tuberculosis Current Affairs - 2019
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Medical Journal Lancet had undertaken a study on Tuberculosis (TB) in three high-burden countries, including India. The findings of the burden of TB in India are:
- India’s goal to end the epidemic by 2025 was too “ambitious” and “unrealistic”, Hence unattainable.
- 57% reduction in incidence and 72% reduction in mortality will been seen only by 2035 and strengthening the care cascade could reduce cumulative TB incidence by 38% in the case of India.
- India needs to adopt measures to prevent TB commensurate with the population levels to eliminate the disease in the coming decades.
- India needs to improve diagnosis and treatment for drug-sensitive and drug-resistant TB.
- Lives of eight million (28%) people with TB can be saved over the next 30 years if tests are subsidised and patients are supported to complete the treatment.
- For this subsidised and complete care, India requires an extra $290 million each year. This is significantly less than $32 billion losses which India incurs associated with TB mortality each year.
- India needs to scale up access to TB services for all those seeking them, optimise engagement of private sector providers and guarantee universal access to drug susceptibility testing and second-line TB drugs.
- Integration of TB services with the primary health system to reduce diagnostic delays is not happening.
- The majority of MDR-TB cases in India due to direct transmission. Early diagnosis and prompt initiation of effective treatment should be a high priority for India to curb MDR-TB transmission since only 14% of people with MDR-TB completed treatment and just 11% remained disease-free at the end of one year.
India’s TB Burden
India accounted for 27% of the 10 million people, who had developed TB in 2017. Also, India accounted for 32% of global TB deaths among HIV-negative people, and 27% of combined TB deaths in 2017. The high out-of-pocket expenses incurred during TB treatment keeps people in poverty for seven years after completing treatment as stated by the Union Health Minister.
India accounts for about a quarter of the global TB burden. India has set the target to eliminate Tuberculosis in India by 2025. To evolve a strategy in this regard, India has put in place National Strategic Plan 2017 – 2025 which sets out the government plans of how the elimination of TB can be achieved.
What does the Elimination of a disease stand for?
Elimination of a disease is defined by the World Health Organisation (WHO) as there should be less than 1 case of TB for a population of a million people.
Step Forwards in 2018
As a step towards eliminating TB, India has made following progress in 2018:
- In 2018, 5, 36,752 TB patients have been notified from the private sector. There has been a 40% increase in TB notification from the private sector as compared to 2017.
- 44,517 (8%) TB patients were given anti-TB drugs from the programme.
- As per State reports till 25.01.2019, 40% notified TB patients, 35% treatment supporters and 8% private practitioners have been paid incentives through DBT.
Elimination of Tuberculosis
The government has envisioned following strategic steps to eliminate TB by 2025:
- A partnership with the private sector has been envisaged under Joint Effort for Elimination of Tuberculosis (JEET) for the elimination of TB by 2025, five years ahead of the global schedule.
- To increase the reporting from the private sector, public-private support agency approach has been initiated.
- Indian Medial Association has been roped in for large scale sensitization and advocacy with private practitioners with standardised digital material.
- States have been supplied anti-TB drugs to provide for TB patients notified from private sector based on demand.achieve
- States have been guided to keep programme provided anti-TB drugs at private practitioner’s clinic or pharmacy
- To ensure the TB patients are not deprived of DBT benefit flexibility to provide the benefit through the existing bank account of a blood relative has been given.
- States have also been advised to facilitate opening of zero balance accounts for TB patients, if necessary, under the PradhanMantri Jan DhanYojana (PMJDY) and Indian Postal Bank.
The Minister of State for Health and Family Welfare, Shri Ashwini Kumar Choubey has stated in parliament that government is committed to achieve the target of TB elimination by 2025 and not considering any revision in targets.