India and the United States are natural partners with a long history of collaboration on the fight against tuberculosis. At U.S. Mission India, the U.S. Centers for Disease Control and Prevention (CDC), the U.S. Agency for International Development (USAID), and the National Institutes of Health have invested more than $150 million with in-country partners since 1998 in the fight to end TB in India by the Government of India’s 2025 target.
U.S. Mission India has supported a number of events commemorating World TB Day 2018 (March 24). First, staff from USAID, CDC, and other agencies attended the End TB Summit (March 13-14), which Prime Minister Narendra Modi inaugurated, and the Stop TB Partnership Board Meeting (March 14-15). Dr. Hamid Jafari, Principal Deputy Director of CDC’s Center for Global Health, and Irene Koek, Senior Deputy Assistant Administrator in USAID’s Global Health Bureau, gave remarks. These highly significant global meetings precede the United Nations General Assembly TB Meeting, which will take place later this year. Their location in New Delhi was noteworthy for the city and the country, particularly given that India has the greatest global TB burden—including multidrug- and extensively drug-resistant strains. During the meeting, CDC’s Global Health Security Agenda partner ICMR received the Kochon Prize for TB Research in recognition of its large body of research across the span of several decades.
Second, USAID Mission Director Mark Anthony White gave the keynote address at the REACH Media Awards for journalists who exhibited excellence in reporting on TB, especially sensitive reporting including human interest stories on TB patients in India. Cheri Vincent, USAID’s Chief of the TB Division in Washington, D.C. served as a panelist at this event.
Third, CDC and USAID co-hosted a panel at the American Center in New Delhi on “Women in TB: Leading the Fight against TB in India.” This panel, which CDC India TB Branch Chief Dr. Christine Ho moderated, featured City TB Officer & Deputy Executive Health Officer, Municipal Corporation of Greater Mumbai Dr. Daksha Shah; Deputy Director, Resource Group for Education and Advocacy to Community Health Ms. Anupama Srinivasan; TB survivor-activist Ms. Mona Balani; and filmmaker-activist Ms. Rhea Lobo. Panelists shared how they have become TB champions and discussed the stigma that disproportionately affects female TB patients and survivors in India. They also discussed the central role women often play in coordinating healthcare in their families and communities. In discussing the stigma female patients and survivors face, Ms. Srinivasan stated, “Five years ago, we wouldn’t have had two survivors on this panel,” because women are often discouraged from sharing their experiences with TB out of fear of divorce, canceled engagements, and shunning, among other issues.
At CDC, work with the Government of India has helped improve tuberculosis treatment outcomes and address drug resistance. Over the past year, CDC has used full-panel drug susceptibility testing for over 1,000 patients who had rifampin resistance diagnosed by CBNAAT, a test that detects TB bacteria and resistance to the TB drug rifampin in two hours. Without this enhanced diagnostic testing, the 44% of patients with multiple drug resistance would have received sub-optimal treatment, diminishing their chances of being cured. CDC’s additional activities have included partnering with private providers to diagnose TB earlier, building communities of practice through new approaches such as tele-mentoring to train TB providers on the management of complex drug-resistant TB, and implementing a program to control airborne TB transmission in healthcare facilities.
At USAID, collaboration with partners has helped diagnose and treat 15 million people with tuberculosis. USAID supports the application of local intellectual, financial, and technical resources that increase cross-sectoral support for combatting the disease. One instance of this collaboration is USAID’s work in mega-million cities through healthcare professional training to ensure that urban patients—particularly slum dwellers and other low-income populations—are diagnosed on their first visit to a healthcare facility. USAID is also working to raise awareness about the disease, reduce social stigma (especially among women), and empower communities to take an active role in the effort through the Government of India’s Call to Action for a TB-free India campaign launched in 2015.