DOTS has been pilot-tested since 1993 at 20 project sites spread over 15 states.

The World Health Organisation (WHO) says the strategy will help, if implemented nationwide, and save India 0.3 per cent of its GDP (or $800 million) every year.

It has achieved an 80 per cent cure rate, besides saving over 10,000 lives. For over a year now, it's been incorporated in the Revised National Tuberculosis Control Programme, which, according to the Minister of State for Health Dalit Ezhilmalai, will be launched with World Bank assistance. It will be done in 102 districts with a population of 271.21 million, over fiveyears.

But the Union Health Ministry says that the country cannot extend the benefits of DOTS to the entire population and the problem, says Deputy Director-General (TB) G R Khatri, is not money.

It is just that his Ministry is daunted by the scale of adjustments the nationwide implementation of DOTS will entail.

According to Health Ministry calculations, the exercise will involve 30 million sputum examinations every year and 100 million observations of 750,000 patients, under treatment at any given point of time. Over 10,000 laboratories, moreover, will have to be supplied with binocular microscopes and improved reagents. Besides, the skills of one million health workers, including one lakh doctors, need to be upgraded.

It is a tall order for a tuberculosis control programme, which, by the Ministry's own admission, has been an unmitigated failure. TB, incidentally, claims a life in India every minute (500,000 in a year), besides giving a dubious tag India contributed 13.09 lakh new cases, or morethan a quarter of the global burden, in 1997-98. Other startling findings of the Central TB Division of the Directorate-General of Health Services:

* The National TB Institute, Bangalore, has revealed that nearly 70 per cent of cases put on treatment after X-ray examinations -- a deficient method that continues to be the principal means of TB screening in the country -- did not have the disease at all.

* More than 80 per cent of patients with TB -- those with a chronic cough for over three weeks -- present themselves at health facilities promptly, but most of them are not sent for the mandatory sputum examination.

* A regular supply of drugs notwithstanding, a third of the patients died and another third remained smear-positive.

``We have failed once and we don't want to repeat the experience, so we are going slow on DOTS,'' reasoned Khatri, after a Ramakrishna Mission seminar here today, ``I would rather have an 85 per cent cure rate than spread myself thin attempting to detect all possible cases.For, it is better to have undetected cases, than have uncured patients with multi-drug-resistant TB who can infect at least ten healthy persons in a year. It costs Rs 2 lakh to cure a multi-drug-resistant case, yet the survival rate assured is just 50 per cent.''