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Newsweek
17-07-2025
- Health
- Newsweek
City of Hope CEO on the Challenge "Greater Than Any One Entity Can Tackle"
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. This is a preview of Access Health—Tap here to get this newsletter delivered straight to your inbox. Every day, I see a new example of inefficiency in the American health care system. Lagging medical research. Siloed data with unclear applications. A tedious revenue cycle. Too few providers despite climbing demand. If you're reading this newsletter, I'm sure you can relate—you likely have your own library of personal and professional moments that made you ask, "Surely this isn't the best we can do?" We usually groan about the daily slowdowns, but it can be tough to translate anecdotes into action. That's why this study, published July 15 in The Lancet Global Health, was so intriguing to me. It actually puts a number on our inefficient health care system and gives us something to measure ourselves against. Researchers from the Institute for Health Metrics and Evaluation (IHME), based at the University of Washington in Seattle, measured health spending inefficiency for 201 countries from 1995 to 2022. They compared each country's health adjusted-life expectancy to its level of health care spending, and estimated the cost of one additional year of healthy life to determine inefficiency scores. "When we talk about inefficiency in this work, what we're describing is a gap between the best possible outcome and then the actual observed outcome," Dr. Amy Lastuka, lead research scientist at the IHME, told me. Previous research has established that the U.S. has the highest per capita health care spending of its peers, but the IHME determined that we have an inefficiency gap of 6.2 healthy years in our life expectancies. In other words, Americans could—and should—be getting 6.2 more years of bang for our bucks. Even after accounting for high levels of behavioral and metabolic risks in our population, we fell short of the best possible health outcomes for the amount that we spend. China, on the other hand, appears to have cracked the spending code. They achieved zero inefficiency in 2022. The good news is that there is a better way; the bad news is that our way is not meeting that gold standard, while our international competitors are. I asked Lastuka why we're lagging—and although the IHME didn't investigate specific drivers of U.S. health outcomes, she did share some global patterns they observed. Higher vaccination rates and higher use of prenatal care were associated with more efficient systems, as were higher investments in preventative care. A higher percentage of government health care spending, as opposed to private insurance or out-of-pocket payments, was also linked to more favorable outcomes. And governance structures are "really important" to health systems' success, Lastuka said. Government corruption was associated with less efficient health care spending. "It does seem to be the case that there are countries that are getting more healthy life years for less money," Lastuka said. "We certainly don't have all the answers in this paper, but I would hope that policy makers and [health care] stakeholders look at who is really performing the best according to this analysis, and try to dig deeper into what they're doing in those locations so we can learn from them." What's the biggest bog to the U.S. health care system right now? Let me know your thoughts at Essential Reading City of Hope recently launched its own generative AI model: HopeLLM. The tool can assist with patient onboarding, summarizing vast medical records in seconds. It also works to match patients with clinical trials and pull relevant data for research. HopeLLM has been a hit with providers and has also attracted interest from the pharmaceutical industry, according to Simon Nazarian, City of Hope's chief digital and technology officer. Read more deployment insights from our exclusive interview here. And read on to the Pulse Check section for a slice of my recent conversation with CEO Robert Stone. HHS proceeded with thousands of layoffs after receiving a green light from the Supreme Court, The New York Times reported on Tuesday. Employees who dealt with communications, public records, medical research contracts and travel coordination for overseas drug inspection were included in the terminations. Health Secretary Robert F. Kennedy Jr. also laid off his chief of staff and deputy chief of staff for policy this week. Kennedy "lost confidence" in these individuals after only a few months on the job, a source told CNN, which broke the news. But it remains unclear what particular event (if any) sparked the firings. Large employers are preparing to scale back health care benefits next year amid rising costs from weight loss and specialty drugs, per a Wednesday report from the consulting firm Mercer, shared with Newsweek. Of the surveyed companies, 51 percent shared plans to increase cost-sharing in 2026—a 45 percent increase from the same survey in 2025. More than three-quarters of employers told Mercer that the rising cost of GLP-1 weight loss drugs was a top issue. This has the potential to make a bad situation worse for employees. KFF released new poll results this week, revealing that 1 in 5 American adults have not filled a prescription because of cost. Plus, patients with employer-sponsored insurance continue to rate their insurance more negatively than those with Medicare or Medicaid, reporting a negative view of their monthly premiums, out-of-pocket costs and prescription co-pays. The Hospital of the University of Pennsylvania is set to pay $207.6 million in a record-breaking medical malpractice verdict for the state. This week, an appellate court upheld a lower court's finding that the hospital delayed a cesarean section—causing the child to be born with severe brain injuries including cerebral palsy. Courts ruled that the 2018 procedure deviated from standards of care. The mother had an infection in her uterus, and the C-section was delayed by 45 minutes. The hospital tried to appeal the case, arguing that it relied on an unlawful "team liability theory," asking jurors to find the collective care team responsible without naming a specific individual. Their appeal was ultimately rejected, but the hospital intends to continue its challenge of the "legally flawed verdict," according to recent statements. Pulse Check Robert Stone is the CEO of City of Hope. Robert Stone is the CEO of City of Hope. City of Hope For this week's Pulse Check, I connected with Robert Stone, CEO of City of Hope, one of the nation's largest cancer research and treatment organizations. Its hospitals are pillars in some of the largest American cities, including Los Angeles, Chicago, Phoenix and Atlanta. But the health system aims to reach beyond the hubs, bringing top-notch cancer care to all corners of the country. Whether through novel AI developments, groundbreaking genomic research or brick-and-mortar expansion, access is a major priority, Stone told me. It's only fitting that I share his thoughts in this aptly named newsletter—find a portion of our interview below. Improving access to cancer care is a major focus for your organization. How, specifically, do you envision large cancer centers like City of Hope bridging those gaps? There is a gap between the innovation taking place at academic cancer centers and the people who can actually access these breakthroughs. That's why we're bringing optimal cancer care closer to where people live and work. We've grown tremendously over the last 10 years, and that includes becoming this national system. We opened and acquired hospitals across the country so that now 86 million people live within a short driving distance of one of our hospitals. There is an aspect of having facilities in the communities where people live, putting your own experts and treatments in those communities. Beyond our long-time campus in Los Angeles, we have just opened a new cancer center and will open a new hospital at the end of the year in Irvine, California, [and we have facilities] just outside of Phoenix, Chicago and Atlanta. Part of the answer though is, really, if you're going to put patients first, if they can stay in their communities to be treated, that's the best answer for them. Their support system is there. Their lives are there. They're most comfortable. And so we've taken a lot of effort to partner with health providers in different communities. We have a subsidiary that we formed five or six years ago called Access Hope, and the purpose of Access Hope was to partner with the treating physician of cancer patients and get our expertise to them, rather than find a way to drive that those patients to one of our facilities. We invited a number of other leading cancer centers to join us in that effort, because if you're putting patients first, it's not about any one center. So Dana Farber, Northwestern, Emory, Fred Hutchinson, UT Southwestern, Johns Hopkins are all partners in servicing and making sure patients across the country get the right diagnosis and the right treatment plan, even without us providing that care. That's part of the solution. Continuing to use technology in new ways to partner with others is also part of the solution. I think the bottom line is cancer represents hundreds of diseases and there's no one-size-fits-all approach. The common denominator is putting patients at the center and figuring out how you're going to get the latest discoveries to them as fast as possible. What's one innovation in the oncology space that you believe will have a significant impact on public health beyond cancer care? A lot of the genomic work that we've seen and that we've applied to cancer has applicability to other rare diseases and rare childhood diseases. Thanks to genetics, we now know that cancer is not one disease but hundreds—unique variants that can be targeted for treatment. Unlocking the human genome has provided an unimaginable amount of information on the human body. If you typed out a sequence in 12-point font at 60 words per minute and for eight hours a day, it would take 50 years to type just one human genome. And that stack of papers would be as tall as the Statue of Liberty. Today, the relative low cost and quick turnaround time has exponentially expanded the use of genomic data to fuel our incredible progress. Things like accurate genomic testing, where we can ensure the correct diagnosis, or precision medicine, with tailored treatment plans designed around specific variants of cancer to greatly improve outcomes and the patient experience. With precision medicine, I think you're going to see patient populations get smaller and smaller over time, because we'll understand that targeted therapies--whether you're talking about cancer, or other therapies or other diseases--you'll have smaller patient populations to apply it to. And I think that that's really important. I'll give you an example in oncology. If we were in a room with 200 people and we all had lung cancer, maybe three of us would have the same type of lung cancer. And so the innovation that allows you to focus on smaller and smaller patient population sets, that approach is going to happen throughout medicine in general. What about the health system status quo needs to change in order for genomics research and innovation to reach its full potential? I think health systems need to embrace change, right? Technology and innovation are going to lead to a changing environment. I tell people that the days of 10-plus-year strategic plans, to me, are over. We have to accomplish 10 years' worth of work in five years because the environment changes so, so quickly. I think the key is focusing on what's good for the patient. If you approach it through that lens, you realize speed is of the essence and that cancer is a challenge greater than any one entity can tackle. It represents a team sport, which makes partnerships and collaborations so important. Historically, thinking has been siloed. Your collaboration tends not to happen at the same level as it should, and you've got to think of cancer care as a team sport. You've got to be able to operate with speed, mobility, agility. You have to be flat and fast. You've got to see change as an opportunity and then create value through differentiation. Those are things that I think health care is waking up to. C-Suite Shuffles Dr. Phillip Chang is the new system SVP and chief medical and quality officer for CommonSpirit Health, tasked with overseeing clinician, quality and safety leaders across more than 2,200 care sites in 24 states. is the new system for tasked with overseeing clinician, quality and safety leaders across more than 2,200 care sites in 24 states. UnitedHealth Group named Mike Cotton its CEO for Medicaid , a role that has been vacant since May. The Medicaid division was previously led by Bobby Hunter, who will now oversee both the Medicare and Medicaid divisions in a streamlined role. named its , a role that has been vacant since May. in a streamlined role. Aledade, the nation's largest network of independent primary care providers, tapped Dr. Lalith Vadlamannati to serve as its chief technology officer. He most recently held the same title at the digital joint and muscle clinic Hinge Health, and previously worked as VP of engineering at Amazon, leading international expansion for its eCommerce business. Executive Edge Dr. Stacey Rosen is the volunteer president of the American Heart Association and executive director of Northwell Health's Katz Institute for Women's Health. Dr. Stacey Rosen is the volunteer president of the American Heart Association and executive director of Northwell Health's Katz Institute for Women's Health. Northwell Health Last week, I sat down with Dr. Stacey Rosen, who was recently named volunteer president of the American Heart Association. She's also the executive director of Northwell Health's Katz Institute for Women's Health in New York—and will be speaking at Newsweek's upcoming Women's Global Impact Summit. We discussed her upbringing and the "mythical" qualities of the heart that compelled her to study it. And, in preparation for the Summit on August 5, we discussed the long history of neglect for women's health in medical research and cardiology: a wrong that Rosen has dedicated her career to righting. I asked her to give her best advice for women health care leaders, but I think parts of her answer will resonate regardless of sex: "Decide what's important to you. Identify your vision, priorities, integrity, mission, and make that always your North Star. Stick to your true values, work hard and keep at it. Stick to your true values, work hard and keep at it. "There have been a lot of times in my career that [I've gotten] frustrated. Things don't go as you want. Your grant doesn't get supported, or 'women's health' becomes a term you're not supposed to use. If it's important to use, you've gotta stick with it. "My advice to women is to decide what's important to you when it comes to how you are perceived at the workplace. Don't make assumptions about things, but also, don't sit quietly in the corner of the room. There are times that it's hard, and times that you have to decide when you ignore a comment and when you don't ignore a comment...I tell women who are often frustrated as the only, or one of few [women in the room] to decide what's important and to keep working at it." Register here to see Rosen speak live at Newsweek's Women's Global Impact Summit in New York City on August 5. This is a preview of Access Health—Tap here to get this newsletter delivered straight to your inbox.
Euronews
17-07-2025
- Health
- Euronews
Why some countries' healthcare spending is more wasteful than others
Wealthy countries spend trillions of euros on health care every year, but not all of them are getting their money's worth, a new analysis has found. Higher levels of health spending are linked to better outcomes, but after a certain point, more money may not be efficient or practical. The more a country spends on medical care, the more it must pay to continue boosting citizens' health, according to the study published in The Lancet Global Health journal. In countries that spend $100 (€85) per capita on health care, for example, spending another $92 (€79) per person earns them an additional year of healthy life. But in countries that spend $5,000 (€4,272) per capita, another healthy year would cost $11,213 (€9,580). 'Countries around the world have made significant progress in converting dollars into health,' wrote the researchers from the US-based Institute for Health Metrics and Evaluation (IHME). 'However, more reductions in inefficiency need to be made in an era of tightening health-care budgets [and] to maximise the returns on their health care spending'. The researchers determined health spending inefficiency by comparing a country's total health spending – including the amount they spend and how they spend it – to the number of years people there can expect to live in good health. The study included 201 countries and territories, and covered a 28-year period from 1995 to 2022. Drivers of efficient and wasteful spending Globally, health spending became more efficient between 1995 and 2019, but this progress was disrupted during the COVID-19 pandemic. While it began to recover in 2022, there are still major 'inefficiency gaps' between countries, the analysis found. The United States spends more per capita on healthcare than any other wealthy country. But its system is not particularly efficient, which costs Americans 6.2 years of healthy life. China was the most efficient country with zero waste, meaning it optimised its spending to deliver the best possible health outcomes for its citizens, according to the analysis. Most European countries were considered fairly efficient. Exceptions included Ukraine, Lithuania, Latvia, and to a lesser extent, the Netherlands, Belgium, Belarus, Finland, Norway, and the United Kingdom. Beyond their actual budgets, the most efficient countries tended to have better governance, greater uptake of primary care, infrastructure that makes it possible for people to access medical services, and more public spending on health care compared with the private sector. Notably, the study does not take into account health care quality, but rather tracks how well a country scores among those with similar levels of spending. The study authors said policymakers could use the findings to maximise their investments in health, which could be particularly important given many countries are facing pressure on their budgets. 'Expanding government-provided health-care coverage would decrease the inefficiency of the health care system,' the researchers argued. 'Countries should also focus on strengthening democracy, building infrastructure, and increasing the use of, and access to, preventive care,' they added.
Time of India
30-06-2025
- Health
- Time of India
Nearly 20% of cancer drugs defective in 4 African nations
Representative Image (AI-generated) An alarming number of people across Africa may be taking cancer drugs that don't contain the vital ingredients needed to contain or reduce their disease. It's a concerning finding with roots in a complex problem: how to regulate a range of therapeutics across the continent. A US and pan-African research group published the findings this week in The Lancet Global Health. The researchers had collected dosage information, sometimes covertly, from a dozen hospitals and 25 pharmacies across Ethiopia, Kenya, Malawi and Cameroon. They tested nearly 200 unique products across several brands. Around 17% — roughly one in six — were found to have incorrect active ingredient levels, including products used in major hospitals. Patients who receive insufficient dosages of these ingredients could see their tumors keep growing, and possibly even spread. Similar numbers of substandard antibiotics, antimalarial and tuberculosis drugs have been reported in the past, but this is the first time that such a study has found high levels of falsified or defective anticancer drugs in circulation. "I was not surprised by these results," said Lutz Heide, a pharmacist at the University of Tübingen in Germany who has previously worked for the Somali Health Ministry and has spent the past decade researching substandard and falsified medicines. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like local network access control Esseps Learn More Undo Heide was not part of the investigative group, but said the report shed light on a problem not previously measured. "I was delighted that, finally, someone published such a systemic report," he said. "That is a first, really significant systematic study of this area." Causes need addressing, but it's not straightforward: "There are many possible causes for bad-quality products," Marya Lieberman of the University of Notre Dame in the US, the investigation's senior researcher, told DW. Those causes can include faults in the manufacturing process or product decay due to poor storage conditions. But some drugs are also counterfeit, and that increases the risk of discrepancies between what's on the product label and the actual medicine within. Spotting substandard and falsified products can be difficult. Usually, a medical professional or patient is only able to perform a visual inspection — literally checking a label for discrepancies or pills and syringes for color differences — to spot falsified products. But that's not a reliable method. In the study, barely a quarter of the substandard products were identified through visual inspection. Laboratory testing identified the rest. Fixing the problem, Lieberman said, will require improving regulation and providing screening technologies and training where they're needed. "If you can't test it, you can't regulate it," she said. "The cancer medications are difficult to handle and analyze because they're very toxic, and so many labs don't want to do that. And that's a core problem for the sub-Saharan countries where we worked. Even though several of those countries have quite good labs, they don't have the facilities that are needed for safe handling of the chemo drugs established." Not only cancer treatments are affected: Nearly a decade ago, the World Health Organization found around one in 10 medicines used in low and middle-income countries were substandard or falsified. Independent research conducted since has backed those figures up, sometimes finding rates that are potentially twice as high. "This could lead to treatment failure, adverse reactions, disease progression," health economist Sachiko Ozawa told DW. Ozawa contributed to the investigation on anticancer drugs and has separately researched other cases of defective medicines. "For the community, there's also economic losses in terms of wasted resources,' she said. 'So countries may be spending a lot of money on medications that are not going to be effective." While high-income countries can monitor supply chains and have stringent regulatory systems in place to identify and withdraw suspect products, the infrastructure to do that is far from common in other regions. In those places, poor access to affordable medication often drives patients to less-regulated marketplaces. Inadequate governance and regulation, as well as a scarcity of surveillance and diagnostic equipment to test pharmaceuticals, are all contributing to the problem in Africa. "In high-income countries, I think there's a much more secure supply chain where you know the manufacturers are vetted, it has to go through very stringent regulatory processes to get gets tested more frequently," said Ozawa. The WHO told DW that following the report's findings, it was working with the four affected countries to address the problem. "We are concerned with the findings the article has highlighted. WHO is in contact with national authorities of four impacted countries and obtaining relevant data," it said in a statement. "We expect to assess full information to evaluate the situation, which often takes time and capacity. But we're committed to address these issues working with the relevant countries and partners." The WHO also reiterated its ongoing call for countries to improve their regulatory frameworks to "prevent incidents of substandard and falsified medicines, including in settings of cancer programs." Prevention, detection and response: In 2017, the WHO's review of substandard and falsified medicines offered three solutions based around prevention, detection and response. S topping the manufacture and sale of those medicines is the primary preventative measure, but where defective products make it to market, surveillance and response programs can prevent poor quality medicines from reaching patients. But regulatory reform sought by experts and authorities takes time. More immediate solutions are being developed in the form of better screening technologies. Lieberman is working on a "paper lab" — a type of test that can be used by trained professionals to chemically test the quality of a product before it's administered to a patient. Other laboratory technologies are also under development. One comforting point is that while a significant proportion of the medication circulating in medical facilities in the four African countries was defective, the majority of the products tested met required standards. "[With] two-thirds of the suppliers, all the products [were] good quality, so there are good quality suppliers," said Heide. "But a few of them really have a suspiciously high number of failing samples."
Business Insider
30-06-2025
- Health
- Business Insider
Nearly 1 in 6 cancer drugs found in Africa are defective, study finds
A new study has found that almost 17% of cancer drugs sampled in Ethiopia, Kenya, Malawi, and Cameroon were substandard or counterfeit, raising concerns over patient safety and gaps in pharmaceutical regulation across Africa. A study published in The Lancet Global Health revealed nearly 17% of cancer medications sampled in Ethiopia, Kenya, Malawi, and Cameroon were substandard or counterfeit. Approximately one in six tested medications had incorrect levels of active ingredients, highlighting risks to patient safety and treatment efficacy. The study attributes issues to factors like poor manufacturing practices and storage conditions, as well as counterfeiting. Published in The Lancet Global Health, the study tested nearly 200 unique cancer drug products collected from hospitals and pharmacies in the four African countries. It found that around one in six contained incorrect levels of active ingredients, putting patients at risk of ineffective treatment and disease progression. Researchers said causes ranged from poor manufacturing and inadequate storage to deliberate counterfeiting. The problem is difficult to detect visually: only about 25% of the defective products could be flagged by inspecting packaging or color, while the majority required laboratory testing to uncover quality failures. 'If you can't test it, you can't regulate it,' said Marya Lieberman of the University of Notre Dame, who led the investigation. 'The cancer medications are difficult to handle and analyze because they're very toxic, and so many labs don't want to do that.' The study points to big challenges for many African countries in making sure cancer drugs are safe. Many places don't have the right labs or trained staff to properly test these medicines. Even where labs do exist, they often can't handle these very strong and dangerous drugs. WHO Addresses Cancer Drug Quality Concerns The World Health Organization (WHO) said it is in contact with authorities in the four affected countries to review the findings and develop a response plan. 'We are concerned with the findings the article has highlighted,' the WHO said in a statement. 'We expect to assess full information to evaluate the situation... But we're committed to address these issues working with the relevant countries and partners.' Defective or falsified medicines are not new challenges in Africa. Previous studies have found similar rates of poor-quality antibiotics, antimalarials, and tuberculosis treatments. The WHO has estimated that roughly 10% of all medicines in low- and middle-income countries are substandard or falsified, leading to treatment failures, adverse reactions, and wasted healthcare spending. Despite the worrying results, researchers noted that most of the cancer drugs tested did meet quality standards, with around two-thirds of suppliers consistently delivering safe products. Experts called for improved manufacturing oversight, stronger regulatory frameworks, and investment in local testing capacity. They also pointed to new screening technologies under development, such as portable 'paper lab' tests designed to help detect poor-quality medicines before they reach patients.
Hindustan Times
14-05-2025
- Health
- Hindustan Times
In fight against TB, poor nutrition a silent killer
MUMBAI: A 32-year-old woman from a Worli slum is battling tuberculosis (TB) for the second time. A few months ago, she was diagnosed with drug-resistant TB—a more severe and harder-to-treat version of the disease. The woman lacks a crucial component in her treatment regimen – one no doctor can provide. The truth is, adequate nutrition alone would greatly raise her chances of recovery. Studies have shown that malnutrition fuels deaths and drug resistance in TB patients, undermining efforts to treat patients with all forms of the disease. On the other hand, a nutrient-rich diet significantly enhances positive outcomes. Part of the reason the woman is malnourished is that, for the last four months, she has not received the ₹1,000 monthly nutritional support under the government's Nikshay Poshan Yojana. The sum, recently doubled, is meant to help TB patients afford the bare essentials of a recovery-friendly diet. 'My monthly food expenses are around ₹2,000. So I skip the ₹700 protein powder prescribed by my doctor,' she told HT. A grim reality Vatsala was one of 2,800 people diagnosed with drug-resistant TB in Mumbai in 2024. That year, Mumbai recorded 60,051 TB cases—averaging 164 new cases diagnosed each day. In Maharashtra, TB detection rose marginally, by 2% in 2024 – 2,28,877 cases were reported, or 627 cases a day. In 2024, Mumbai alone witnessed 2,264 TB-related deaths—averaging over six deaths a day. Parel recorded the highest toll – 377 deaths, according to data obtained through the Right to Information Act, 2005. Nutritional support Health activists say the government should consider food a medical necessity for TB patients. Ganesh Acharya, a health activist working with TB patients in Mumbai, said, 'The ₹1,000 support should be raised to at least ₹2,500 if we want patients to recover. Nutrition is not a luxury—it is the core of TB treatment.' His concerns are reflected in the findings of the RATIONS trial—a landmark study (conducted between 2019 and 20-22, and published in The Lancet in 2023) in tribal Jharkhand, where TB-affected families were provided macronutrient-rich food baskets (1,200 kcal for patients and 750 kcal for household contacts). The trial showed significantly improved treatment outcomes and a reduction in TB incidence among contacts (family members). Based on this, a modelling study published in The Lancet Global Health (March 2025) estimated that providing food and supplements to just 50% of India's TB-affected households could prevent 361,200 deaths and 880,700 new TB cases between 2023 and 2035. Dr Finn McQuaid, one of the RATIONS researchers, told Hindustan Times, 'My understanding is that ( ₹1,000) is a big step in the right direction but it's not quite there yet. Another issue is that the composition of food baskets is important (they must contain sufficient proteins and micronutrients), which cash support alone may not address.' Dr Pranay Sinha, assistant professor at the Boston University School of Medicine, said implementation, not just policy design, is the bigger challenge. 'Lack of access to banking and other logistical delays prevent persons with TB from receiving the money at the most critical juncture of their treatment. We need some operational innovations to ensure that PWTB get the money as soon as possible post-diagnosis.' Role of Body Mass Index BMI is a key clinical indicator in TB outcomes—lower BMI increases mortality risk. However, McQuaid cautions against targeting support based on BMI. The RATIONS trial showed benefits even in patients with normal BMI, he underscores. On the flipside, Dr Pranay Sinha points out, even TB patients with normal BMI may suffer micronutrient deficiencies, noting studies linking Vitamin A deficiency to a ten-fold TB risk and citing 25% mortality in patients with BMI below 14 in Tamil Nadu, where he advocates early inpatient nutritional care. Sponsor a patient Experts feel it is not wise to lean too heavily on government schemes for nutritional support, an issue the Ni-kshay Mitra scheme hopes to address. A government scheme, it aims to enhance community involvement in the fight against TB by linking patients with supporters, or 'mitras', who provide assistance. Pulmonologist Dr Vikas Oswal said, 'The ₹1,000 is not meant to cover an entire diet, but it's a helpful supplement. The Ni-kshay Mitra initiative enables individuals and organisations to sponsor patients and provide regular food baskets.' However, patients from high-burden areas such as Govandi and Dharavi told HT that this support too is inconsistent. A 44-year-old autorickshaw driver from Dharavi, who is undergoing treatment for bone tuberculosis, said he last received the food basket in November 2024. 'The local politician who was distributing it stopped. The basket had apples, pomegranates, and grains—it helped us survive for seven months. I can't work due to my health, and my wife supports the household. TB medicines kill my appetite, but getting good food encourages me to eat better than just dry roti at home,' he said. According to the Ni-kshay Mitra dashboard, Maharashtra currently has 1,50,579 people undergoing TB treatment. While 14,194 donors have registered under the scheme—and 83.2% committed to providing food baskets for at least six months—coverage remains patchy. In Dadar, of the 3,041 patients under treatment, only 1,569 received food baskets. In another ward, just 1,646 out of 2,133 got assistance—barely 60%. 'There's a system,' said Acharya, 'but it's breaking where it's needed the most.' Dr Sandeep Sangale, Joint Director (TB and Leprosy), Maharashtra, dismissed claims that some TB patients are still receiving ₹500 instead of the revised ₹1,000 nutrition support. 'All patient accounts are centrally linked and payments are generated alphabetically through the system. There is no possibility of anyone receiving ₹500 now. The disbursal is done every three months, so patients in earlier payment cycles may have received a lump sum for three months. The next instalment will be credited once their cycle resumes,' he said.
