference. It gave us hope, particularly the messages you shared about advanced diagnostic facilities which will be made available at district levels. It heartened me because even while you were making a difference on the world stage, a few of us were trying to help a young, too young MDR-TB survivor who had relapsed. She lives in Ilkal, a small town of Northern Karnataka and had no way of knowing her real drug resistance status where she lived, because of lack of testing facilities.

We needed to transport her sputum to Mumbai because she was too ill to travel to give the sample herself. Through  very generous responses and directions from Dr Zarir Udwadia, Dr Camilla Roderigues, and their teams from Hinduja Hospital, Mumbai, we did transport the sputum and this young girl is awaiting next steps now. We used very local techniques, mobile phones, emails and WhatsApp to transmit messages and accomplished the job. We hope her story will now find a happy ending.

You will be happy to know that it is the private sector that stepped in to help (the same private sector which is often damned), and the public healthcare sector which did the right things by her too, showing that right from the very grassroots (which included an outreach worker, a government doctor and myriad other people who extended hands of support), across sectors, and right up to the very high levels at which you were speaking, the commitment was firm and this can translate to good results. I saw the same multi-sectoral response here, which you were all discussing in Moscow.

This shows that India is ready and waiting to give a good fight back to TB, and what’s more, defeat it. Ilkal is a very small town, and if there is this kind of strong awareness and will to fight here, then extrapolating that can really mean wonderful things for us.

This alone is not enough – a lot rests on you now

Let me now begin grumbling. What did you mean Dr Nadda when you said that the three pillars of TB elimination in India were Aadhaar, Jan Dhan and Nikshay (as reported by Indian Express)? I can understand the third, but pray what do the first two have to do with TB elimination? Surely you being a doctor yourself know that TB is as tough a nut to crack as it is easy to prevent. It could be as simple as providing good living, food and other requisites and you can scare it away. On the other hand, it is difficult to control as you only have to breathe to get the bacilli into you and given the poor nutritional and immunity status among the majority in India, TB has a free run in the country.

Oh yes! I think you meant that if people have Aadhaar cards, they get their subsidized grains and get to eat and don’t die (ref: recent hunger deaths in Jharkhand) and then they can have the resistance to fight TB. And I think you also meant that having Aadhaar cards meant they could get their medication and be saved from dying. Or that illegal immigrants and other unfortunates who got TB could be detected and thrown out God knows where and TB rates would come down. I understand now. But did you think of what it meant to deny facilities simply on the basis of lack of Aadhaar cards? No, I’m sure you didn’t because you were expected to make ‘political’ commitments and you were doing that.

And what about Jan Dhan? Don’t we all know that having a bank account doesn’t translate into having money in it? And pray how will Jan Dhan help? Isn’t TB medication free? Or are we (God Forbid!) planning direct fund transfers for TB medication too? Kindly educate me on this.

Sir, I request you – do not complicate issues. Kindly speak to grassroots stakeholders before you make sweeping changes to the current scenario. Just when we are poised to win this war, do not bring in counter-productive weapons and force us to push back. Each person in this sector has fought hard and long to come this far. Don’t force us to step back now. Let us #stepupforTB and not the other way!

We have already signed up for too many commitments and declarations and then gone ahead and thrown them into dusty archives. Don’t let the Moscow Declaration go the same way! Kindly stand by it!

Yours in support and solidarity of those who need your help,

Bharathi Ghanashyam

Views expressed here are solely of the author.

 

Written by JournalistsAgainstTB

November 18, 2017 at 12:35 pm

Posted in TB and Media

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