TB burden

Pakistan is facing a public health emergency that can no longer be sidelined. The revelation that the country now hosts the fifth-largest tuberculosis (TB) caseload in the world is a stark warning of a deepening crisis. Even more critical is our fourth place ranking for drug-resistant TB — a severe and far more complex complication arising from systemic gaps, weak regulation and behavioural failures. These grim figures transcend medical statistics, standing as a profound social indictment that demands immediate corrective action.

This crisis is particularly tragic because TB is entirely curable when diagnosed early and treated with a complete antibiotic course. Instead, the disease thrives here due to socio-economic deprivation, overcrowded living conditions, limited access to timely healthcare and behavioural negligence. As Sindh Health Minister Dr Azra Pechuho noted, poverty and density in hotspots like Karachi's Baldia Town drive infection. At the same time, the rise of drug-resistant strains stems from patients discontinuing medication prematurely or seeking unqualified help. We are effectively turning a manageable illness into a lethal threat.

To curtail this illness, the government's role must extend beyond diagnostics and sporadic interventions. While initiatives like the new MSF clinic in Karachi are commendable, the state must strictly regulate the over-the-counter sale of antibiotics, which fuels resistance. A national tracking system is recommended to ensure every diagnosed patient completes their months-long regimen, supported by nutritional grants for the underprivileged, as undernutrition and TB are fatal bedfellows.

However, the state cannot fight this alone. We must normalise wearing masks when coughing, and prioritise hygiene in overcrowded homes. Communities must also recognise the collective responsibility of supporting TB patients rather than ostracising them. Above all, adherence to professional medical advice must take precedence over anecdotal remedies and personal whims, as ending a medication course halfway is not just careless but deadly.