Sunday, January 15, 2023

MEDICAL SYSTEMS

NOBLE PROFESSION

hit a bad patch

Dr. T. Rama Prasad May 2024

An artist’s depiction of a hospital in COVID times.

To add a tad of glamour and gaiety to the gloomy picture of the tragedy, I painted a few figures going around dancing.

The ‘COVID medical scenario’ offered a paradox of people being afraid of hospitals and of hospitals being afraid of people.

SCARED of HOSPITALS & SCARED of PATIENTS

Before I scribble something about the surrealistic subject of "MEDICAL FEAR" among the public and the professionals, let me pen a few lines about the ongoing tug of war in the Supreme Court about a case of conundrum among systems of medicine in India.

BATTLE BETWEEN SYSTEMS OF MEDICINE

India provides various systems of medicine, official and unofficial. Presently, in 2024, a legal war is being fought between ‘Allopathy’ (Indian Medical Association - IMA) and ‘Ayurveda’(Patanjali Ayurved). It is alleged that ‘Patanjali Ayurved’ discredited ‘Allopathy’ and made false claims of cure through ‘Ayurveda’. After a few hearings of the arguments, it seems that a little war broke out between the IMA and the Supreme Court. The court is reported to have criticised the practices of private doctors – “the phenomenon of inflated bills and doctors allegedly prescribing over-priced medicine brands in cahoots with pharmaceutical companies.” In turn, the IMA chief, R. V. Asokan, is reported to have said : “It does not behove the Supreme Court to take a broadside against the medical profession of the country which after all sacrificed so many lives for the Covid war.”Reacting to this, Justice Hima Kohli is reported to have asked the IMA lawyers : “After all this, you dothis ? The IMA has not coveted itself with glory … How can you decide which way we [Supreme Court] should go ?” (THE HINDU, May 1, 2024). At last, the Supreme Court has slammed both the parties. Whatever be the system, let’s call a spade a spade. The ‘Patanjali case’ seems to be a clear example of violation of checks and balances which called for stepping in of courts to regulate the regulators for actions without fear or favour. Which is the “noble” system ? Let’s wait for the final verdict. Ultimately, it is the judgement of the PEOPLE that matters, not of the Supreme Court, not the Government, or the professional bodies. A majority of 44,000 out of 70,000 hospitals exist in the private sector in India. This apparently speaks good of the private hospitals as people voluntarily seek treatment at the private hospitals. No doubt, there are excellent hospitals and dedicated doctors in India. But, but, but … read the following.

SCARED of HOSPITALS

No, it’s not the fear of injections, procedures or ventilators when it came to ‘COVID hospitalizations’ especially during the ‘second wave’ in

This is the first page of my article of 20 pages -- T. Rama Prasad

https://drtramaprasad.blogspot.com/2017/04/noble-profession.html

Tuesday, January 10, 2023

MODERN WELLNESS CENTRES

MODERN WELLNESS CENTRES

Dr. T. Rama Prasad

Wellness centres are facilities focused on holistic health, promoting overall well-being through preventive care, lifestyle improvements, and a balance of physical, mental, and emotional health. Unlike traditional gyms (which emphasize fitness alone) or hospitals (which treat illness), wellness centres integrate services like yoga, meditation, massage therapy, nutrition counselling, fitness classes, acupuncture, stress management, and sometimes medical screenings or alternative therapies.

They create relaxing, supportive environments to help prevent disease, reduce stress, and enhance quality of life, often catering to mind-body-spirit alignment.

MODERN WELLNESS NATURE POOL

The zeal to be more healthy and to live longer is gaining steam around the world. It started with biohacking (experimenting with regimens and supplements to improve body performance) and extended to variants like cryotherapy, light therapy, oxygen therapy, gravity therapy, injecting supplements, yoga practice, meditation modifications, mind engineering, etc.

'Wellness Centres' had been in existence for a very long time as extensions of luxury health facilities attached to many high-end holiday resorts. The 'Westin Resort & Spa’ in Himalayas still holds space for the traditional practices for deeper emotional calibration through a luxurious escape from the chaos of urban life to a forest stay with chirping mornings and dancing waterfalls tempered with Ayurvedic massages and sunrise yoga. 'Swastik Luxury Wellbeing' in Peacock Valley in ‘Khadakwasla Pune’ is one more centre.

The escape from the din of a city life has, of late, taken a further step to the extreme of SILENCE which is golden for some. In 2026, the ‘silent’ wellness tourism (hush tourism)is evolving into a major industry trend -- a niche trend with silent destinations with AI concierges and silent dead zone cabins with no Wi-Fi or cellular signal. Minimal human interaction – even the reception area is silent without receptionists (replaced by digital-only check-ins) and without small talk with staff or other guests ! It’s a refuge from auditory overstimulation leading to peace, healing and transformation. For the ‘auditory detoxing’, ‘Ayana Resort’ in Bali, ‘Six Senses Vana’ in Uttrakhand, ‘Santani Wellness Resort’ in Sri Lanka, and ‘Chiva-Som International Health Resort’ in Thailand are some to choose from. Ladakh, Uttarkhand, ‘The Azores’, Portugal (Islands of Silence) and ‘Atacama Desert’, Namibia, Middle East (for silent stargazing / celestial observation), and some centres in Himalayas are some more in this category which are becoming popular.

The wellness travel to 'spa breaks' in Bali or 'Ayurvedic retreats' in Kerala seems to be old-fashioned and passe, with the establishment of ultramodern establishments all over the world with cleverly crafted introductory words of incomprehensible pseudoscientific expressions --- science and rituals stitching together BODY, MIND and SPIRIT; rewiring of neuro pathways; etc. The ''wellness language' is borrowing more and more fancy jargon from the neuroscience and psychology using terms like "emotional detox" and "dopamine fasting and "neuroelectric modelling" and "metacognition" and so on.

AI stepped in

As the wellness industry is advancing, wellness tools like 'Mindfulness apps', 'Headspace', 'Calm', generative artificial intelligence like 'Chat-GPT', etc. have stepped in. Clients are increasing in number, partly due to chronic exposure to toxins -- from blue light to environmental pollution, leading to cellular exhaustion. Many of the 'modern' wellness centres are located in posh localities and high-cost resorts.

Even on the USA’s Silicon Valley frontiers, a wide array of unproven and unregulated ‘Chinese Peptides’ has taken hold. People are using BPC-157 and TB-500 to stimulate new blood vessel growth for faster healing of injuries; oxytocin for improving eye contact (an OpenAI researcher called it “Ozempic for autism”); epitalon for sleep enhancement; and retatrutide (a next generation weight loss drug, still in clinical trials) for everything from appetite suppression to increased focus of mind !

Imports into the USA of hormones and peptide compounds from China doubled to $328 million in the first nine months of 2025 from the same period of 2024. All for unproven benefits. The FDA of the USA has warned that many peptides pose “serious safety risks” because of potential impurities and immune reactions.

Gravity & temperature

At a sleek retreat outside Lisban, guests float in a chamber of 1,200 pounds of Epsom salt, where gravity is suspended and the brain is said to enter a theta-wave, with an experience described as eerie and liberating.

In Goa, at a luxury wellness centre, clients emerge from minus 110 degrees cryo-chambers / pools claiming that they are exhilarated, their metabolism jolted awake and their mood lifted by a rush of endorphins. In some centres, alternate ‘cooling’ and ‘heating’ is adapted.

Visuals, Vitamins, and water

Numerous wellness centres have come up -- in Rishikesh, headsets project visuals tailored to stress levels, transporting one into digital versions through Visual Reality Technology (VRT).

In another biohacking centre, a suffusion of magnesium or glutathione or vitamins, along with sipping of water infused with ‘adaptogens’ is practised for ensuring better health. In some centres, expensive drinking water is sourced from some remote mountain ranges, deep oceans, and selected places for special benefits. And, some supply expensive packaged and branded drinking water -- Rs. 30,000 (thirty thousand) for 750 ml; ‘cheaper’ ones at Rs. 700 for 355 ml; and there are many other imported costly brands such as Kona Nigari, Saratoga Spring water, Voss Artesian, Perrier, San Pellegrino along with the Indian premier aqua brand Aava. Water, like wine, has different taste, texture, and mineral content, when sourced from different regions.

At Aravallis, near Jaipur, guests step into sensory deprivation pods filled with warm saline water.

PEPTIDES

Peptides are short chains of amino acids, the basic building blocks of proteins in the body, that regulate hormones, metabolism, immune. responses and reduce inflammation. In therapy, these peptides are used to mimic the body's natural signals and send targeted instructions to certain cells. They are generally better tolerated than some conventional drugs. Some best known and currently popular peptides are in the weight reducing GLP-1 class of drugs (semaglutide, tirzepatide, etc). But in the gray market, many unproven and unapproved peptides are available -- BPC-157, and TB-500 for healing injuries; epitalon for sleep disorders; retatrutide for weight loss; and some others for anything from stomach problems to mind disorders. Many of them come from China, and the US imported more than $300 million in the first nine months of 2025. People are using them as 'biobackers', while the FDA of USA has warned that many peptides pose 'serious safety risks'. However, more than 80 peptide-based drugs are currently being studied, and many of hem are already being used in wellness, fitness and anti-ageing centres, as peptides are promoted as a 'targeted and advanced' way to improve health, appearance and performance. The safety issue remains unknown.

Sound & Yoga

At 'Siddhayu Wellness Ayurveda', an immersive sound approach is said to infuse natural ambient sound, spiritual chanting of mantras, and mindful stillness, creating a deeply resonant and healing sonic environment.

In Gujarat, the 'WOODS' at Sasan, the 'Sonorium Sound Healing Space' and the 'Sound Healing Bed' are considered to guide guests through a 30-minute 'Five Elements Journey' which realigns body energy.

In Iceland, geo-thermal sound baths combine hot springs with immersive soundscapes. Japan's futuristic spas now offer Virtual Reality Meditation (VRM) pods. The Maldives introduced submarine yoga activity in glass pods under turquoise waters where 'manta rays' glide past as witnesses.

Red-light & Oxygen

At 'Fairmont Mumbai', 'Red-light therapy' is claimed to stimulate collagen production, boost cellular repair and reduce oxidative stress, and they combine Indian Naturopathy with precision diagnostics.

At Atmantan, it is claimed that ‘Reax Neuroreactive Training’ (RNT) induces wellness by enhancing reflexes, coordination, and sensory responsiveness through dynamic, real world stimulus training.

Hyperbaric Oxygen Therapy (HOT) is positioned to replicate a mountain escape's rejuvenation, easing brain fog amid the city's hustle and bustle, at the 'Blu Xone' centre.

Back to Grandma

The 'WOODS' also offers culinary healing treks, where food is tailored to be a medicine by local grandmothers who forage herbs into broths that soothe gut, mind and spirit.

Various wellness centres offer various methods, claiming various benefits using various pseudoscientific and technical terms.

In these days of digital fatigue and stressful life, running parallel to overstimulation of the senses, people are confused and hence run to these exotic and expensive wellness centres. There are always celebrities to testify the benefits. Did not the former Prime Minister of India, Morarji Desai, who practised drinking his own urine and lived a long healthy life, wrote a book on the benefits of drinking one's own urine which costs nothing !!!

It all started with BIOHACKING practices long ago. Biohacking means making small, intentional changes to your diet, lifestyle, environment, or using technology to "hack" your biology and optimize your health, energy, mood, and mental or physical performance, ranging from simple habits like sleep optimization to more complex self-experimentation.

It's a DIY approach to self-improvement, essentially applying a hacker's mindset to your body's systems for better function.

Common Biohacking Practices

Diet & Nutrition:

Intermittent fasting, reducing refined carbs, mindful eating, or timing meals for steady energy.

Sleep Optimization:

Improving sleep quality for better health, stress management, and immunity.

Mindfulness & Focus:

Meditation, breath-work, and structured work/break cycles for cognitive enhancement.

Environmental Adjustments:

Using light exposure, cold therapy (like cold showers or ice baths), or sound therapy.

Technology & Wearables:

Using devices to track data (sleep, heart rate, etc.) to inform changes.

Supplements & Nootropics:

Using substances like caffeine strategically or exploring other cognitive enhancers.

BILLIONAIRE’s BURROW

In the sculpted valleys of Cappadocia (Turkey), the ultimate WELLNESS symbol is a Rs 3.5 lakh-a-night palatial suite carved into ancient volcanic stone. The concealed hotels like ‘Museum Hotel’ looks from outside like folded cliffs and fairy chimneys. Inside, are super-luxury chambers, carved from volcanic stone and layered with silk, marble, crystal and curated antiquities. The ambience expands into multi-level fantastic accommodation with private courtyards, heated indoor cave pools and dedicated five-star butler service. Limestone walls rise into cathedral-like ceilings, and the floors are dressed in hand-woven Anatolian carpets, and bathrooms gleam in heated marble with free-standing soaking tubs set beneath arched alcoves. ‘Argos hotels’ stretches across restored monasteries and subterranean tunnels in cinematic fashion, with vaulted salons, hidden passageways, private wine cellars and candlelit private indoor cave pools. Suites are built around preserved archaeological features and Ottoman artefacts, some with private plunge pools, overlooking ‘Pigeon Valley’ and its sunrise ballet of hot air balloons. And many more, including private hot air balloon charters and helicopter transfers. For destination weddings and milestone celebrations, the charges are around Rs 50 lakh per night. All this is said to bring a lot of WELLNESS to the rich.

-- Dr. T. Rama Prasad

Go to : https://drtramaprasad.blogspot.com/2023/01/right-or-wrong.html

Monday, January 9, 2023

World TB Day 2026

India is the first in the list of the countries with high burden of tuberculosis (TB).

If there is an effective VACCINE, we have to search for a case of TB !!!

An alternative to the vaccine is to lift the living standards to that of the 'developed' countries !!!

https://drtramaprasad.blogspot.com/2023/01/world-tb-day-2026.html

INDIA is the "TB hub of the WORLD."

For more on TB, written by Dr. T. Rama Prasad, click on :

(1) https://drtramaprasad.blogspot.com/2023/01/tuberculosis-in-2026.html

(2) https://drtramaprasad.blogspot.com/2017/04/tb-and-covid.html

(3) https://drtramaprasad.blogspot.com/2017/04/tuberculosis-in-india_29.html

(4) https://drtramaprasad.blogspot.com/2023/01/tuberculosis-drug-resistant.html

(5) Rama Prasad, T., COVID and Tuberculosis. The Antiseptic, 2021 December;

Vol. 118; No.12; P: 11-17; Indexed in IndMED -- www.antiseptic.in

Certain wars can't be won by money and missiles (TRUMP should know about it). The same is the case with our WAR against TB. We deployed (all free of cost) latest AI-powered portable X-ray machines, molecular testing facilities, latest treatment strategies including BPaLM regimen, nutrition support ('Ni-Kshay Mitra Yojana'), money support of Rs 1,000 every month ('Ni-Kshay Poshan Yojana'), under 'Pradhan Mantri TB Mukt Bharat Abhiyaan', and a lot more, for a long period. Yet, the WAR is going on with our position at the top of the list of countries with high burden of TB in the world. Let us continue to fight, as there is no option for a TRUCE !!!

WORLD TB DAY -- March 24, 2026

, the war is going on

Writer : T. Rama Prasad

Email ID : drtramaprasad@gmail.com

For the OPENPAGE of THE HINDU

India has the dubious distinction of being the "TB capital of the world"

On March 24, 1882, Robert Koch announced to the Berlin Physiological Society that he had discovered the cause of tuberculosis (TB) – TB bacillus. To commemorate this, March 24 is celebrated as World TB Day. It is ironical that India, despite being the fastest growing economy in the world, continues to grapple with a high burden of TB, an age-old disease, both preventable and curable. India has the highest (2.5 million TB patients) tuberculosis (TB) burden globally, consistently accounting for around 25-27% of the world's TB cases despite significant progress in recent years. The figure may even be higher, as many cases may have been missed. And sadly, more than 300,000 people are dying annually due to TB in India.

OVERAMBITIOUS : India's National TB Elimination Programme (NTEP) — formerly the Revised National TB Control Programme (RNTCP) — aims to eliminate TB (reducing incidence by 80% and deaths by 90% from 2015 levels, with zero catastrophic costs for patients) ahead of the global 2030 target. India set an ambitious goal to achieve this by 2025, but the country has missed that deadline, as progress — while impressive — has not reached the required scale amid challenges like undernutrition, socioeconomic disparities, stigma, delay in care seeking, rural diagnostic gaps, non-adherence to treatment advice, drug resistance and lack of empathetic psychological support. Of course, it’s better to aim for the unachievable rather than not attempting to achieve.

The government of India worked hard for elimination of TB by 2025, five years ahead of the global target of 2030. The India’s ‘National Strategic Plan (NSP)’ aimed for elimination of TB by 2025. But the country is nowhere close to that goal. Statistics on the current scenario of TB in the country indicate that elimination of TB in India anytime soon might actually be an overambitious goal, despite the favourable trends reported by official statistics. No doubt, the progress is admirable. As the tenure of the NSP for Tuberculosis Elimination (2017- 25) of the Government of India draws to a close, a review of the status of TB in the country becomes imperative now in 2026.

Key initiatives included:

Pradhan Mantri TB Mukt Bharat Abhiyaan — Community-driven support via "Ni-kshay Mitras" (adopters providing nutritional/vocational aid). TB patients get Rs. 1,000 per month.
Widespread use of advanced diagnostics (e.g., molecular tests, AI-powered mobile X-ray tools), decentralized services, and schemes like Ni-kshay Poshan Yojana (nutrition support).
Screening of vulnerable populations, preventive treatment for contacts, and handling of drug-resistant TB with newer regimens (BPaLM).
And, in future, "Near Point-Of-Care Nucleic Acid Amplification Tests (nPOC-NAAT), testing non-sputum samples such as tongue swabs, etc may be introduced.
It's not the dearth of facilities that is standing in the way for the elimination of the disease. Elevation of the LIVING STANDARDS would automatically check all the challenges, but it's a long term objective.

DRUG RESISTANCE : India accounts for more than a quarter of the global incidence of TB, and features as a ‘High Burden Country’ of ‘Drug-resistant TB’, for more than a decade now. India accounted for over 32% of global ‘multidrug-resistant/rifampicin-resistant (MDR/RR-TB)’ cases in 2024, remaining a major challenge. Half-a-century ago, I wrote in the columns of THE HINDU of April 28, 1977 that " … development of drug resistance, which is a result of inadequate and irregular treatment mostly, has far-reaching implications and if unchecked would make tuberculosis totally unmanageable by the present methods in course of time, whatever be the means.”

SYSTEMIC FAILURE : Data on TB notifications from the NIKSHAY portal of the government of India reveals an increasing trend in the number of notified TB cases between 2017 and 2024. Despite a public TB control programme providing standard, free-of-cost diagnosis and treatment to TB patients, running for decades now all over the country with revisions in structures and nomenclatures, the incidence of TB in India remains appallingly high. There is a dearth of public health infrastructure and meagre overall share of health expenditure of India’s GDP.

CAUSES : There has been a weak advocacy around TB with limited political commitment, and a perpetual underinvestment by the government. Despite investments by the Union health ministry on campaigns like “TB Harega, Desh Jeetega”, involving popular celebrities like Amitabh Bachhan, awareness about TB is poor among the masses. Stigma, often, holds them back from availing the good cost-free facilities. Stigma pushes them further down socioeconomically and results in depression, apathy and stress. Empathetic psychological support is largely lacking despite the presence of around 40,000 "TB CHAMPIONS (TB survivors / volunteers)" and MY Bharat volunteers, self-help groups, etc.

Challenges

Undernutrition contributes to 50% of India's TB burden.
High MDR-TB rates and occasional drug shortages.
Gaps in rural access and persistent stigma delaying care.
Socioeconomic factors and overcrowding fuel transmission.
Lack of an effective vaccine

Despite missing the 2025 target, India's accelerated decline, high treatment coverage, and innovations position it as a leader among high-burden countries, with continued multi-sectoral efforts needed to approach elimination in the coming years. For the most current official data, refer to the WHO Global TB Report or India's Ministry of Health and Family Welfare updates.

MEDIA APATHY : And, unfortunately, there has been minimal concern and involvement of the media to generate large-scale public awareness about this disease. A death due to an odd virus grabs headlines while 1,000 deaths every day in India due to TB goes unreported by the media. It is high time TB receives the attention long overdue and the backing of strong political will so that its elimination no longer remains a goal on paper but is actually realised.

T. Rama Prasad

April 7, 2026 is the WORLD HEALTH DAY falling a couple of weeks after the WORLD TB DAY. TB is a stark reminder that unless the GENERAL HEALTH ENVIRONMENT is improved, TTB can't be eliminated.

We tirelessly repeat the slogan HEALTH IS WEALTH. Ground reality is regrettable. Even TB, which is curable and preventable, could not be eliminated in India, despite focused efforts over a long period of time. It is not the increased number of doctors, hospitals and medical advancements that ensure good health. “HEALTH FOR ALL” should not only start when people fall sick, but when adverse factors like bad environment, pollution, poor living conditions, malnutrition, overcrowding, overworking, overstress, under-remuneration, and exploitation of manpower become visible.

India's urban health system and TB

TB is not just about infection and treatment of the disease. If it is to be eliminated, we have to take care of impoverishment, precarious livelihoods, and fragile health care systems. For most people, the immune system contains the infection. Disease develops when vulnerabilities converge -- poverty, malnutrition, overcrowding, long working hours in poorly ventilated confines, weak social support systems, excessive physically demanding work, pollution, low remuneration, low hygiene, under-treated co-morbidities, etc. All these adverse factors are abundant in INDIAN CITIES making many people as reservoirs of infection to spread the disease to the non-vulnerable population throuugh the air they breathe. Nearly 35% of the Indian population lives in urban areas. Huge chunks of manual labourers in rural areas had shifted to slums in cities, and cities are expanding continuously as people arrive in search of work, education, and opportunity. And these people move about from one place to another making it impossible for the health providers to track them and continue the long TB treatment. And urban primary health care remains fragmented and unevenly distributed. And people prefer to go from one private doctor to another for temporary relief. All these urban elements make this 35% of the Indian population vulnerable to TB, and make elimination of TB impossible. To set this right, our cities' systems are to be built and governed in a way to address these challenges.

Some writings, presentations, papers and comments related to TUBERCULOSIS by Dr. T. Rama Prasad:

1. https://www.thehindu.com/opinion/open-page/a-bad-patch/article31069356.ece

2. Five years Plans and TB Control Programme (Special Article) -

The Hindu, Vol.101, No. 275, November 24,1978

3. How effective is the TB control programme ? (Special Article) -

The Hindu, Vol.100, No. 274, p.8, 1977.

4. https://drtramaprasad.blogspot.com/2017/04/yellow-nail syndrome_28.html

5. https://drtramaprasad.blogspot.com/2017/04/tuberculosis-in-india_29.html

6. Rama Prasad, T., COVID and Tuberculosis. The Antiseptic, 2021 December;

Vol. 118; No.12; P: 11-17; Indexed in IndMED -- www.antiseptic.in

7. https://drtramaprasad.blogspot.com/2017/04/tb-and-covid.html

8. Drug Resistance in Tuberculosis - Journal of the Indian Medical

Association, Vol. 64, pp. 264-267, 1975.

9. Childhood Tuberculosis - Part I - The Antiseptic, Vol. 76, pp. 449-504,1979

10. Childhood Tuberculosis - Part II - The Antiseptic, Vol. 76. pp. 567-574, 1979

11. Short-course Chemotherapy - The recent Advances in the Treatment

of Respiratory Tuberculosis - Current Medical Practice, Vol.24,

pp. 41-46, 1980.

12. Drugs in the treatment of Tuberculosis - The Antiseptic,

Vol. 75, p.678, 1978

13. Chemotherapy of Tuberculosis - The Antiseptic, Vol. 76, p.248, 1979.

14. Streptomycin in Tuberculosis - The Antiseptic, Vol. 76, p.516, 1979.

15. National Tuberculosis Control Programme - views presented,

on invitation by theTuberculosis Association of India, at the 32nd

National Conference on Tuberculosis and Chest Diseases, 1977.

16. Correlation between Geomagnetic Activity and Haemoptysis -

paper presented at the II Tamil Nadu State Conference on Tuberculosis

& Chest Diseases, 1980.

17. https://drtramaprasad.blogspot.com/2023/01/tuberculosis-in-2026.html

18. https://drtramaprasad.blogspot.com/2017/04/tb-and-covid.html World TB Day –

TB & COVID

19. https://drtramaprasad.blogspot.com/2023/01/tuberculosis-drug-resistant.html

20. BCG and COVID

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A MONTHLY JOURNAL OF MEDICINE AND SURGERYS

ISSN 0003 5998

Indexed in IndMED Email: admin@theantiseptic.in www.theantiseptic.in

ELIMINATION of TUBERCULOSIS by 2025

RAMA PRASAD T. and VERSHA RAJEEV

Dr. T. Rama Prasad,

Formerly: Medical Superintendent (Special) of Ramalingam Tuberculosis Sanatorium & IRT Perundurai Medical College and Research Centre, Perundurai, Tamil Nadu.

Presently: Director & Senior Consultant in TB and Lung Diseases of ‘PAY WHAT YOU CAN’ Clinic, Perundurai, Erode District, TN – 638052.

Ms. Versha Rajeev (Co-author)

MBBS student, Sri Ramachandra Medical College, Chennai.

Specially Contributed to “The Antiseptic”

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“Science like life, feeds on its own decay. New facts burst old rules; then newly divined conceptions bind old and new together into a reconciling law.”

-- William James

ABSTRACT

True to this quote, a ‘Revised National Tuberculosis Control Programme (RNTCP)’ emerged out of the decay of the ‘National Tuberculosis Control Programme (NTCP) of 1962. And the revised programme of 1993 gave birth to the ‘National Tuberculosis Elimination Programme (NTEP)’ in 2020. Though the approach, innovation, and implementation are slightly different, the old and new components are bound together with the common objective of eliminating or eradicating tuberculosis (TB). The effects of the dynamic strategy to ‘eliminate’ the insurmountable scourge by 2025, the formidable defenses of the resistant bacillus, the gains and disappointments during the NTEP war, and the possible ways to win in the next battle are briefly outlined in this semiformal writing. In this scenario of the seemingly unending battle fought by multiple means, let’s hope for that stroke of serendipity which may facilitate elimination of this monstrous killer, in the near future, if not by the end of 2025.

Key words: Tuberculosis (TB), Elimination, National Tuberculosis Elimination Programme (NTEP), WHO’s Global Tuberculosis Report 2025, Coinfection of COVID and tuberculosis,

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Introduction

2025 is set as a goal to ‘ELIMINATE’ tuberculosis (TB) from India by the Government of India. Now that we have reached the end of 2025, it is time to take stock and have a look at the scenario. On November 13, 2025, media ran the headline “Tuberculosis incidence falling in India by 21% a year : WHO report” on the occasion of the release of the ‘Global TB Report 2025’ of the World Health Organization (WHO). The report paints a positive picture about the anti-TB activity in India in the recent years while cautioning about the immense burden of the disease still in the country and the world at large. Some of the relevant facts and figures related to the elimination of the disease are briefly mentioned in this article in a semiformal format.

To read the full article, click on : https://drtramaprasad.blogspot.com/2023/01/tuberculosis-in-2026.html

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INDIA is the "TB hub of the WORLD

India has the highest tuberculosis (TB) burden globally, consistently accounting for around 25-27% of the world's TB cases despite significant progress in recent years.

According to the WHO Global Tuberculosis Report 2025 (released in November 2025), key statistics for India include:

TB incidence (new cases per year) declined by 21% from 237 per 100,000 population in 2015 to 187 per 100,000in 2024. This reduction is nearly double the global decline rate of 12% over the same period.
Estimated 2.7 million people developed TB in India in 2024 (out of a global total of about 10.7-10.8 million cases).
TB mortality decreased from 28 deaths per 100,000 population in 2015 to 21 per 100,000 in 2024.
In 2024, India diagnosed and notified approximately 26.18 lakh (2.618 million) TB patients, achieving treatment coverage of over 92% (up from 53% in 2015), out of an estimated 27 lakh cases.
Treatment success rates reached 90% for drug-susceptible TB (ahead of the global average of 88%), though lower for drug-resistant forms.
India accounted for over 32% of global multidrug-resistant/rifampicin-resistant (MDR/RR-TB) cases in 2024, remaining a major challenge.

As of early 2026, no major new global report has superseded these 2024-based figures from the 2025 WHO report, though ongoing efforts continue to drive reductions.

National Efforts and Targets

India's National TB Elimination Programme (NTEP) — formerly the Revised National TB Control Programme (RNTCP) — aims to eliminate TB (reducing incidence by 80% and deaths by 90% from 2015 levels, with zero catastrophic costs for patients) ahead of the global 2030 target. India set an ambitious goal to achieve this by 2025, but the country has missed that deadline, as progress — while impressive — has not reached the required scale amid challenges like undernutrition, socioeconomic disparities, rural diagnostic gaps, and drug resistance.

Key initiatives include:

Pradhan Mantri TB Mukt Bharat Abhiyaan — Community-driven support via "Ni-kshay Mitras" (adopters providing nutritional/vocational aid).
Widespread use of advanced diagnostics (e.g., molecular tests, AI tools), decentralized services, and schemes like Ni-kshay Poshan Yojana (nutrition support).
Screening of vulnerable populations, preventive treatment for contacts, and handling of drug-resistant TB with newer regimens.

States with the highest burden include Uttar Pradesh, Maharashtra, Bihar, and Madhya Pradesh, while Delhi has high prevalence rates.

Challenges

Undernutrition contributes to 50% of India's TB burden.
High MDR-TB rates and occasional drug shortages.
Gaps in rural access and persistent stigma delaying care.
Socioeconomic factors and overcrowding fuel transmission.

The first outbreak of COVID in the world was reported in China on the very next day (31.12.2019) of taking the above photo on 30.12.2019 !!!

CLICK ON : (1) https://drtramaprasad.blogspot.com/2023/01/tuberculosis-in-2026.html

(2) https://drtramaprasad.blogspot.com/2017/04/dr-t-rama-prasad.html

(3) https://drtramaprasad.blogspot.com/2017/04/tb-and-covid.html

To know a little about PERUNDURAI SANATORIUM & MEDICAL COLLEGE, click on :

https://drtramaprasad.blogspot.com/2017/04/perundurai-medical-college-sanatorium_29.html

A brief introduction

In the words of Prof C H Sivaraman, FRCP (London):

“ ... Dr. T. Rama Prasad belongs to a distinctly different and unconventional species of doctors. He speaks sparingly and does not even display his qualifications or merits, but his innumerable published writings (he calls them ‘scribblings’ though they are ‘pearls of wisdom and knowledge’, sprinkled with a bit of humour and sarcasm) which received wide acclaim talk eloquently for him. The ‘PAY WHAT YOU CAN’ Clinic where services are available for which one may pay whatever one can is a facility run by Dr. Prasad for a very long time which could be a world record. Dr. Prasad is called a “god” by his patients, and many of them named their children after his name “Prasad” -- that is the height of recognition of goodness of a human being.."

Service to Humanity is service to God; Kindness costs nothing

Just to while away the time,

type on GOOGLE SEARCH

RAMA PRASAD BLOG

and read the “SCRIBBLINGS.” Can be translated into many languages through your phone instantaneously.

Or click on : https://drtramaprasad.blogspot.com or

https://drtramaprasad.blogspot.com/2017/04/what-you-can-clinic_30.html

Write your comments to

Dr. T. Rama Prasad,

98427 20393 (WhatsApp)

The following is a list of some of my 'scribblings', including a few from the 28 articles on COVID published in a monthly medical journal in 30 months (a world record). To open them, click on any of the titles. -- T. Rama Prasad

Blog Archive

▼ 2017 ‪(115)

▼ March ‪(1)

COVID MEDICAL LITERATURE

▼ April ‪(112)

OREIKLE

DEEPAAVALI

Science and Nonsense about COVID

AMC BATCH 1959 (revised)

Nurses Day 2017

FOOD, EXERCISE and SLEEP

OMICRON -- a paper tiger ?