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]}