Tuberculosis has long been identified as a major killer among the Nepalis. But there is a relatively robust mechanism set up to tackle it. For example, there is the National Tuberculosis Centre which devises strategies to control the spread of the disease. The afflicted also can avail of free treatment through the Directly Observed Treatment Short course, better known as DOTS, under which those suffering from tuberculosis are administered medicines in a number of health centres, dispensaries and clinics across the country. The service has been quite a success although there are those habitual skippers who do not report for the next dose. Such erratic behaviour, however, has been a major problem in tackling the spread of the disease as it often makes the bacteria multi-drug resistant. And there are those who develop drug resistance even under strict therapy, luckily for whom, the Centre is planning to introduce DOTS Plus service, courtesy the World Health Organisation.

According to one estimate, around 90,000 Nepalis suffer from tuberculosis, and the number is rising steadily. A disease that claims over 8,000 lives annually is a serious killer and if left untreated the fear of confronting even stronger strains of the disease looms large. But if the anti-tuberculosis drive has not achieved its goal it is because a large number of people do not report for check up. It is also because the efforts have been unable to effectively penetrate the rural areas, where, prevailing illiteracy has bred ignorance and lack of sanitation and hygiene combined with poverty have all earned tuberculosis the sobriquet, “the disease of the poor.” If it is important for the health officials to make available DOTS Plus along with the DOTS course, it is also important for the health workers to join hands with social workers and organisations to tackle the disease.

Another nightmare arising out of tuberculosis is drug resistance among those who have already tested positive for HIV, another health battlefront. An earlier estimate has it that 17 per cent of HIV/AIDS patients have contracted tuberculosis, including multi-drug resistant strains. The surest way of tackling the disease is to raise awareness. And it is important to inform people that completing a drug regimen is vital. Family support for anyone suffering from tuberculosis is no less important, while care must be taken about the communicable aspects of the disease. Because tuberculosis takes a longer period of time to be fully cured, the overall effect it produces for the patients after combining with other ailments makes it all the more virile and dangerous. There must not be any let up in the government’s efforts to fight tuberculosis.