The Telegraph
Since 1st March, 1999
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Pat & rap in WHO’s tuberculosis report card

New Delhi, Sept. 28: A World Health Organisation review of India’s revised tuberculosis control programme has noted its “remarkable” progress but underlined a lack of knowledge about the infection among medical staff ranging from general specialists to nurses.

“There has been good dissemination of information among the community members. Even if one patient is cured, the community seriously advocates the programme,” said Dr Fabio Luelmo, consultant to TB control programmes. The same, however, is not true of private and public practitioners.

“We have also noted a dearth of enough people at managerial levels, both at the national and state levels,” he said. “But there is no dearth of field staff,” Luelmo added.

According to the WHO, one of the reasons for the shortage in managerial staff is the pace at which the Revised National TB Control Programme has been carried out since its inception in 1993. The programme includes the Directly Observed Treatment Short Course, which enjoys a high success rate throughout the world. It has also worked well here.

In India, 1.8 million people contract TB every year — until recently, the infection claimed 400,000 lives every year. An estimated 100 million workdays are lost because of the disease.

While lauding the success of the programme in India, WHO’s review commission also pointed to its uneven graph. “While states in the south and others like Gujarat, Maharashtra have done extremely well, Uttar Pradesh and Bihar are still lagging behind,” Luelmo said.

For instance, only 28 districts out of 70 in Uttar Pradesh have implemented the programme and that too only in the last few months. Uttar Pradesh has also fallen behind in the pulse polio programme. About a year ago, there was a sudden spurt in polio cases in the state while the other states were going ahead with the programme. “Bihar is still to implement the programme,” Luelmo said.

Deepak Gupta from the health ministry, however, said the uneven graph resulted from different states beginning the programme at different times.

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