TB's Global and Indian Burden
Tuberculosis (TB) is the leading infectious disease killer worldwide, with global TB death targets of a 90% reduction in TB deaths and 80% reduction in new cases by 2030.
India continues to carry 26% of the global TB burden and is the hub for drug-resistant TB (DR-TB) and TB-related deaths.
The COVID-19 pandemic has delayed India’s ambitious goal to end TB by 2025, set by the government in 2018 with political commitment.
Challenges in Treatment and Diagnosis
India’s National Tuberculosis Elimination Programme (NTEP) provides effective TB drugs, with over 95% of notified cases initiated for treatment.
However, the country faced a nationwide drug supply chain break in 2023, leaving patients without key medicines, disrupting treatment, and increasing antibiotic resistance risks.
TB patients often have to buy medicines from outside, causing catastrophic health expenses for families.
Extrapulmonary TB (EP-TB), affecting organs beyond the lungs, makes up 24% of cases but is frequently missed or diagnosed late due to vague symptoms.
Training of general practitioners and better integration of EP-TB screening into healthcare systems is crucial for early diagnosis.
Vulnerable Groups and Contributory Factors
High-risk groups, such as miners exposed to dust and migrant workers with poor healthcare access, face a higher risk of TB.
Other contributing factors include silicosis (lung damage from dust inhalation), undernutrition, overcrowding, and uncontrolled co-morbidities like diabetes, which complicate TB outcomes.
Migrant workers are particularly vulnerable, often unable to continue their TB treatment due to their movement across regions, complicating tracking and continuity of care.
A multisectoral approach, including addressing nutritional and healthcare access issues, is needed to reduce TB risks among these vulnerable groups.
Path Forward and Hope
India has made progress by increasing case notifications and reducing TB deaths by 24% compared to 2015, which is better than the global decline.
Political leadership, community participation, and local advocacy, have proven effective in achieving TB elimination targets.
Collaborative cross-learning from global best practices, like Vietnam’s use of active case finding for high-risk groups, could improve India’s response.
The NTEP must adapt to local challenges and update its approach, integrating new knowledge and rethinking conventional frameworks to enhance TB elimination efforts.
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