Nikshay Poshan Yojna | 25 Aug 2022

For Prelims: Tuberculosis, Efforts to Combat Tuberculosis.

For Mains: Nikshay Poshan Yojna, Health, Government Policies & Interventions.

Why in News?

Only two-thirds of people living with tuberculosis benefitted from the Union government’s Nikshay Poshan Yojana (NPY), sole nutrition support scheme, in 2021, which raises major public health concern.

What is Tuberculosis (TB)?

  • About:
    • TB is caused by a bacterium called Mycobacterium tuberculosis, belonging to the Mycobacteriaceae family consisting of about 200 members.
      • Some Mycobacteria cause diseases like TB and Leprosy in humans and others infect a wide range of animals.
    • In humans, TB most commonly affects the lungs (pulmonary TB), but it can also affect other organs (extra-pulmonary TB).
    • TB is a very ancient disease and has been documented to have existed in Egypt as early as 3000 BC.
  • Transmission:
    • TB is spread from person to person through the air. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air.
  • Symptoms:
    • Common symptoms of active lung TB are 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.

What is Nikshay Poshan Yojna?

  • About
    • The NPY was launched in 2018 by the Ministry of Health and Family Welfare.
    • It aims to support every Tuberculosis (TB) Patient by providing a Direct Benefit Transfer (DBT) of Rs 500 per month for nutritional needs.
      • Since its inception around Rs 1,488 crore has been paid to 5.73 million notified beneficiaries.
  • Performance:
    • As per India TB Report 2022, only 62.1 % of 2.1 million notified cases across the country received at least one payment in 2021.
    • In Delhi, which has the highest burden of all forms of TB at 747 cases per 100,000 people, only 30.2 % of patients have got at least one DBT.
      • Other poor performers are Punjab, Jharkhand, Maharashtra, Bihar, Rajasthan and Uttar Pradesh. In the North East, Manipur and Meghalaya fared the worst.
  • Challenges:
    • Several hurdles were found in the DBT for both health providers and patients such as non-availability of bank accounts and unlinked bank accounts.
    • Lack of communication, stigma, illiteracy and the multi-step approval process as key hurdles.
    • States have their own nutritional support schemes, but caveats remain here too; for instance, some schemes are only for patients showing resistance to TB drugs.

What is the Status of TB in India?

  • As per India TB Report 2022, during 2021, the total number of TB patients was more than 19 lakhs. In 2020 it was around 16 lakhs, increasing 19 %.
  • In India, the mortality rate due to all kinds of tuberculosis increased by 11% between 2019 and 2020.
  • The total number of estimated TB-related deaths for the year 2020 was 4.93 lakh, which is 13 % higher than the estimates of 2019.
  • Malnutrition, HIV, diabetes, alcohol, and tobacco smoking are the comorbidities that impact a person suffering from TB.

What are the Initiatives to Combat TB?

  • Global Efforts:
  • India’s Efforts:
    • National Strategic Plan (NSP) for Tuberculosis Elimination (2017-2025), The Nikshay Ecosystem (National TB information system), Nikshay Poshan Yojana (NPY- financial support), TB Harega Desh Jeetega Campaign.
    • Currently, two vaccines VPM (Vaccine Projekt Management) 1002 and MIP (Mycobacterium Indicus Pranii) have been developed and identified for TB, and are under Phase-3 clinical trial.
    • 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.

Way Forward

  • India has set a target to eliminate TB by 2025. Experts believe that to reach this goal, the country must go beyond the medical aspects.
  • The government needs to take stock of where the bottlenecks are. There is no point in pouring more money into a failing system.
  • Any investment in diagnostic treatments is irrelevant if people fighting TB are living on an empty stomach. It affects the poorest populations and almost every family is in financial distress due to medical costs and lost wages.
  • A broader approach is needed to prevent TB, there should be schemes to include food support for those in close contact with the patient as they are also at high risk of contracting the disease.

Source: DTE