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Tuberculosis in India

BMJ 2015; 350 doi: (Published 23 March 2015) Cite this as: BMJ 2015;350:h1080
  1. Zarir F Udwadia, consultant physician, P D Hinduja National Hospital and Medical Research Centre, Mumbai, India,
  2. Chapal Mehra, public health specialist, New Delhi, India
  1. Correspondence to: zfu{at}

An ancient enemy just gets stronger

Twenty years ago it was widely believed that India was successfully on its way to controlling its alarming tuberculosis (TB) epidemic. The country’s massive scale-up and implementation of directly observed treatment short course (DOTS) therapy under the Revised National Tuberculosis Control Program (RNTCP) was lauded internationally as a global model of excellence.

Yet this represented only half of the story of TB in India. A terrifying picture of the death, devastation, poverty, and suffering caused by TB began to emerge almost two decades later, when it became apparent that TB in India was not just a national crisis but a global one. Each year India has 2.2 million new cases, more than 300 000 deaths, and economic losses of $23bn (£14.9bn; €20.3bn) from TB,1 making it India’s biggest health crisis.

At …

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