Tuberculosis in India: Road to Elimination | Current Affairs & Hindu Analysis: Daily, Weekly & Monthly - UPSC PDF Download

Introduction

• Tuberculosis, caused by the bacteria Mycobacterium tuberculosis, is a major global cause of death and the top cause of death from a single infectious agent, surpassing HIV/AIDS.
• Although TB primarily affects the lungs, it can also affect other parts of the body and is spread through the air when infected individuals with pulmonary TB cough or exhale bacteria.
• Factors such as poverty, HIV infection, malnutrition, and smoking also contribute to the TB epidemic.
• Diagnostic tests for TB include rapid molecular tests, sputum smear microscopy, and culture-based methods. If left untreated, TB has a high mortality rate.

Global tuberculosis report

• Since 1997, WHO has been publishing a yearly global TB report which aims to assess the TB epidemic and progress in preventing, diagnosing and treating the disease at the global, regional and country levels.
• This is done in light of recommended global TB strategies and targets, such as WHO's End TB Strategy and the UN's Sustainable Development Goals (SDGs) for the period of 2016-2035.
• TB is the world's leading infectious killer, with 10 million people falling ill and 1.5 million dying from it annually. While most TB cases are found in low- and middle-income countries, it is present worldwide, with 8 countries accounting for around half of all cases.
• TB is also the leading cause of death for people with HIV and a significant contributor to antimicrobial resistance, ranking among the top 10 leading causes of death globally.

India's TB Challenge

• India holds the highest number of TB cases in the world, accounting for 30 percent, followed by China and Indonesia. TB is a significant health challenge in India, with severe consequences for patients and communities, including health, social, and financial impacts. The country has the world's largest caseload of TB patients, estimated at 2.64 million, and aims to eradicate TB by 2025, five years before the global target of 2030.

Combatting TB

• TB has gained significant attention globally and in India, with landmark events such as the first-ever High-Level Meeting on TB held at the United Nations in 2018 and 2019. In India, there is a strong political commitment to end TB, and efforts are underway to increase budgets, implement new social support schemes, and amplify the voices of TB survivors. World TB Day is observed on March 24, and strategies to fight TB include increasing access to prevention and treatment, promoting accountability, sustainable financing, ending stigma and discrimination, and adopting an equitable, rights-based, and people-centred TB response.

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

• The End TB Strategy aims to reduce global incidence by 20% and mortality by 35% by 2020 compared to the 2015 baseline year.
• To reach these targets, the global incidence needs to drop by 4-5% per year, while the percentage of deaths must decrease from the current 16% to 10%. With India having the highest TB incidence and mortality rates globally, its success in meeting the End TB targets depends significantly on strengthening its systems. 
• Recording every diagnosed patient through case notification is a crucial step towards defeating the disease and achieving the targets. Better funding and commitment on all fronts are necessary to help India reach its goal of ending TB by 2025.

Initiatives

• Despite India's battle against TB since the launch of the National TB Programme in 1962, TB remains the most significant killer disease in the country, outnumbering all other infectious diseases combined. However, TB treatment is free in India, and the country aims to eliminate TB by 2025, while the UN aims to do so by 2030. 
• Mass BCG vaccination for newborns began in 1978, achieving over 90% coverage, and the Revised National TB Control Programme launched in 1993 offers free diagnosis and treatment for patients. A fund of Rs 12,000 crore has been allocated to fight TB over the next three years, and Tamil Nadu aims to become a global leader in TB control after being a leader in TB research from the 1960s to the 1990s. The TB Harega Desh Jeetega campaign is also underway.

Prevention of TB

Preventive measures for TB include vaccinating infants with BCG, maintaining respiratory hygiene, refraining from spitting in public, avoiding damp areas, wearing face masks if infected, avoiding close contact with people, and following Directly Observed Treatment Short Course (DOTS).