Mumbai: BEST emerges as safe haven for some TB patients when medicines run out

A BEST employee who was treated for TB

Just ahead of elections, reports of vital drug-sensitive (DS) tuberculosis medicines supplied by the Centre being out of stock have emerged from parts of the country. However, there is one unlikely place where medicines are made available to patients in case of unavailability which is at government-supported Direct Observation Treatment Short-Course (DOTS) centres - the Brihanmumbai Electric Supply & Transport (BEST) undertaking.

Its officials claim a cure rate of 98 per cent. "Anytime government-supplied medicines have not been available at DOTS centres, we have procured medicines locally and made them available to our patients. That is why we have a high cure rate," said Dr Anil Kumar Singal, Pulmonologist and BEST's Chief Medical Officer.

All of its patients are its employees, whom they routinely test and put on treatment. In 2022, 80 of the 40,000 employees, most of whom are BEST drivers, and conductors, were diagnosed with tuberculosis. In 2023, the number came down to 60, of whom about 10 were diagnosed with drug-resistant (DR) TB.

BEST received an email of appreciation from the Central TB Division. File Pic

At present, 27 are on treatment for DS-TB and around four are taking treatment for DR-TB. India has some of the highest burden of TB in the world, with a little over 25 lakh cases reported in 2023. In 2018, Prime Minister Narendra Modi set a target of TB elimination by 2025 under the country's national program.

"There have been multiple prolonged shortages of medicines in the country and TB patients missed dosages leading to risks of drug resistance and further spread. How is it possible to eliminate TB by 2025?" said Ganesh Acharya, a TB survivor who is the city's prominent face in the fight against TB.

Last year, when DR-TB drugs became unavailable in the city for a few months, patients at BEST faced no issues, claimed Dr Singal, and added that they have reserved funds for such a situation. Despite reports of stockouts, he believes the COVID-19 pandemic has also slowed down the goal of TB elimination. "It is possible they could provide medicines to its employees during shortages or stockouts because the numbers are so low," Acharya said.

The figures have come down to two digits after consistent efforts since 2012 when the numbers were as high as 400 BEST employees diagnosed with TB every year. For its work in tackling TB among its employees, BEST has received several international accolades. This is also because they have allowed their employees diagnosed with TB paid leave of up to one year. "Most join back duty in six months once they feel a little better," Dr Singal said.

On Tuesday, BEST received an email of acknowledgement and appreciation from the Central TB Division (CTD). "On behalf of the Central TB Division, Ministry of Health & Family Welfare, Govt. of India, I would like to convey sincere thanks for the time and support extended to the National Tuberculosis Elimination Programme (NTEP)," the email read, which was sent by Dr Sanjay Kumar Mattoo, Deputy Director-General, CTD.

"Companies need to take into account the seriousness of lapses in treatment because of work commitment and extend prolonged leaves to its employees like how BEST has done," Acharya said.