Tuberculosis in India: Road to Elimination | Gist of Rajya Sabha TV / RSTV (now Sansad TV) - UPSC PDF Download

Tuberculosis:

• TB is one of the leading causes of death worldwide and the leading cause from a single infectious agent, ranking above HIV/AIDS.
• TB is an infectious disease caused by the bacillus Mycobacterium tuberculosis.
• It typically affects the lungs (pulmonary TB) but can also affect other sites.
• The disease is spread when people who are sick with pulmonary TB expel bacteria into the air, for example by coughing.
• Broader influences on the TB epidemic include levels of poverty, HIV infection, under nutrition and smoking.
• Diagnostic tests for TB disease include – Rapid molecular test, Sputum smear microscopy, Culture-based methods
• Without treatment, the mortality rate from TB is high.

Global tuberculosis report

WHO has published a global TB report every year since 1997.

• The main aim of the report is to provide a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease at global, regional and country levels.
• This is done in the context of recommended global TB strategies and targets endorsed by WHO’s Member States and broader development goals set by the United Nations.

For the period 2016–2035, these are WHO’s End TB Strategy and the United Nations’ (UN) Sustainable Development Goals (SDGs), which share a common aim: to end the global TB epidemic.

• Every year, 10 million people fall ill with TB and 1.5 million people die from TB each year, making it the world’s top infectious killer.
• Most of the people who fall ill with TB live in low- and middle-income countries, but TB is present all over the world.
• About half of all people with TB can be found in 8 countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines and South Africa.
• It is the leading cause of death of people with HIV and also a major contributor to antimicrobial resistance. It is one of the top 10 leading causes of deaths worldwide.

India’s TB Burden:

India has 30 percent of the world’s TB cases, which is the highest in the world, followed by Indonesia and China.

• Tuberculosis continues to be one of India’s most critical health challenges, which typically has devastating health, social and financial consequences for patients and communities at large.
• With an estimated 2.64 million tuberculosis patients, India has the largest caseload in absolute numbers, globally.
• The government aims to have a TB-free India by 2025, five years ahead of the global target of 2030.

Fight against TB:

In many ways, TB has never been more visible than before. The years 2018 and 2019 have been landmark years in the fight against TB, globally and in India, with the first ever High-Level Meeting on TB held at the United Nations last year.

In India, there is high political will and commitment to end TB, budgets are slowly increasing, new social support schemes have been announced and TB survivors are speaking up.

World TB Day is observed on March 24.

• scale up access to prevention and treatment;
• build accountability;
• ensure sufficient and sustainable financing including for research;
• promote an end to stigma and discrimination, and
• promote an equitable, rights-based and people-centred TB response.

What should be done to achieve the set targets under End TB strategy?

The targets set in the End TB strategy are global reduction of 20% in incidence and 35% in mortality by 2020, taking 2015 as the base year.

• To reach that target, the global drop in incidence has to be 4-5% a year — currently it is about 2% a year.
• The percentage of deaths should come down from the current 16% to 10%.
• With India accounting for the highest TB incidence and mortality globally, success in realising the End TB targets hinges largely on the country strengthening its systems.
• The major step in defeating the disease and achieving the targets is to record every diagnosed patient through case notification.
• When a person is diagnosed with TB, it is reported to the national surveillance system, and then on to the WHO.
• While better funding might help India inch closer to its stated goal of ending TB by 2025, much more is needed in terms of funding and commitment on all fronts.

Initiatives:

• Tuberculosis (TB) remains the biggest killer disease in India, outnumbering all other infectious diseases put together this despite our battle against it from 1962, when the National TB Programme (NTP) was launched.
• TB treatment is free in India.
• India aims to eliminate TB by 2025.
• UN aims to eliminate TB by 2030.
• Mass BCG vaccination to prevent TB.
• In 1978, the Expanded Programme on Immunisation (EPI) began, giving BCG to all babies soon after birth and achieving more than 90% coverage.
• In 1993, the Revised National TB Control Programme (RNTCP) was launched, offering free diagnosis and treatment for patients, rescuing them from otherwise sure death.
• Rs 12,000 cr fund to fight TB over the next 3 years.
• Tamil Nadu, an erstwhile global leader in TB research during the 1960s through the 1990s, will now become the global leader in TB control.
• TB Harega Desh Jeetega campaign.

Prevention of TB:

• BCG vaccination for infants.
• Maintaining respiratory hygiene.
• Not spitting in public.
• Avoiding damp areas.
• Wearing face masks, if infected.
• Avoiding close contact with people.
• Directly Observed Treatment Short Course.