ON 24 MARCH 2023, commemorated by the World Health Organization as World Tuberculosis Day, Prime Minister Narendra Modi inaugurated the One World TB Summit in his Lok Sabha constituency of Varanasi. With characteristic and unearned confidence, Modi reiterated his promise, first articulated five years earlier, to eradicate the disease in the country by 2025. As part of his claims to world leadership during India’s presidency of the G20, he boasted that “India’s efforts are a new model for the global war on tuberculosis.”
The doctors and patients actually waging the war had a damning assessment of this “new model.” In 2023 alone, over three hundred and twenty thousand Indians died of tuberculosis—a curable and preventable disease—accounting for over a quarter of the global mortality figures. Today, thanks to rampant misgovernance, India’s 2.8 million tuberculosis patients struggle to access the drugs that would save their lives. “It is like we have learnt nothing from COVID-19,” Ganesh Acharya, a tuberculosis survivor and activist, told me. “We are in a public-health emergency of genocidal proportions. It sounds like an exaggeration, until you look at the number of people dying.” Two separate epidemiologists used a different term: policide, or death by policy.
A hallmark of India’s failure to control tuberculosis—one that should define the Modi years, much like Thabo Mbeki’s government in South Africa is remembered for its AIDS denialism in the early 2000s—is that politics has trumped science, as well as humanity, every step of the way. The Modi government’s flagship tuberculosis control policy, the Pradhan Mantri TB Mukt Bharat Abhiyaan, creates a medical dystopia in which corporations, non-profits and individuals are invited to “adopt” patients. By pledging support for up to three years, the donors, known as Ni-kshay Mitras, can get themselves photographed handing food baskets to patients. “TB has so much stigma, and the government is using patients as props for photo-ops,” Acharya said. “It is so humiliating.”
President Draupadi Murmu launched the scheme, in September 2022, by noting that, “in some patients or communities, there is an inferiority complex associated with this disease, and they view the disease as a stigma.” Murmu was, in essence, placing the blame for the stigma on the stigmatised. “Everything has become a photo-op for some director of some company, without any care for how patients are being robbed of their dignity,” a tuberculosis researcher told me, on condition of anonymity. “This is an infectious disease. Confidentiality has to be maintained. Historically, Indian governments have implemented food delivery schemes without this tacky photo app.” According to a government dashboard, over a hundred and sixty thousand Ni-kshay Mitras have committed to supporting nearly a million patients by providing food baskets worth Rs 700 per month. Almost eighty percent of the donors have signed up for just six months.