Tuberculosis Elimination Strategy

Assessing India’s tuberculosis burden

Note4Students

From UPSC perspective, the following things are important :

Mains level: Issues related to health care;

Why in the News?

The Global Tuberculosis Report 2024 indicates that India recorded the highest burden of tuberculosis (TB) in 2023.

Current Scope of Tuberculosis in India

  • High Burden: According to the Global Tuberculosis Report 2024, India accounts for 26% of all tuberculosis (TB) cases worldwide, making it the country with the highest TB burden. The report indicates that over 55.9% of global TB cases are concentrated in five countries: India, Indonesia, China, the Philippines, and Pakistan.
  • Mortality Rates: Although TB deaths in India have decreased from 580,000 in 2010 to 320,000 in 2023, the country still accounted for 26% of global TB deaths among people with and without HIV in 2023.
  • Incidence Trends: The incidence of TB has decreased from 275.7 cases per 100,000 population in 2010 to 194.9 cases in 2023. However, there has been a notable increase in notified TB relapse cases, reaching the highest level since 2010.
  • Risk Factors: Individuals with nutritional deficiencies, diabetes, and smoking habits are at the highest risk of contracting TB. The prevalence of TB infection among individuals aged 15 and older is reported at 31.4%, according to the National TB Prevalence Survey conducted from 2019-2021.
  • Preventive Treatment Uptake: The number of people receiving preventive treatment has been rising, indicating an increased focus on preventing TB progression among high-risk populations.

Strategies and Programs Implemented by Govt to Reduce TB Incidence

  • National Tuberculosis Elimination Program (NTEP): This program aims to eliminate TB by 2025 through various strategies including early diagnosis, treatment support, and preventive measures.
  • TB Preventive Therapy (TPT): The introduction of TPT marks a significant shift in TB care in India. It focuses on providing preventive treatment to individuals at high risk of developing active TB.
  • Project Axshya Plus: Launched with support from the Global Fund, this project implements comprehensive interventions such as contact tracing, testing for infection, and managing latent TB infections.
  • Increased Funding: Domestic funding for TB prevention and treatment increased by 38% in 2023 to $253 million, although international funding has declined during the same period.
  • Community Engagement Initiatives: Programs like the Pradhan Mantri TB Mukt Bharat Abhiyan encourage community involvement in supporting TB patients through initiatives like Ni-kshay Mitras.
  • Digital Health Initiatives: The NTEP leverages digital platforms for monitoring patient progress and ensuring adherence to treatment protocols through tools like the Nikshay portal.
  • Awareness Campaigns: Public health campaigns aim to reduce stigma associated with TB and educate communities about prevention and treatment options.

Challenges India Faces in Eliminating Tuberculosis by 2025

  • Funding and Infrastructure Gaps: Despite increases in domestic funding, overall financial resources remain lower than pre-COVID levels, impacting program implementation and outreach efforts.
    • Inadequate healthcare infrastructure, particularly in rural areas, hampers access to timely diagnosis and treatment for many patients.
    •  The COVID-19 pandemic disrupted TB services significantly, leading to a backlog of undiagnosed cases and impacting ongoing treatment programs.
  • Stigma and Discrimination: Stigma associated with TB continues to deter individuals from seeking diagnosis and treatment, which can lead to delayed care and increased transmission rates.
    • Social determinants such as poverty, malnutrition, and living conditions contribute to higher susceptibility to TB among vulnerable populations.
  • Drug Resistance Issues: The rise of drug-resistant strains of TB poses significant challenges for effective treatment and control strategies.
  • Multi-sectoral Coordination Challenges: Effective elimination requires collaboration across various sectors (healthcare, education, social services), which can be challenging due to bureaucratic hurdles.

Way forward: 

  • Strengthening Multi-Sectoral Coordination: There is a need to foster collaboration among healthcare, education, and social services to address the social determinants of TB.
  • Enhancing Accessibility and Outreach: Need to improve access to TB diagnosis and treatment in rural areas by investing in healthcare infrastructure, training local health workers, and implementing mobile health units.

Mains PYQ: 

Q Can overuse and free availability of antibiotics without Doctor’s prescription, be contributors to the emergence of drug-resistant diseases in India? What are the available mechanisms for monitoring and control? Critically discuss the various issues involved. (2014)

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