E D I T O R I A L

Kathmandu, Wednesday March 26, 2003  Chaitra 12,  2059.

TB awareness

The World Tuberculosis Day was observed in Nepal amid great fanfare, perhaps like in the rest of the world. Prime Minister Lokendra Bahadur Chand participated in the celebration, highlighting the importance this country attaches to eradication of this deadly disease. Chand may not be far from truth when he pointed out that one of the main causes of the disease was the incidence of poverty that is so rampant in the Himalayan Kingdom. According to statistics, every year about 7,000 people die of the disease in Nepal and scores of thousands more are afflicted with the same. This does not make a pleasant reading. But efforts are on in Nepal and in the rest of SAARC countries to bring the disease under control.

The new scheme known as DOTS is presently being used in most parts of the world to control the spread of the disease and cure the afflicted persons. The programme has been going on in the country for about a decade. And this is where the catch lies. For several years, the figures given are virtually the same. The point is if DOTS were as successful in Nepal as it is being claimed to be, why have not the death rate and new case rate come down? There is little doubt that DOTS is a viable and reliable programme and its proper implementation can indeed bring down the death and new affliction rates. This being so, the question that needs to be asked is whether the programme is being honestly implemented. Or is the government claiming success on the basis of the micro-level monitoring while the macro-level situation remains hardly changed? Eradication of tuberculosis is a big challenge in a country like Nepal where there are not enough para-medics to ensure proper health care for all. The DOTS programme makes it mandatory for every patient to be administered the daily dose of medicine in the presence of volunteers or other qualified persons.

The difficult terrain of the country is indeed a challenge for those responsible for implementing the programme for one cannot ask TB patients to walk half a day every day to receive his or her dose of medicine. No doubt, the authorities are trying to avoid this kind of tardiness by stationing volunteers or others in each village. But this is still an uphill task. However, this is a task that must be done properly not only in this country but in other SAARC countries and especially in countries that have open borders through which not only men and women can pass freely but they can also freely transport the disease from one country to another. The government and its implementing agencies need all the support to make DOTS a real success story. For TB at present comes in many forms, and is said to be closely tied to other killer diseases like HIV-AIDS. But the government should stop making tall claims of success and implement the DOTS programme honestly and earnestly. The people themselves need as much awareness about the disease as possible so that they themselves can take preventive measures.