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The Indian Express
20 Nov 2012

Dressed in a outrageous suit and bow tie, Bulgum Bhai has peculiar eyebrows and waits in a den of sorts with a device to catch coughing sounds from all over. No sooner does he hear the sound than the superhero with twirling moustaches transports himself to the source and says, "Do hafte ho gaye kya?" (Have two weeks passed?) "If you have been coughing for more than two weeks, better get your sputum tested," advises Bulgum Bhai.

It is India’s latest campaign for control of tuberculosis. The spoof, aimed at reversing perceptions about TB, is part of the ambitious Project Axshya, which means TB–free. And India’s campaign stood out among those of 123 countries that presented new strategies to break barriers and bring tuberculosis under control at the recently concluded Union World Conference on Lung Health in Kuala Lumpur.

Showcasing the success of Project Axshya was a poster presentation and a 13–minute video that showed how one of the remotest districts in the country, Neemuch at Madhya Pradesh, was able to identify as many as 1,256 TB suspects .

Axshya is a Global Fund Round 9 TB project, a civil society initiative, launched two years ago and expected to reach over 700 million people at 374 districts across 23 states in a phased manner. The recipients of the $199.54 million grant are the government, International Union Against Tuberculosis and Lung Disease (The Union) and World Vision India.

Subrat Mohanty, project coordinator, told The Indian Express that one of the major highlights has been developing a mass media campaign in the form of Bulgam Bhai (Mr Sputum) to create awareness on treating two weeks of coughing as a symptom of TB and promoting testing for the disease.

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India has the highest TB burden in the world, accounting for nearly one–fifth of the global incidence. Two years ago, out of the estimated global annual incidence of 9.4 million, two million were estimated to have occurred in India out of which 0.9 million were infectious cases.

Mr Sputum appears on TV, speaks on radio and features in street theatre performances. According to Mohanty, the programme has already been scaled up from 90 to 240 districts, reaching out to 430 million people. Several Axshya Mitras (volunteers) have been empowered to work in district TB forums. Nearly 1,000 NGOs and over 8,000 rural healthcare providers have joined the fight, apart from nine key organisations such as Mamta Health Institute for Mother and Child Health, Voluntary Health Association of India, Christian Medical Association of India, Catholic Bishops Conference of India and Coalition for AIDS and Related Diseases.

Satara in Maharashtra has been chosen as a model district. E R Babu, one of the coordinators, said, "This Diwali, schoolchildren, sugar factory owners and a cross–section of people took a pledge to fight TB. At the Suzlon Windmills, DOTS centres have been set up and provisions are being made to set up a similar facility at the Bhandar Jail."

(Anuradha attended the conference as a guest of Global Health Strategies)

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