COVID-19 Has Hampered India's Tuberculosis Fight: Dr Madhukar Pai

Indian hospitals are getting overcrowded by COVID-19 patients, while patients suffering from ailments even as severe as tuberculosis have been put aside. A post COVID-19 healthcare system crisis awaits India after the lockdown is lifted, according to Dr. Madhukar Pai, Canada Research Chair in epidemiology and global health and director of the McGill International TB Centre in Montreal, Canada.

In 2018, the 30 high TB burden countries accounted for 87% of new TB cases. Eight countries account for two-thirds of the total, with India leading the count, followed by, China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh, and South Africa.

Speaking to BOOM's Govindraj Ethiraj, Dr. Madhukar Pai said that since the COVID-19 pandemic, there has been an 80% drop in monthly notifications of TB. India reports 2.7 million TB patients every year.

India has planned to eradicate TB in India by 2025, according to the campaign launched by Prime Minister Narendra Modi in 2018. The COVID-19 pandemic, coupled with the fact that India continued to be the first on the list with patients with tuberculosis according to a 2019 report released by the World Health Organisation has meant that the country is still a long way to go to be free of tuberculosis. "Now we will be lucky if we can end TB by 2035 because that much more work will need to be done. Same thing for other diseases. In fact, TB [control] is predicted to be set back by 5-8 years," said Dr Pai.

Dr. Pai believes that TB patients haven't sought care due to the COVID-19 pandemic which would only lead to their symptoms worsening. This means they are more likely to transmit tuberculosis when they start seeking care. They already would have transmitted the infection within the household because of the lockdown.

The only way to battle this looming crisis is through tying up with the privatised health sector, says Dr. Pai. India's healthcare investment is just 1.5% of its GDP which is especially inadequate to tackle a healthcare crisis while 80% of India's outpatient care is in the private health sector.

Dr. Pai says, "The government needs to work harder to win the trust and work with them. Somehow, getting private and public--the all-hands-on-deck approach--is almost critical in this crisis, because no one sector can do this. The government's job, I think, would be to regulate, to enforce certain policies and norms, and reimburse the private sector for what is a fair tariff for the service. You cannot expect the private sector to do it for nothing."

But in the long run, Dr. Pai says, India needs to increase investment in healthcare to 2.5% of the GDP, which economists like Amartya Sen have been wanting since decades.