Zarir Udwadia (born 1960) is an Indian pulmonologist and researcher. ^{[1] [2] [3]} His work on drug resistant tuberculosis has led to improvements in India's National Tuberculosis Control Programme. ^{[1] [4]} Udwadia was the only Indian invited by the WHO to be part of the TB ‘Guidelines Group’, which formulated the 4th edition of the TB Guidelines, published in 2010. ^{[5] [6] [2]} He was also the only doctor to be named among India's best strategists. ^[7]

Professional life

Udwadia is a graduate of the Grant Medical College, Mumbai. ^[6] He spent five years training in the UK at various centres, including Brompton Hospital, London. ^{[6] [4]} He practices at the P.D. Hinduja National Hospital and Medical Research Centre and the Breach Candy Hospital, in Mumbai. ^{[6] [8] [9]} Approximately 8,000 patients pass through his OPD annually. ^{[10] [11]} Udwadia established a Chest Medicine Department at the Hinduja Hospital in 1992, and the city’s first Sleep Laboratory in 1994. ^[6] He serves on the editorial board of Thorax, a respiratory medicine journal, ^[12] and has authored over 140 publications. ^[5]

Drug-Resistant tuberculosis

Udwadia runs a free weekly TB clinic at the Hinduja Hospital, which he set up in 1992, on his return to India, after his training in the UK. ^[13] It is the busiest outpatient clinic at the Hinduja hospital, ^[13] with patients traveling from many parts of the country, and some lining up overnight, to be seen by him. ^{[1] [4]}

In December 2011, Udwadia documented twelve cases of what he called totally drug-resistant ('TDR') TB, a strain of the disease that seemed to show resistance to all known treatments. ^{[14] [15] [16]} There were only two other episodes of TDR-TB reported in the world before this- in Iran in 2009, and Italy in 2007. ^{[14] [16]} Along with his colleagues at the Hinduja Hospital, he published a letter describing four of these cases in the journal Clinical Infectious Diseases. ^[14] The journal letter prompted extensive media attention. Government officials publicly denied the issue, accused him of wrongly spreading panic, and a Mumbai health official seized patient samples from his laboratory. ^[13]

While the WHO eventually said that defining resistance beyond XDR-TB was not recommended, ^[4] Udwadia's research drew the attention of the medical community to the growing epidemic of drug-resistant TB. ^[1] The coordinator of the WHO's STOP TB department called his findings a wake up call. ^[16] His research eventually led to improvements in the way TB is managed in India, and elsewhere, and forced the government to make changes to the state-run TB control initiative, or the Revised National Tuberculosis Control Programme. ^[7] The government increased the budget for the program, and dispatched rapid GeneXpert machines, which can conduct highly sensitive molecular diagnostic testing. ^[4]

He continues to be an outspoken critic of the government's failures to address the TB problem, ^[17] and a vocal advocate for newer diagnosis and treatment for TB patients. ^{[13] [18] [9] [3]}

References