Politics of the Revised National Tuberculosis Control Programme

I came across Ranjith Babu and his colleagues’ exceedingly ambitious article titled, “Resource Optimisation for Tuberculosis Elimination in India” (EPW, 7 May 2016). It comes from a little- known organisation called the “Union South East Asia, New Delhi.” I have been working on tuberculosis (TB) as a public health issue in India and also on a global scale since 1960. Frankly, I felt bewildered reading it. Unwittingly, it provides documentary evidence of the profound decay and degeneration of the very scientific basis of the discipline of dealing with TB as a public health problem in India. It lays bare the long and very painful account of how some of the rich countries have unscrupulously and ruthlessly used their influence on international organisations such as the World Health Organization (WHO), World Bank and UNICEF and major non-government organisations (NGOs) such as the Global Fund to Fight AIDs, Tuberculosis and Malaria, the Bill and Melinda Gates Foundation, the Global Vaccine Safety Initiative and International Union Against Tuberculosis and Lung Disease to impose their agenda on TB on the poor countries of the world.

Significantly, the article fails to deal with all the three issues it sought to discuss in the heading; the authors are far off the mark when it mixes up “resource”—which should have also included issues such as manpower development, organisation, management and people’s response—with mere spending of money (that too in dollars!); there is no mention whatsoever of how they intended to opitimise the systems using interdisciplinary research tools such as operational research and systems analysis, as, for instance, was done in the formulation of the National Tuberculosis Control Programme (NTcP) in the famous Anantapur study at the National Tuberculosis Institute (NTI) of India in 1963 (Banerji 2012). Finally, in picking up the highly fragile WHO jargon of “tuberculosis elimination,” the authors do not even give the epidemiological context in which the term is used. Then, where does the article stand? It is not only needless but also a somewhat crude effort to put pressure on the obviously uninformed and not-so-competent bureaucrats, clinics and political leaders who make decisions on behalf of the people of India. It is irresponsible and unethical.