除了新冠还有"老对手", 印度正坐在定时炸弹上

 India is sitting on a healthcare time bomb, and no, it is not the coronavirus


By Ragini Saxena

As India’s surging coronavirus caseload becomes an increasing worry for the globe, another health disaster is silently unfolding.


The world’s strictest lockdown crippled both routine and critical health services. More than a million children have missed crucial immunizations and hospital births have shown a sharp decline, indicating many women may have gone through unsafe childbirth at home. Outpatient critical care for cancer plunged 80% from February levels, the latest government data show.


But the biggest crisis is India’s longstanding battle with tuberculosis. The country has as many as 2.7 million TB patients currently, by far the most in the world, and the disease kills an estimated 421,000 Indians each year. The current gap in care could lead to an additional 6.3 million cases and 1.4 million deaths from tuberculosis by 2025, according to a study by Zarir Udwadia, a pulmonologist at Mumbai’s P.D. Hinduja Hospital and Medical Research Centre.

但印度最大的危机是与结核病的长期斗争。印度目前有270万结核病患者,居世界首位,估计每年有42.1万印度人死于结核病。孟买P.D. Hinduja医院和医学研究中心的肺科医生Zarir Udwadia的一项研究显示,由于目前的治疗缺口,到2025年,结核病病例可能增加630万例,并将有140万人死于结核病。


“Miss a few days of any other treatment and you may not be harmed, but gaps in TB treatment will amplify resistance,” Udwadia said. “Our lack of health infrastructure is the reason we have been floundering amidst the sea of Covid cases. It’s the reason why we have not been able to make progress against traditional and old enemies like malaria, typhoid, dengue.”



The failure to control tuberculosis has long plagued successive governments in India, which spends just 1.28% of gross domestic product on public health. That has left the system ill-equipped to control deadly diseases such as coronavirus: The South Asian nation now has the second-highest Covid-19 infection tally in the world, trailing only the U.S.


More than 65 million people in India live in densely packed and poorly ventilated slums like Dharavi in Mumbai, one of the biggest in Asia, which has long struggled with tuberculosis before it became a coronavirus hotspot. The fact that both TB and Covid-19 have a significant overlap in symptoms -- breathlessness, cough, fever -- make these areas critical to controlling both diseases.


The strict stay-at-home orders the country enforced at the end of March shut down India’s giant tuberculosis program for almost three months. In April, one million fewer children received the BCG vaccine that prevents severe tuberculosis, government data shows.


“There should’ve been bi-directional screening from the begng, because in checking for one you may be missing the other,” said Chapal Mehra, a public health specialist and author of “Tuberculosis -- India’s Ticking Time Bomb.” “India has ignored investing in health for three to four decades, and governments across the board have been guilty of this. We lack political will, we lack moral compulsions and we don’t seem to value our citizens’ lives enough it seems.”


While Prime Minister Narendra Modi has been quick to laud front-line health workers, calling them “coronawarriors,” the federal government has only allocated an additional $2 billion to the fund the epidemic’s medical needs. That has sapped resources for non-virus related spending.


A spokesman for India’s Ministry of Health did not immediate respond to requests for comment. Finance Minister Nirmala Sitharaman has said the “government will be increasing investments in public health to be absolutely ready for such eventualities in future.” But she mentioned no specific figure or timeline for this.


India’s health infrastructure is run down at the best of times, with understaffed public hospitals, chronic shortages of hospital beds, low intensive-care capacity and poorly trained staff. India has 1.7 nurses per 1,000 people, 43% less than the World Health Organization recommends, and a dearth of doctors as well.


The pandemic has also exposed the fragility of under-resourced health systems around the region. India’s neighbor Pakistan had 40 million children miss their polio vaccination, while Nepal faced a 50% increase in stillborn babies.


When the pandemic broke out in India, understaffed and overcrowded hospitals had patients slee on the floor until beds were freed up and multiple patients being serviced by a single oxygen station. Limited transport during and after the lockdown also restricted people’s access to primary health centers and pharmacies, resulting in interrupted treatment and delayed diagnoses.


India “takes no crisis seriously” since it deals with so many, and government advisers struggled to mount an effective response to the coronavirus that would also ensure an ability to fight other diseases, according to T. Jacob John, one of India’s top virologists and the former head of the Indian Council for Medical Research’s Centre for Advanced Research in Virology.

印度顶级病毒学家之一、印度医学研究委员会病毒学高级研究中心前负责人T. 雅克布·约翰说,印度“不把危机当一回事”,因为该国要应对的危机太多了,政府顾问们努力制定有效的疫情应对措施,同时确保该国具备抗击其他疾病的能力,


译文来源:三泰虎 http://www.santaihu.com/p/50806.html 译者:Jessica.Wu


Easily fixable. First eat well. Dont live like animals. Be clean. TREAT EVERYTHING ASAP. DO NOW!!!

很容易解决的。首先要吃好,不要像动物一样生活。其次讲卫生,尽快治疗。现在就开始! !


Harshad Rane

True article. The lockdown did slow down the National immunisation scheme and other health goals of India. We will see the effect of this in Substantial development goals. It is true that the TB patient develops resistance against drugs if they discontinued and prognosis of such patients is weak. If we don’t act fast TB will cause more deaths. Minimum of 4% of GDP should be allocated to Health Sector. Lockdown has also affected the polio vaccine schedule, MMR vaccine schedule. Result of this will be seen in longterm.




Amit Khandagale

I don’t understand does this problem mentioned by all hypocrites are there in India since last many years. If India is investing on its military or infrastructure people of India will get benefits. But some people in India as well as out side India think all is not well. As per these analyst India will be bankrupt or no one in India will survive within next few years. Why it so?



Prajeev Prabhakaran

root cause of 99% of the ailments caused by over eating.i.e.Eating more than one requires. One Example is Diabetes. Ever heard a Doctor advising to reduce the Food intake or advice to fasting ? Instead they would advise not to skip any Meal.



varadharajan balasubramanian

Government hospitals are worst. Long back I have gone to Bowring Hospital in Shivinagar in Bangalore and saw rats running around beds with patients. The only choice before Indians is private hospitals.



hari krishna Johri

Pathetic state of affairs. Disgusting.



Harminder Puri

India has purchase latest fighter planes from France to fight these diseases,. How much India is spending on defence the biggest buyer of weapons, just to be a world power, ignoring it is not the land but people who make the country great.




What the BJP will get if they save the children



varadharajan balasubramanian

Our twin enemies Pakistan and are trying to destroy us through all means. Any time may attack us through a limited scale to downsize us. What choice has the Government ? If we dont have weapons as was the situation 1962 then will occupy half of our land and Pakistan not only Kashmir even other parts of India.




These Bloomberg and Reuters articles written by Indian correspondents refer to India as a "South Asian" country. If the readers are indeed ignorant of India or where it is, they might as well be ignorant of where South Asia is.



Parvez Iqbal S. I. H

It is very sad to learn about the TB bomb which is about to explode. This is the time India sho ld invest in Healthcare facilities rather to spend billions of dollars in defence budget.



Bush Gulati

A leading veterinarian in India once told me that the vast majority of cows,dogs,monkeys and pigs that roam freely and live cheek by jowl with the denizens of India are stricken with tuberculosis or some other communicable disease.

Is there nothing we can do about curbing their population control?



Preetesh Sahani

We cant make a difference in immediate near future but yes we can expect to see the change in next 20 to 30yrs time.



Mohan Sharma

So many Young MBBS n Dentist who are qualified but don't have Job n Not paid properly. Govt's should give them break to cope up the current situation .



Sujit Ghosh

We have policy makers for the country. They make policies benefiting their political exstence. We dont want to do good to ourselves.


Yash Pal

'They make policies benefiting their political exstence.'

Beautifully summed up the root cause of the crisis


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