India TB Report 2020

• 25 Jun 2020

Why in News

Recently, the Ministry of Health and Family Welfare has launched the annual Tuberculosis (TB) Report 2020.

• Eliminating TB by 2025: India is committed to eliminating tuberculosis from the country by 2025, five years ahead of the global target by the World Health Organisation (WHO) i.e. 2030.
  
  • National Tuberculosis Elimination Programme: To align with the ambitious goal, the programme has been renamed from the Revised National Tuberculosis Control Programme (RNTCP) to National Tuberculosis Elimination Programme (NTEP).

Key Points

• State TB Index: On the basis of the score in State TB Index, Gujarat, Andhra Pradesh and Himachal Pradesh were the top three best-performing states for tuberculosis control under the category of states with 50 lakh population.
  
  • Tripura and Nagaland were best-performing in the category of states having less than 50 lakh population.
  • Dadra and Nagar Haveli, and Daman and Diu were selected as the best performing Union Territories.
• Rising Tobacco Consumption: It also revealed that Tobacco consumption is rising among Indian TB patients.
  
  • 8% of TB cases can be attributable to tobacco usage.
• HIV Patients and TB: People living with HIV are the most vulnerable among all those TB patient groups which have other comorbidities (rate of death). Hence, the World Health Organization lays social emphasis (through awareness programmes) on them.
  
  • HIV-associated TB: India accounts for 9% of all HIV-associated TB deaths in the world, the second-highest number globally.
    
    • A total of 92,000 HIV-associated TB patients were recorded on an annual basis.
    • Awareness among TB patients about their HIV status has gone up to 81% from 67%.
• Diabetes Associated TB: The other such group is patients suffering from diabetes. According to the report, 20% of all TB cases in India also suffer from diabetes.
  
  • In 2019, among the notified TB patients under the Revised National TB Control Programme, 64 % were screened for Diabetes.
• Missing Patients: The report highlighted that the notification of TB is a major hurdle in surveillance of the disease in India.
  
  • Nearly 0.54 million TB cases are still missing across India.
• Lower Reporting than WHO: According to the report, India notified the highest number of 24.04 lakh tuberculosis cases last year (2018) as against an estimated 26.9 lakh cases by WHO, indicating that around three lakh patients missed out from the national TB programme.
  
  • Low Fatality: It stated that 79,144 deaths due to tuberculosis were reported in 2019, which is much lower than the WHO estimate of 4.4 lakh fatalities.
• Treatment Success Rate: It is around 70-73% in the last two years. From 2014-2016, it was between 76 and 77%.

Initiatives by India

• The Nikshay Ecosystem: It is the National TB information system which is a one-stop solution to manage information of patients and monitor program activity and performance throughout the country.
• Nikshay Poshan Yojana (NPY): This scheme is aimed at providing financial support to TB patients for their nutrition.
• TB Harega Desh Jeetega Campaign: Launched In September 2019 it is showcasing the highest level of commitment for the elimination of TB.
• The Saksham Project: It is a project of the Tata Institute of Social Sciences (TISS) that has been providing psycho-social counselling to DR-TB patients.

Tuberculosis

• TB is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs.
• Transmission: TB is spread from person to person through the air. When people with TB cough, sneeze or spit, they propel the TB germs into the air.
• Symptoms: Cough with sputum and blood at times, chest pains, weakness, weight loss, fever and night sweats.
• Treatment: TB is a treatable and curable disease. It is treated with a standard 6-month course of 4 antimicrobial drugs that are provided with information, supervision and support to the patient by a health worker or trained volunteer.
• Anti-TB medicines have been used for decades and strains that are resistant to 1 or more of the medicines have been documented in every country surveyed.
  
  • Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to isoniazid and rifampicin, the 2 most powerful, first-line anti-TB drugs. MDR-TB is treatable and curable by using second-line drugs.
  • Extensively drug-resistant TB (XDR-TB) is a more serious form of MDR-TB caused by bacteria that do not respond to the most effective second-line anti-TB drugs, often leaving patients without any further treatment options.

Way Forward

• Despite the notable successes achieved by the different programmes, robust efforts are needed to improve the early and accurate diagnosis followed by a prompt appropriate treatment which is vital for ending TB.
• India must collaborate with global efforts which are being done to eliminate the TB along with the paradigm shift in the control measure.
• There is a need for expanding both the laboratory network as well as diagnostic facilities to cover the entire country under the National TB Elimination Programme. There is a requirement of the crucial contribution from the private sector in terms of providing mandatory tuberculosis notification and quality care.
• There is a need to fight the stigma surrounding it so that every TB patient can seek care with dignity and without discrimination. Hence, advocacy, communication & social mobilization is vital.

Source: DTE