The Growing Tuberculosis Threat: Can India Control This Drug-Resistant Threat?
ON THE MORNING OF 14 OCTOBER 2011, Zarir Udwadia, one of India’s foremost chest physicians, sent an email halfway around the world, to the Boston offices of the medical journal Clinical Infectious Diseases. The message was a brief one: just 15 sentences of precise, academic prose, submitted to the correspondence section of one of the most prominent journals in its field. The letter, jointly authored by Udwadia, microbiologist Camilla Rodrigues, and their research registrars, Rohit Amale and Kanchan Ajbani—all colleagues at Mumbai’s PD Hinduja Hospital—recounted their struggles to treat patients suffering from increasingly drug-resistant forms of tuberculosis. As the letter stated, “We describe the first patients from India with TDR Tuberculosis.”
This sentence, innocuous to untrained eyes, spawned the sort of reaction rarely seen in the measured world of the medical sciences. The letter was first published online on 21 December, and immediately caught the attention of the medical community: doctors, health officials and scientists put aside their post-Christmas ennui to debate the implications of this dramatic announcement. But this was just the calm before the storm.
Two weeks later, on 7 January 2012, Udwadia’s findings were splashed across the front page of the Mumbai edition of The Times of India, under the headline ‘New, deadlier form of TB hits India’. Correspondents for foreign newspapers immediately picked up the story, and soon the news was zipping through wire services and hitting front pages across the world.
Udwadia became something of a celebrity, at least in medical circles—he joked that his career “peaked in January”—as requests for reprints of his letter poured in from doctors and journalists. Health authorities also began to take note: within 10 days of the Times of India report, India’s Central TB Division, part of the Union health ministry, sent a three-member fact-finding team to Mumbai. A few months later, tuberculosis was declared a notifiable disease, a designation that requires private doctors to inform the health ministry of all tuberculosis patients they treat.