Tuberculosis (TB) remains a serious health concern in Balochistan, despite progress in combating the disease across Pakistan. The province, which spans vast, largely underdeveloped territories, has long faced health challenges due to its lack of infrastructure, poverty, and remote, hard-to-reach populations. While national and international efforts have led to improvements, TB continues to pose a significant threat in Balochistan, particularly in rural areas where access to healthcare remains limited.
Over the past decade, Pakistan has made substantial progress in addressing TB, thanks in large part to the National TB Control Program (NTP) and support from international organizations such as the World Health Organization (WHO) and the Global Fund. Through these efforts, TB diagnosis and treatment services have been made available at little or no cost to patients across the country. The introduction of modern diagnostic tools, such as GeneXpert machines, has enabled more accurate and rapid detection of TB, allowing for quicker treatment initiation.
However, while these measures have improved TB control in many parts of the country, the situation in Balochistan remains far from ideal. The province faces unique challenges that make TB management particularly difficult. Its vast, sparsely populated landscape means that many people live far from healthcare facilities. In addition, Balochistan’s health infrastructure is one of the weakest in Pakistan, with fewer hospitals and medical professionals per capita than in other provinces. As a result, many TB cases go undiagnosed, and those that are diagnosed are often treated late, increasing the risk of transmission to others.
Poverty and malnutrition further complicate the situation. TB thrives in environments where people are already in poor health, and in Balochistan, where poverty is widespread, many individuals have weakened immune systems due to malnutrition and other health conditions. These factors not only make people more susceptible to contracting TB but also make it more difficult for them to recover fully from the disease.
A major challenge in the fight against TB in Balochistan is the emergence of drug-resistant strains of the disease. Multi-Drug Resistant TB (MDR-TB) occurs when patients do not complete their full course of treatment, allowing the bacteria to evolve resistance to first-line drugs. MDR-TB is much more difficult and costly to treat, often requiring longer, more intensive treatment regimens. In a region where healthcare access is already limited, the rise of MDR-TB is a worrying development. In Balochistan, incomplete treatment is often the result of patients having to travel long distances to receive care or discontinuing treatment due to a lack of education and awareness about the importance of completing the course.
Public health experts also highlight the significant role that stigma plays in the continued spread of TB in Balochistan. In many communities, TB is still viewed as a disease of poverty and shame, leading to social isolation for those diagnosed with it. This stigma discourages people from seeking treatment early or disclosing their condition to others, which exacerbates the spread of the disease. Health authorities and NGOs have been working to raise awareness and educate people about TB, but changing long-held cultural attitudes is a slow process.
Despite these challenges, there is hope for Balochistan’s fight against TB. The government, in partnership with international health organizations, continues to expand TB control programs across the province. The implementation of the Directly Observed Treatment, Short-course (DOTS) program has helped ensure that patients are taking their medications correctly, thereby reducing the risk of developing drug-resistant strains. There are also efforts to strengthen healthcare infrastructure, with new diagnostic centers being established in more remote areas of the province.
The battle against TB in Balochistan is far from over, but the progress that has been made shows that, with continued effort and investment, the disease can be brought under control. What is needed now is a sustained commitment from both local and national authorities to ensure that every person, no matter how remote their location, has access to the care they need. In a province as vast and complex as Balochistan, this will be no easy task, but it is one that cannot be delayed if the tide of TB is to be turned.
Articulated by Rukhsar Baloch an independent freelance journalist.
