| PYQ Relevance:Mains: Q) “Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyse. ( UPSC IAS/2021) Q) Appropriate local community-level healthcare intervention is a prerequisite to achieving ‘Health for All’ in India. Explain. (UPSC IAS/2018) Prelims: In India, the term “Public Key Infrastructure” is used in the context of (UPSC IAS/2020) a) Digital security infrastructure b) Food security infrastructure c) Health care and education infrastructure d) Telecommunication and transportation infrastructure |
Note4Students:
Prelims: Governance; Health Care; TB Elimination Program 2025;
Mains: Governance; Health Care Syatem in India; Issues related to TB and measures;
Mentor comments: Globally, and in India, tuberculosis (TB) continues to loom large as a public health challenge impacting millions. About 85% of people who develop TB can be successfully treated with drug regimens of 6 months. Universal health coverage (UHC) is necessary to ensure that all those with the disease can access these treatments. Today although India aims for 2025, the recent TB elimination policy in India necessitates person-centered solutions to address the challenges of tuberculosis effectively.
Let’s learn.
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Why in the News?
On account of World TB Day (March 24), we must recognize the needs and interests of TB patients, and the communities must form the basis of disease elimination.
Context:
- The theme for World TB Day 2024: ‘Yes! We can end TB!‘.
- The MoHFW along with various development partners of the Health Ministry launched the Tuberculosis (TB) Mukt Bharat Abhiyaan in 2021 under the NSP India 2020–25 for TB Elimination in a major mission activity for ending the epidemic of TB by 2025.
- Despite ambitious goals set by India’s health authorities to eliminate TB, the challenge is huge and progress is not fast enough.
| Present Scenario: National Strategic Plan for Eliminating TB (2020-25): NSP India 2020–2025 intends to accelerate the national response to TB. The actions included: Provide top-priority reinforcements to the existing workforce; Scale up private provider engagement; Changes in approach from passive community to active community participation and ownership; Investment in TB surveillance staff and systems for accurate, complete and timely information; Deployment of new precision diagnostic tools; Support patients comprehensively throughout treatment; Redesign and pursue targeted active case finding; Deploy and evaluate ambitious plans to implement TB preventive treatment in households and other close contacts, children, People living with HIV (PLHIV), and other locally defined “high-risk” groups, using new and short regimens. |
Why there is a need for a person-centered approach to TB care and management?
1) Need to Understand through shift paradigm:
- TB as a human crisis: Tuberculosis is one of the ten major causes of mortality worldwide. The trend of increasing TB cases and drug resistance in India is very disturbing.
- TB as a gendered crisis: Women and other gender minorities living in violently patriarchal societies face unique challenges in accessing timely diagnosis and treatment for TB. It is particularly difficult for gender minorities to seek care due to structural and social barriers, stigma in the health system, and widespread poverty.
- TB as an economic challenge: The largest indirect cost of TB for a patient is income lost by being too sick to work. Studies suggest that on average three to four months of work time are lost, resulting in average lost potential earnings of 20% to 30% of annual household income.
- TB as a Social and Environmental Challenge: For centuries, TB has been linked anecdotally with environmental risk factors that go hand-in-hand with poverty: indoor air pollution, tobacco smoke, malnutrition, overcrowded living conditions, and excessive alcohol use.
2) Care needs to be more Humane
- Need for Strengthening Community-Based Care: Efforts are needed to strengthen community-based TB care models, empowering frontline healthcare workers to deliver comprehensive care that is closer to where patients live.
- Need for Mental Support: This is important as survivor narratives tell us the stigma, discrimination, and mental stress they go through, not to mention the side effects of treatment.
- Need to address discrimination: While TB can affect people of any class, religion, ethnicity, gender, and socioeconomic status, it disproportionately affects the most marginalized in society, including children, the urban poor, prisoners, and people living with HIV/AIDS. It is needed to address that disease has gone beyond being a health crisis alone.
How technology can be tapped to address these challenges?
- Leveraging technology and innovation: The adoption of AI and digital health solutions for TB diagnosis, adherence, and surveillance can revolutionize the way TB care is delivered and accessed in the country.
- Working on treatments: The path to TB elimination in India requires a concerted effort to prioritize person-centered care, address social determinants of health, and embrace innovation. By investing in developing better vaccines, we can hope to ultimately eliminate this airborne disease.
- The System for TB Elimination in the Private Sector (STEPS) has been introduced as a low-cost solution to address gaps in quality care for TB patients accessing the private sector.
Conclusion: By adopting a holistic and person-centered approach, India can overcome the barriers that stand in the way of TB control and create a healthier future for all its citizens.
