Despite taking various initiatives to eradicate TB and setting an ambitious target of 2025 for elimination of the disease in India, drug-resistant TB still remains a major halth crisis in the country.

Going by the defiance of the ancient disease despite advancements in medical science, the bacteria may persist in several Indians even beyond 2025 -- the deadline set by Prime Minister Narendra Modi to eradicate tuberculosis from the country. Day before the World Tuberculosis Day on March 24, the Prime Minister set the deadline to eradicate the epidemic from India, which accounts for 25 per cent of the global tuberculosis cases. This is five years ahead of the 2030 deadline set by other countries.

"Globally, TB incidence is falling at about 2 per cent per year. This needs to accelerate to a 4-5 per cent annual decline to reach the 2020 milestones of the 'End TB Strategy'. Ending the TB epidemic by 2030 is among the health targets of the Sustainable Development Goals," said World Health Organization (WHO) on its website. TB is one of the top 10 causes of death worldwide. In 2016, 10.4 million people fell ill with TB and 1.7 million died. Over 95 per cent of TB deaths occur in low-income and middle-income countries. Seven countries account for 64 per cent of the total, with India leading the count, as per WHO.

While the Indian government has given itself an ambitious target and taken several steps to reach it, including jail terms for doctors, hospitals and chemists if they fail to report TB cases, the country is facing the threat of rise in multi-drug resistant tuberculosis (MDR-TB). Though the number of new cases has been falling for some years, multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat.

"India accounts for about a quarter of the global TB burden. Worldwide India is the country with the highest burden of both TB and MDR TB. Over the period of years, it is observed that not all tuberculosis cases are new patients. Significant patients present to us with recurrence or relapse of tubercular infection," said Dr Sandeep Nayar, Senior Consultant and HOD, Respiratory Department, BLK Super Speciality Hospital.

However, tuberculosis is curable and preventable. "The treatment is a lengthy one but most patients who take medications in a proper way can beat the disease effectively," said Dr Puneet Khanna, Senior Consultant & Head, Respiratory Medicine Intervention Pulmonology and Sleep Medicine, Aakash Healthcare Super Speciality Hospital. The disease spreads through air and the symptoms include cough, fever, weight loss, chest pain, and fatigue.

"Early diagnosis can cure TB completely. The complete course of TB treatment is minimum 6 months. In certain cases, patients do not respond to the commonly used TB treatment. There is an increase in MDR TB patients in last few years. Prevalence of MDR TB is almost 4-7 per cent," said Dr Salil Bendre, Chest Physician, Nanavati Super Speciality Hospital. Tuberculosis is one of the oldest and serious illnesses known to mankind, which, despite advances in medicine and vaccination, continues to cause high mortality.

"We are already seeing a rise in the number of Multi-Drug Resistant (MDR) and Extremely Drug Resistant (XDR)-tuberculosis. Such cases are extremely difficult to treat and are a major cause of mortality," said Dr Pradeep Mahajan, Regenerative Medicine Researcher, StemRx Bioscience Solutions Pvt Ltd. "The need of the hour is newer treatment modalities that target the disease from an unconventional angle. Cell-based therapy/ immunotherapy is one such modality wherein cells from ones' own body may be used to treat TB," said Mahajan.

Dr Animesh Arya, Sr Consultant in Respiratory Medicine, Sri Balaji Action Medical Institute said, "It is advisable to maintain a good immunity and avoid coming into contact with people having tuberculosis. Few basic hygiene practices should be adopted like covering their mouth while coughing, refrain from spitting in public areas and to follow proper medication regimen."

Further, as per Dr Sweta Gupta Clinical Director and Sr Consultant - Fertility Solutions, Medicover Fertility, tuberculosis causes tubal damage, resulting in rigid, pipe-like tubes which further impairs transport of egg from the ovary. When endometrium is damaged due to TB, it may lead to recurrent implantation failure, miscarriage, and recurrent pregnancy loss.