INDIA BATTLING AGAINST TUBERCULOSIS

30.08.2024

INDIA BATTLING AGAINST TUBERCULOSIS

IN NEWS –

• Tuberculosis (TB) remains one of India’s most significant public health challenges, with the country bearing over a quarter of the global TB burden. In 2023 alone, 25.1 lakh TB cases were diagnosed, reflecting the magnitude of the problem.

ABOUT TB -

• TB has long plagued populations worldwide, persisting as a major health issue despite advances in medicine and public health.
• India’s fight against TB has seen significant progress, largely due to strong political will and enhanced case detection strategies. However, the battle is far from over.

Treatment Innovations

• Recent innovations in TB treatment offer hope for more effective and patient-friendly therapies. The introduction of the WHO-recommended shorter regimen known as BPaL/M (Bedaquiline, Pretomanid, and Linezolid/Moxifloxacin) marks a significant advancement, particularly for drug-resistant TB.
• This regimen, which requires only 3-4 tablets daily for six months, has demonstrated a success rate of 89%, compared to the 68% success rate of traditional treatment regimens.
• Additionally, BPaL/M is associated with minimal side effects, making it more tolerable for patients, which is crucial for improving treatment adherence and outcomes.

Economic Impact

• The economic benefits of adopting the BPaL/M regimen are substantial. Implementing this shorter regimen could reduce the costs of TB treatment by 40% to 90%, potentially leading to global savings of approximately $740 million (₹6,180 crore) annually.
• The long duration and complexity of current treatments often result in loss of employment and income, driving affected families further into poverty.
• Thus, the introduction of a more efficient treatment regimen not only benefits public health but also has significant economic implications by reducing the financial burden on both patients and healthcare systems

CHALLENGES ASSOCIATED WITH THE ISSUE

• Despite these advancements, several challenges remain in the path towards TB elimination.
• The current treatment regimens remain lengthy, arduous, and fraught with severe side effects, posing a significant barrier to successful treatment adherence and completion.
• Identifying and screening vulnerable populations, particularly those with comorbidities, is critical.
• Many TB cases present without typical symptoms, complicating detection efforts.
• Additionally, there is a need to improve access to advanced diagnostic technologies in remote and rural areas, where healthcare infrastructure is often limited.
• Addressing these challenges requires a multifaceted approach, leveraging technology, targeted screening, and improved healthcare delivery systems.

Government Schemes

• The Indian government has launched several initiatives aimed at eradicating TB.
• The National TB Elimination Programme (NTEP) serves as the cornerstone of these efforts, complemented by the TB-Free India Campaign and the Nikshay Poshan Yojana, which provides nutritional support to TB patients.
• The Active Case Finding (ACF) initiative has been instrumental in identifying hidden cases of TB, while Universal Drug Susceptibility Testing (UDST) ensures that patients receive the most appropriate and effective treatment.

International Best Practices

• India can draw inspiration from international best practices in TB management.
• The WHO-recommended BPaL/M regimen is one such example, offering a shorter and more effective treatment for drug-resistant TB.
• The use of AI-driven tools in conjunction with portable X-ray machines has shown promise in TB detection, as has the expansion of rapid molecular tests, which provide quicker and more accurate diagnosis.
• The use of rapid molecular tests, such as GeneXpert, enables the quick and accurate detection of TB and its drug-resistant forms.
• Community-based TB care models involve bringing diagnosis, treatment, and follow-up services closer to patients.
• Targeted screening programs focus on high-risk populations, such as individuals with HIV, prisoners, and migrants, who are more susceptible to TB.

Way Forward

• To achieve TB elimination, India must expedite access to the BPaL/M regimen for all eligible patients across the country.
• Targeted, multi-disease focused screening drives, utilizing health datasets and GIS mapping, could significantly improve early detection rates.
• Moreover, increased investment in advanced diagnostic technologies will be essential for improving TB detection and treatment outcomes, particularly in underserved areas.
• International best practices in TB elimination emphasize the importance of innovation, community engagement, and collaboration.
• By adopting shorter drug regimens, expanding rapid diagnostic tools, integrating AI-driven technologies, and implementing community-based care models, countries can significantly improve TB detection, treatment, and prevention efforts.

Conclusion

• While significant progress has been made in the fight against TB, sustained efforts, innovation in treatment and diagnostics, and strong political will are essential to realize the goal of TB elimination in India by 2030.
• By addressing the challenges and capitalizing on the opportunities, India can set a global example in the fight against this persistent disease.