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A minor unkind cut

An incurable infection emerges from the primeval filth and squalor of India and infects thousands around the world, forcing the West to spend billions to contain it and find a cure. Sanchita Sharma writes.

india Updated: Mar 06, 2011 18:05 IST
Sanchita Sharma

An incurable infection emerges from the primeval filth and squalor of India and infects thousands around the world, forcing the West to spend billions to contain it and find a cure. That's the gist of the new superbug study reported in The Lancet Infectious Diseases last week. Add unscrupulous native doctors infecting gullible foreigners and you have a plot worthy of a medical thriller.

Over the past two decades, this paradigm has been used to frame almost all emerging infections, which have been blamed on deviant sexuality, filthy micro-environments and/or squalid lifestyles in developing countries, wrote Priscilla Wild in Contagious: Cultures, Carriers and the Outbreak Narrative last year.

Of course, infections that are confined to poor countries aren't worthy of popular concern. Japanese encephalitis infects and kills thousands each year in Asia and Africa but is relatively unknown outside the tropics. The Ebola virus, however, found book and film fame because it escaped the confines of central Africa to cause an outbreak in imported monkeys in the US in 1989 — 13 years after the first recorded deaths in its home continent. The virus made a bestseller of Richard Preston's 1994 bio-thriller, The Hot Zone (2.5 million copies sold), while the movie, Outbreak, made $200 million. The new hospital-acquired New Delhi superbug hasn't made fortunes yet. But it's got media attention for blaming India's R1,200 crore medical industry for creating a global public health disaster.

The Indo-British study reported last week that New Delhi metallo-beta-lactamase was being imported to Britain in patients returning after treatment from India. India accused the researchers of being alarmist and motivated by concern that Britain was losing thousands of pounds to hospitals and doctors in India each year. Developing drug-resistance was the nature of bacteria, pointed out Indian scientists, and it was unfair to malign India because new superbug infections were being reported from all over the world.

They have a point. More than the superbug, Britons are catching the bug of going overseas for treatment. What's more, they are happy with the results. In 2009, around 60,000 British patients travelled abroad for treatment. Of these, 97 per cent said they would go again. Seven out of 10 of these trips were to cut costs and the rest to incorporate the surgery or treatment into a holiday. On an average, medical costs in India are one-fifth of the cost in Britain and America.

Apart from lower costs, skilled surgeons and good surgical outcomes have made India among the most popular destination for surgery. According to Confederation of Indian Industry (CII) estimates, 1.1 million foreigners travel to India each year for treatment, making it the second-most popular destination for overseas surgery after Thailand. And the sector is growing, at a phenomenal 30 per cent per year. A CII-McKinsey report estimates medical tourism will contribute R5,000-10,000 crore additional revenue through allied services by 2012. Already, India has the fastest growing healthcare information-technology market in Asia — worth R19,803 crore in 2010 — with an expected growth rate of 22 per cent, followed closely by China and Vietnam.

Since most hospitals catering to overseas patients have international hospital accreditations — like the Joint Commission International (JCI) — that include mandatory infection audits four times a year, implying India is underplaying its hospital infection data does not make sense. Now even Chennai-based author Karthikeyan Kumarasamy has backtracked, saying the superbug threat is not as big as was being projected and that the study's conclusion about the bacteria being transmitted from India is hypothetical.

What prompted the lead British scientist to digress from a scientific review to giving travel advice is still a mystery. What isn't is that India's medical tourism industry has remained unaffected. There have been no cancellations from overseas patients since the report came out on August 11, report the five biggest corporate hospitals.