LONDON, July 7. – INDIAS plan of campaign to bring down the annual death roll from tuberculosis of 500,000 people by mass inoculation with B.C.G. vaccine was outlined in London today by Dr. Verghese Benjamin, Tuberculosis Adviser to the Govt. of India.
He told the Commonwealth Tuberculosis Conference, attended by delegates from 50 countries, that if B.C.G. had reduced tuberculosis mortality among the north American Indians by four- fifths, it was reasonable for India to anticipate a reduction by the same method.
It was too much, however, to expect that B.C.G. could make any appreciable effect upon the epidemiology of tuberculosis in India, unless it was carried out on a mass scale and this in the shortest possible time.
“It is estimated,” Dr. Benjamin added, “that 100,000,000 people in India are likely to be tuberculin negative and will need vaccination. They are mostly in the age groups below 20.
“If at least 80 per cent of these can be vaccinated during the next five years, and if succeeding generations vaccinated, then in about 15 to 20 years we may be able to note an appreciable reduction in tuberculosis morbidity and mortality.
“If a reduction in mortality similar to that achieved among the North American Indians can be attained in India, the present annual mortality of 500,000 can be reduced to 100,000.
“This is what we aim to achieve by B.C.G. vaccination. Can it be done?.
“One team of vaccinators consisting of a doctor, a nurse or health visitor and other necessary staff with a mobile van can test and vaccinate about 100,000 persons a year. Two hundred such teams should be able to test all the tuberculin negative people in the country in five years.
“Two hundred teams could be equipped at a cost of Rs.3,00,00,000 and work at the cost of another Rs.3,00,000,000 per year.
“We require roughly 40,000 tuberculosis clinics and about 500,000 beds for tubercular patients; about 1,500 doctors and a large number of nurses, health visitor and ancillar staff.
“Against this we have a present only about 125 clinics, 7,500 beds for tuberculosis patients and about 200 odds trained personnel.
“Four thousands clinics would need about Rs.40,00,00,000 and the provision of 500,000 beds would require at least Rs.400,00,00,000.
The cost of running these institutions is not included in these figures, nor is the amount needed for improving housing, sanitation, education and so on.
“The expenditure of about six crores of rupees per year for the next 15 years would probably save three and a half times that cost on the construction of institutions. Vaccination is, therefore, probably the cheapest way in which tuberculosis can be controlled.
“The first B.C.G. centre in India was inaugurated in August 1948 at Madanapalli. It is hoped that 200 teams will be trained and working by the end of 1950.
RESULTS OF EXPERIMENTS.
B.C.G. has been in use for 20 years among small groups of population in different Western countries. The results of controlled investigations show that tuberculosis mortality and morbidity can be reduced considerably by this vaccination.
“It should be noted that wherever these investigations were done the standard of living and the conditions in which people lived were better than what they are in India at present.
“These countries also had well-co-ordinated anti-tuberculosis measures with a large number of institutions and tuberculosis had been controlled to a large extent even without B.C.G. vaccination.
“Whether B.C.G. can be expected to show as good results in India as shown by the controlled investigations in the West is a matter which cannot be definitely answered at present. Some years would have to pass before results could be noted.”.
Among those present was Rajkumari Amrit Kaur. Indian Health Minister.