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INDIA: Food security is a key for preventing Tuberculosis in India

March 26, 2009

A Statement by the Asian Human Rights Commission

INDIA: Food security is a key for preventing Tuberculosis in India

India is the highest Tuberculosis burdened country in the world accounting for one fifth of the global incidence of the dreadful disease. It has remained so for the past three years. This is according to the report published by the Central TB Division functioning under the Ministry of Health and Family Welfare.

Ever since German physician Robert Koch distinguished mycobacterium tuberculosis and discovered the vaccine in 1882, many medical scientists have improved the cure. In an attempt to wipe out the scourge of the devastating disease, Governments across the world have developed medical programmes geared to get many people cured. The Government of India has also been making considerable efforts towards this goal through the Revised National Tuberculosis Control Programme (RNTCP) and introduction of DOTS (Directly Observed Treatment Short-Course).

However, efforts to eradicate the disease have not been very successful because the emphasis down the years has been on the cure. The reason why the rate of TB morbidity and mortality has been rarely reduced is not because the medical technology remains at a low level. It is because the TB related programmes by the government in India are not sufficient.

Very simply, the vulnerable groups do not have a favourable social environment for a latent TB infection not to convert to active disease. Persons infected by the disease or highly vulnerable to the infection are mostly from the marginalized communities in the country. This includes low-income families and the members of the Dalit communities in India.

TB is an infectious disease transmitted by bacteria. The asymptomatic and latent infection is common. Once infected with TB there is a lifetime risk of around 10% of developing the full blown manifestations of the disease. The main factors that contribute to the development of the disease are malnutrition and a congested living environment. A single case of pulmonary TB can infect as many as 15 persons in a year. For example, in recent times, the rise of TB infection in the youth in developed countries is primarily based on their unbalanced nutrition as well as life style in a closed space. Similarly, but more disadvantaged, is the handloom weaver community in India, which is one of the vulnerable groups.

Many weavers work within a small and closed space. They once enjoyed sufficient food and nutrition when their crafts were acknowledged as an art and valuable product. But as their market got overtaken by cheaper power loom products and Chinese silk thread, the weavers got involuntarily pushed into abject poverty and hunger. Today, the erstwhile silk-weavers of Varanasi and other parts of India like Tamilnadu and Andhra Pradesh are greatly exposed to TB infection.

The Asian Human Rights Commission (AHRC) has consistently reported their plight and held a public hearing on weavers particularly those living in Lhota area, Varanasi district of Uttar Pradesh (UP) suffering from TB and hunger since 2007. Also, recently the AHRC reported malnutrition deaths of five children within seven months in a weaver community of Dhannipur village, Varanasi district of Uttar Pradesh.

The deceased children got neither any vaccines nor nutrition from the public medical institutes in the event of the non-functioning of the Child Care centre or primary health centre in the village. It is feared that other surviving children of weavers who suffer from malnutrition might face the fate of their parents who were once weavers or continue to remain weavers with no other option for an alternate livelihood. Emaciated weavers faced with starvation and TB do not have appropriate access to medical treatment. Very often doctors refuse to attend to them, as they cannot afford to pay. Poor patients are at the mercy of a doctor’s authority.

The government medical policy of merely waiting for the patient who would develop a disease from a latent infection, cannot eradicate TB although huge budgetary investments are made on the Stop TB programme.

Instead, the government has to ensure food security including sufficient and nutritious food and adequate housing for the vulnerable groups, which is the only way to reduce the TB morbidity as well as malnutrition. The prevention of active disease converted from a latent infection is more important than a success rate for cure as reported.

The AHRC has been demanding the government's special consideration to the handloom weaver community in Varanasi. The AHRC once again call for the government attention to the weavers suffering from TB and hunger.

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