The Central government is all set to launch its ambitious smart city scheme next month. Experts and planners working with the central urban development department have suggested that the government should focus mainly on urban housing to resolve health and economic issues in the cities.

According to Central government sources, the Union urban development department is working with the states' health departments to draft a strategy on 'healthy housing' to help eliminate TB by 2020.

"The government of India has decided to take some major steps to streamline haphazard urbanization. Healthy housing is one part of this steps and the government is linking housing to TB eradication in urban areas. TB control should be taken up as both a development issue and a medical subject. Housing is one of the major factors in proliferation of TB in urban areas. The ongoing wave of urbanization has intensified the chances for the infection to spread in cities because of unhealthy living conditions. TB bacteria proliferate in congested slums with little ventilation," said one of the state health officials who attended the recent meet in New Delhi held by Union minister of urban development M Venkaiah Naidu.

Chapal Mehra, an activist working with civil society groups on TB, said that cities like Pune and Mumbai have a major chunk of the population living in slums. About 60% in Mumbai and 40% Puneites live in slums, which have become a hotbed for TB proliferation. Mehra said that proper housing would help to curb spread of infection.

"Slum rehabilitation schemes have not yielded any positive results. Instead, the number of slums in urban areas is on rise. Housing shortage in urban areas is expected to rise to 300 lakh units in 2022 from the present 190 lakh. India spent Rs 500 crore in fiscal 2013-14 on the treatment of tuberculosis, including providing free medicines. If we need to address TB at its root cause, we must focus on providing healthy living to people in urban areas," said a senior medical practitioner working with the government on the housing scheme.

In 2011-12, the amount incurred on prevention and control of TB was Rs 391.16 crore, which went up to Rs 467 crore the next year. He added that the government was also consulting the world Health Organisation (WHO) in this regard.

"There is a clear need and opportunity for governments and others to promote health in the course of making investments in housing. Examples of key housing-related health risks include respiratory and cardiovascular diseases from indoor air pollution, illness and deaths from temperature extremes, communicable diseases spread because of poor living conditions, and risks of home injuries. Inadequate ventilation is also associated with a higher risk of airborne infectious disease transmission, including tuberculosis," states the WHO document on Housing and Health. Poor housing quality and design also can exacerbate the health impacts from exposure to temperature extremes, which are occurring more frequently due to climate change, adds the document.

Experts say that airborne bacteria know no boundaries and people in cities living in apartments and bungalows are not immune. "TB should not be treated as problem of poor but as a problem of the entire society. Poor are more vulnerable to the TB and they come on record because they cannot afford private treatment. The rich generally go to private hospitals and prefer to keep mum on disease. But we have to keep in mind that the overall health environment of the city affects all. Good housing with basic infrastructure will help city to fight TB as majority of patients come from slums," said Pune Municipal Corporation's (PMC) TB officer Narendra Thakur.