More than a third of TB cases and almost two-thirds of drug-resistant cases are found in the BRICS countries — Brazil, Russia, India, China and South Africa, collectively seen as drivers of global economic prosperity and innovation that attract huge sums of foreign investment and that have burgeoning middle classes. The BRICS countries must stop the spread of this scourge by investing in health care delivery systems that are able to find, diagnose and treat individuals exposed to and sick from TB. They must also put a priority on care for poor and vulnerable populations.
This is not news to health officials in these countries. In January 2013 the minister of health from each BRICS country gathered in India and announced they would put together a framework and collaborate on projects to expand access to treatment for tuberculosis and to improve the quality of treatment. Yet little progress has been made toward this goal.
Stopping a TB epidemic is difficult but not impossible. New York City had an epidemic of the disease in the late 1980s, fueled by a rise in HIV, homelessness and underfunding of its public health system. At one point, the rates in parts of the city were as high as we see in India today, more than 200 cases per 100,000 people. Standard epidemic control approaches were followed: actively locating those already sick, putting them on the correct treatment immediately, using preventive therapy to protect individuals exposed to the bacteria, ensuring that patients received the clinical, economic and social supports that they needed to successfully complete therapy, and strengthening the local public health system so that it was able to deliver comprehensive care to patients outside of the hospital setting. As a result, the epidemic was halted.
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