Over the last six years Dr Raman Kakar has made a list of 5,300 cases in which patients suffered from a relapse of TB even after they completed the full medication dose. The doctor noticed that in multiple cases, the patients had completed the full medication course on six occasions but still the disease reared its head again, forcing the patients to seek another dose.

This last Monday, the Haryana based doctor was vindicated when his IPL prompted the Central government to overhaul the entire TB program and set a deadline for the new drug regimen. With the new regimen, daily dosage will be introduced instead of intermittent dose which involves administering medicines thrice a week.

Submitting the affidavit in response to a notice issued by a bench led by the Chief Justice of India, T S Thakur, the Ministry of Health and Family Welfare mapped out the revised TB program. With the new program the 20 year old regimen will see a significant alteration in the way in which patients are administered the dosage.

Representing the government, Additional Solicitor General, Maninder Singh apprised the bench that the transition from intermittent to a daily drug regimen is already approved and also that the program will be phased out starting December 2016. Five Indian states will introduce the daily dosage that month. As per the affidavit, the entire nation will be covered under the new program by June 2018.

Books, lecture, a movie, a PIL-the doctor who did everything to fight TB

The government’s stance, in fact, came as a surprise for Kakar. As a doctor in a state government hospital in Haryana, he had spent the last six years trying to convince the concerned that the intermittent drug regimen was prone to MDR TB and also that the chances of relapse were high under the program.

Once he left his private practice, Kakar-now 63, joined a TB hospital in Faridabad where in 2010, he took over the TB control program.

“I have done extensive research on TB and have been working tirelessly for its eradication. I have made a movie on TB, ‘A death every minute’, written books and delivered lectures to spread awareness about dangers of the disease. So when I was called to join the hospital on ad hoc basis, I treated it as an opportunity to serve hundreds of people instead of helping a few dozen who would come to my private clinic,” the doctor said to The Indian Express.

Working at a government hospital where a large number of TB patients visited, he found that his biggest fears were true- the patients had relapse even after multiple courses and also after they were administered the drug as part of the Directly Observed Treatment(DOTS).

“There were 5,300 repeaters. Two sisters came to me after relapse. Both died within a week. Patients who had been given medicines six times before also came to the hospital, asking for another dose. Their families had also been affected and they were now moving factories of germs,” he said.

Arguing his petition on his own at the court

Moving a PIL in the Supreme Court was not an easy thing either, especially since the doctor didn’t know anything about the technicalities involve. “I filed the PIL in August 2015 but the registry informed me that I must cure 32 defects (in the petition) if I wanted it to be heard by court. It took me months to rectify all that and be able to stand before the CJI to argue my case,” he said.

The doctor said that he was nervous arguing the petition on his own in court. When his PIL came up for hearing the first time, the bench asked the ASG to consider his suggestions to revamp the TB program. However, no formal notice was issued to the government. “I was a little confused what had happened. I asked a few lawyers who said there was a hope that my PIL would get admitted on merits,” said Kakar.

Image credits: indianexpress.com

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