Remarks by David C. Mulford, U.S. Ambassador to India, at the Signing of the U.S. Government and World Health Organization Joint Statement on Tuberculosis Control in India, New Delhi

September 26, 2006

It is a pleasure to be here today to announce over $4 million (19 crore rupees) in U.S. Government funds for tuberculosis control in India this year. I am pleased that Dr. Chauhan, who oversees the Revised National Tuberculosis Control Program, has also joined us. Also, I would like to thank Dr. Salim Habayeb of the World Health Organization for being here as well.

For eight years, the U.S. Government has supported programs to control tuberculosis in India through the U.S. Agency for International Development’s partnership with the World Health Organization (WHO).  This partnership has helped to strengthen the Government of India’s Ministry of Health and Family Welfare’s Revised National Tuberculosis Control Program.

Since 1996, our government has provided $56 million (256 crore rupees) to WHO to combat infectious diseases in India, $40 million (183 crore rupees) of which has used for tuberculosis control.  In Haryana alone, this assistance has helped to improve tuberculosis control and to save over 19,000 additional lives from the disease.  We have also partnered with WHO on other public health efforts in India such as disease surveillance, polio eradication, malaria control and avian influenza preparedness and response.  Our partnership has strengthened public health and helped to provide leadership for key public health initiatives.

U.S. Government support for tuberculosis control in India began in Chennai in 1998 with a USAID grant to support operations research for DOTS (Directly Observed Treatment, Short course) – a successful program for diagnosis and treatment. The DOTS research was used extensively in the design of the Revised National Tuberculosis Control Program and the roll-out of DOTS across the country. This year’s funding will be used for continued support to India’s National Program.

Our government supports tuberculosis control in India because of our over-riding value of the relationship and because of the enormous public health impact and economic burden of the disease. Each day, one thousand Indians die from the disease. It may come as a surprise that tuberculosis is the leading cause of death within India’s adult population. Every year, more than 300,000 children must leave school to take care of sick parents or to work in place of their parents. Affected families often lose up to three to four months a year in household income. Overall, the economic cost of tuberculosis is estimated to be $3 billion (13.7 thousand crore rupees) each year.

In the battle to control tuberculosis, there are emerging challenges. Private healthcare providers must be increasingly involved in country-wide schemes. Over 50% of AIDS patients in India actually die from tuberculosis – control programs must address this deadly nexus. Finally, the issue of drug resistant strains must be tackled.

The U.S. and Indian Governments are working together to tackle global issues, including health. President Bush and Prime Minister Manmohan Singh have agreed to expand joint efforts in the area of science and technology, including medical research on infectious disease control. U.S. Government Agencies such as USAID, the National Institutes of Health and the U.S. Centers for Disease Control and Prevention all work closely with counterparts in India to support research and programs, including those for tuberculosis, malaria, avian flu, HIV/AIDS and others. Under USAID alone, support for health initiatives in India totals over $106 million ( 484.9 crore rupees)for this year.

The U.S. partnership with India will help to meet some of the global health challenges that face today’s world. I am confident that the longstanding and fruitful partnership between USAID and WHO to control infectious diseases, including tuberculosis, will play a role in meeting these challenges.

Thank you.