A group of health activists under the banner of Treatment Action Group has called upon the Indian government to fix nine deadly implementation gaps in India’s TB response.

The nine gaps identified by the activists include, the roll-out of daily fixed-dose combination (FDC) TB treatment for people with HIV (PLHIV); the provision of appropriately dosed pediatric FDC treatment for children; the scale-up of GeneXpert, a test that can diagnose TB and resistance to first-line TB drug rifampicin in less than two hours; the scale-up of drug susceptibility testing; the expanded rollout of TB drug bedaquiline to treat drug-resistant TB, of which less than 100 courses have been accessed to date; isoniazid preventative therapy (IPT) for PLHIV to treat latent TB infection; IPT for children under five who are in close contact with people living with TB; the provision of rifabutin for treatment of TB co-infection with HIV; and the immediate end to use of the category II retreatment regimen.

The activities call in this regard comes in the light of new data released earlier this month by the World Health Organization (WHO) in its annual report on TB, which found that 29 per cent of all TB deaths in the world occur in India. The report further estimates that 1,400 Indians die each day from TB, a disease that is both preventable and curable. Improved TB surveillance data from India resulted in the WHO upwardly revising its estimates of the global TB epidemic to 10.4 million new TB cases and 1.8 million TB deaths in 2015.

The activists interrupted a session chaired by Jagdish Prasad, Director General of Health Services of the government of India at the 47th Union World Conference on Lung Health at Liverpool University, UK. Unveiling a banner before the audience, the activists urged the joint-secretary to take back an urgent message to India’s Prime Minister Narendra Modi, Health Minister JP Nadda, and Deputy Director General of the Central TB Division Sunil Khaparde to fix nine deadly implementation gaps in India’s TB response.

One of the activists from India read a statement describing the community-level impact of inaction by the Modi government of India on TB. “In my own state, Nagaland, we have poor infrastructure for diagnosing TB, people are not aware of TB,” said Ketho Angami, a TB activist based in Northeast India. “There is no spirit of partnership between implementing agencies and civil society networks, and the release of TB funds from the state government has been delayed for more than a year.”

The action is part of a bigger campaign called #BrokenTBPromises that has counted up each day that has passed since the Indian government announced it would rollout FDC treatment for children and people with HIV in December 2014. By today’s count, this promise has gone unfulfilled for 662 days. Recently the Indian government has placed orders for the FDCs, but access and availability to treatment for impacted communities through TB treatment centers remains to be seen.