These four medicines attack the TB bacilli in different ways: Isoniazid and Rifampicin kill the most active bacteria, Pyrazinamide works on those in hiding, and Ethambutol protects the others from developing resistance. The treatment is long—six months at least—because we must eliminate every last dormant germ, or it will come back stronger.
I say this watching our DOTS provider, Geeta didi, walk three kilometres every day without fail to ensure a daily wage labourer takes his medicine. The length of the treatment isn't a medical puzzle for us here; it is the time needed to build a bridge of trust between the system and a patient who feels fine after one month.
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