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.