The BRICS, namely Brazil, Russia, India, China and South Africa were bundled together by dint of their impressive growth rates, lifting swathes of the population out of poverty and increasing their economic weight in the world economy. With a combined population of 3 billion and a combined GDP of 16 trillion USD, these countries have the potential to shape international relations and shift global trends in their favour be it in the field of finance, security or health.[1]
TB is a disease all five countries are currently battling with, carrying 60% of the world’s TB burden.[2] With 9 million newly diagnosed cases annually and 3 million slipping through national health care systems, it is evident that BRICS initiatives will make or break international efforts to curb TB levels.[3] In India alone, there are 2 million TB sufferers, which makes it the highest burden country in the world and a focal point of global TB prevention activity.[4]
The prevalence of MDR-TB in the BRICS is especially worrying: China, India and Russia jointly bear 56% of the estimated global burden.[5] This is an immense weight on a country’s shoulders, especially as large income disparities persist and universal health care is by no means ensured. The severity of the situation was illustrated by a 2012 Joint Communiqué by the Health Ministers of the BRICS stating that “multi-drug resistant tuberculosis is a major public health problem for the BRICS countries due to its high prevalence and incidence mostly on the marginalized and vulnerable sections of society.”[6]
Indeed, it is those who generally do not have a voice -prisoners, sex workers, children and refugees inter alia- who are typically most affected. Moreover, social inequalities within countries between rural and urban communities, the rich and the poor, mean that those affected do not always have access to treatment. It is thus evident that the trickle-down effect of economic growth is yet to be felt by all segments of society. Social stigma further aggravates the situation as treatment is not sought for fear of being subjected to discrimination and being excluded from one’s community. Delay in seeking diagnosis is further fuelling the epidemics within affected communities.
Despite these commonalities, certain specificities can be noted at the individual BRICS level: while South Africa is largely plagued by high tuberculosis-HIV coinfection rates, Brazil faces more standard variants of TB and coinfection is rare. Russia struggles with high prevalence of MDR-TB and TB-HIV coinfection among vulnerable groups, especially prisoners, migrants, and people who inject drugs. In China, insufficient access to MDR-TB treatment is a major hurdle whereas India has a serious problem with diagnosis, with a large number of cases being missed.
Despite these difficulties, government strategies have been employed to fight against TB in all its forms. In fact, all five BRICS countries have utilised domestic funds in the fight against TB. In Russia for instance, more than 1 billion USD has been allocated to TB care while India is active in producing anti-tuberculosis medication for treatment and may potentially play an instrumental role in lowering treatment costs for MDR-TB globally. Nevertheless, it remains to be seen how local communities will be integrated into national TB action and whether BRICS governments will support them in their activities.
;
