In a scathing editorial (Tuberculosis of the Governance Nodules) on Wednesday, June 19, 2013, The Economic Times called for the sacking of India’s health minister for his failure to procure drugs for men, women and children suffering from tuberculosis. There is a massive and unprecedented stock-out of anti-TB drugs across the nation because the procurement process failed. In other words, people failed to fill out forms and push files. The editorial also said bureaucrats and others responsible for this should be punished. This is the first time in recent memory that a leading national daily has taken such a strong position on public health, laying the blame squarely where it belongs. It is not too soon, and hopefully more calls for action and accountability will come from the media whose first job, like public health, is to serve public interest. If India’s battle against tuberculosis has met a new challenge in a deadly incurable strain which makes patients totally drug-resistant, the callousness with which we approach drugs, disease and disability is reprehensible.
To say that India is sitting on a public health time-bomb would be an understatement. And what do we do? To borrow a phrase from Ravinar of MediaCrooks, used in another context, we play dossier-dossier. Experts from World Health Organisation are “in constant touch” with India as they monitor the situation. Our mandarins are writing letters to each other wondering why they failed to procure drugs since 2012, the tendering for which should have been done the previous year and diving deep into files and notes ensuring their backs are protected while there are indications that contracts may be given to privileged companies.
TB kills two Indians every 180 seconds and the country bears the world’s largest burden. Some 19 lakh people need treatment with one lakh multi-drug resistant TB cases. The media does not want to write about it and nobody wants to walk the ramp with a coughing partner who will pollute the air. The disease is associated with damp and dark places where poor people live. Go tell that to a cough, to spray elsewhere.
Every state in India has run out of TB drugs, and patients including children are being turned away from medical centres. No one in the health ministry wants to be quoted but will tell you between two coughs and a splutter that the situation is critical and that paediatric drugs ran out a long time ago in public dispensaries where most of India’s TB patients go for treatment.
Experts will tell you interesting things about first and second line of drugs but no one will be able to tell you how to reach them as soon as possible to those in urgent need. The worst part is that experts – national and international – were aware of the situation and were sending each other warning signals about the reality on the ground. The WHO alerted India to the crisis some 10 months ago. The UN body is a global policy setter, a guide. It is neither a research agency nor a donor, although it can assist countries in securing multilateral and bilateral funding. What was India doing on the ground?
Indian and WHO officials discussed TB during the recently concluded World Health Assembly (WHA) in Geneva in May 2013. It is not clear if the urgency of the matter was discussed with the health minister who was in Geneva briefly. Attempts by journalists, including Newslaundry, to speak to the minister were not successful despite several promises to the contrary.
The point is simple. The public has a right to know what is going on in public health, what decisions are taken or not taken in their name – we pay taxes for a reason. We also have the right to demand accountability and transparency from our elected leaders. It is critical for health issues to be discussed in editorial pages, financial journals and political columns – health is everybody’s business. The Economic Times took a big step in that direction. It is no small irony that India is among the largest producers of TB drugs globally.