Tuberkulosebekæmpelse i det uafhængige Indien 1948-1978 – et dansk bidrag til internationalt sundhedsarbejde

Lektor, PhD Niels Brimnes, Institut for Historie og Områdestudier, Aarhus Universitet

I 1947 var tuberkulose næst efter malaria Indiens største enkeltstående sundhedsproblem, men Skandinavien – og i særdeleshed Danmark – kom omkring 1950 til at spille en afgørende rolle landets kamp mod tuberkulosen, da ’International Tuberculosis Campaign’ (ITC) i 1948 begyndte at vaccinere med BCG-vaccine (også kendt som Calmette-vaccine) i Indien. ITC var et samarbejde mellem UNICEF, WHO og tre skandinaviske nødhjælpsorganisationer (heriblandt Dansk Røde Kors), og blev ledet fra København. Da ITC i 1951 trak sig ud af Indien, havde man vaccineret 1.6 millioner indere. Med assistance fra UNICEF og WHO fortsatte vaccinationsprogrammet under de indiske myndigheder, og endnu i dag vaccineres der med BCG-vaccine i Indien.

BCG-vaccinen var imidlertid kontroversiel i medicinske og ikke-medicinske kredse og der var betydelig modstand blandt inderne mod vaccinens indførelse. Samtidig dukkede der i løbet af 1950erne en række antibiotika-baserede midler op, som effektivt kunne benyttes mod tuberkulose. Derfor stod de indiske myndigheder og de internationale organisationer efterhånden med to komplementerende, men også delvist konkurrerende strategier mod tuberkulose. En omstridt forebyggende strategi baseret på vaccinationer og en omkostningsfuld helbredende strategi baseret på antibiotiske midler.

Med specielt fokus på det danske perspektiv skal projektet belyse de medicinske, sociale og kulturelle processer, som tuberkulosebekæmpelse i det uafhængige Indien førte med sig. Projektet er dermed også en analyse af et tidligt eksempel på dansk udviklingsbistand.

Forskningsrejse til Chennai i Indien foretages i perioden 25. september til 20. oktober 2006.

English Version:

Controlling Tuberculosis in Independent India 1948-78 – a Danish contribution to international public health

In 1947 Tuberculosis was one of the most deadly diseases in India. It was estimated that tuberculosis claimed 500,000 lives every year; a number only exceeded by malaria. The Scandinavian countries – and Denmark in particular – came to play a significant role in India's fight against tuberculosis, when the 'International Tuberculosis Campaign' (ITC) in 1948 to vaccinate with the BCG-vaccine. ITC was a collaboration between UNICEF, WHO and three Scandinavian relief organisations (among those were the Danish Red Cross) and was directed from Copenhagen. In 1951, when the ITC withdrew from India, 1,6 million Indians had been vaccinated. Assisted by UNICEF and WHO the vaccination programme was continued by the Indian authorities, and today the BCG-vaccine is still part of the vaccination programme in India.

The BCG-vaccine was, however, controversial in both medical circles and the wider public and the campaign faced considerable resistance from the Indian population. Moreover, during the 1950s a number of effective anti-biotic drugs against tuberculosis were developed. Thus the Indian authorities and international organisations were faced with two complementary, but also partly competing, strategies against tuberculosis. A contested preventive strategy based on vaccinations and a more expensive curative strategy based on antibiotic drugs.

With special emphasis on the Danish Perspective, the project seeks to illuminate the medical, social and cultural processes imbedded in the attempts to control tuberculosis in independent India. At the same time the project is an analysis of an early example of Danish development assistance.

A research trip to Chennai, India will be conducted between 25. September and 20. October 2006.