In India, tuberculosis (TB) solely accounts for 26% of the world’s TB cases, making it the hotbed of TB. The Ministry of Health and Family Welfare has published the India TB report, which emphasizes significant accomplishments, ongoing challenges, and critical areas of concern as the nation progresses toward its ambitious goal of eradicating TB by 2025.
Tuberculosis (TB)
- Tuberculosis (TB) is an infectious disease that most often affects the lungs and is caused by the bacteria Mycobacterium tuberculosis.
- It spreads through the air when infected people cough, sneeze, or spit.
- Symptoms: prolonged cough (sometimes with blood), chest pain, weakness, fatigue, weight loss, fever, as well as night sweats.
Key Highlights: India TB Report 2024
| Year | Total TB Cases (lakh) | Mortality Rate (per lakh) | Private Sector TB Cases (lakh) |
|---|---|---|---|
| 2015 | 19.1 | 28 | 1.9 |
| 2023 | 25.5 | 23 | 8.4 |
- Decline in Mortality Rate: TB mortality dropped from 28 per lakh in 2015 to 23 in 2022.
- Increase in Private Sector Involvement: Private sector notifications rose from 1.9 lakh in 2015 to 8.4 lakh in 2023, showing improved engagement in TB detection.
- Case and Mortality Trends: TB incidence slightly increased to 27.8 lakh in 2023, whereas TB mortality held steady at 3.2 lakh.
Challenges
- Drug-resistant TB cases: India has a huge burden of drug-resistant TB, including multidrug-resistant TB (MDR-TB). It is harder to treat this kind of TB which as it is expensive, requiring specialised drugs and a longer duration of treatment.
- Diagnostics and Case Detection: The accurate and timely diagnosis of TB remains a challenge. Due to this, some areas lack access to modern diagnostic tools, compelling themselves to rely on traditional methods with limitations.
- Poor primary health-care and infrastructure: In rural and remote areas, there is limited access to healthcare facilities. As a result, delayed diagnosis and treatment occur, which eventually allows TB to spread within communities.
- Stigma and Awareness: Due to Stigma around TB, delays in seeking healthcare ahs become a norm. Moreover, inadequate awareness about the disease exacerbates the current situation.
- Private Sector Engagement: A significant portion of healthcare services in India is provided by the private sector. So, here PPP(public private partnership) Model and standardized treatment protocols are crucial for effective TB control.
- Treatment Adherence: Its treatment demands a prolonged course of antibiotics, and ensuring patient adherence to the full course is quite challenging.
- Vulnerable Populations: Populations like migrant workers, urban slum dwellers, and those living in crowded conditions are the most susceptible to TB.
Government’s initiatives
- Revised National Tuberculosis Control Program (RNTCP): The RNTCP, launched in 1997, was the flagship program to control TB in India. The program has been continuously revised and strengthened over the years.
- National Tuberculosis Elimination Program (NTEP): The Government of India has developed a National Strategic Plan (2017-25) for Ending TB in the country by 2025.
- Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA): Launched in 2022 for community support to TB patients to provide people with TB with additional nutritional, diagnostic, and vocational support.
- Universal Drug Susceptibility Testing (DST): It helps in identifying drug-resistant strains of TB early and tailors treatment accordingly. Earlier, the patients were given first-line treatment, after which they were tested for drug resistance only if the therapy didn’t work.
- Ni-kshay portal: An online Ni-kshay portal is there to track the notified TB cases.
WHO Recommendations for TB Control
- Molecular Diagnostics: Faster, more accurate diagnostics similar to COVID-19 testing.
- MDR-TB Management: Better prescription practices, drug quality, and treatment completion.
- Patient-Centered Care: Managing treatment’s side effects and enhancing treatment completion.
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Key Recommendations
- Strengthen Multi-Sectoral Collaboration: To address TB’s root cause, Engagement of healthcare, social services, and education is a prerequisite.
- Enhance Rural Access: To ensure last last-mile approach, acceleration of local healthcare infrastructure, deployment of mobile health units for speedy services, and training of community health workers is important.
- Stigma Reduction and Awareness: The Major role of public campaigns is to reduce stigma among the people, also they will educate them on TB prevention, symptoms, and treatment.
- Clear and strict norms and standards on TB prevention and care should be there as they will effectively promote and facilitate their implementation.
- To prevent TB and enhance care, the development and promotion of evidence-based policy options is essential.
- Most importantly, constant monitoring and prompt reporting of TB cases, financial progress, as well as implementation of response at the global, regional and country levels should be there.
Conclusion
A holistic, coordinated approach, while addressing healthcare gaps and social determinants, will ensure accessible and effective TB care. Also, international collaboration, enhancing diagnostics, and addressing the social factors influencing TB, India can expedite its progress toward a TB-free nation.