Where does India stand
India accounts for one fourth of global TB burden. TB kills more adults in India than any other infectious disease. As per global TB report 2022, India bears highest TB and DR-TB and second highest numbers of cases of TB-HIV.
After effects of the Pandemic
The COVID- 19 pandemic and the lockdown had damaging impact on access to TB diagnosis, treatment and the burden of TB disease.
We have not yet understood whether the lock down lead to transmission of TB within close family members or the use of face mask had a positive impact on reducing its transmission that may have resulted in lesser patients reporting for follow-up.
I have observed that patients had difficulty in access to medical facility leading to great number of drop-outs from the treatment. There was a drop in number of people provided with treatment for RR TB and MDR TB.
As per global TB report, the progress made in the years up to 2019 has either slowed or reversed and global TB targets are off track.
From a peak of 7.1 million in 2019, the global cases reported fell to 5.8 million in 2020 (-18%), back to the level last seen in 2012. In 2021, there was a partial recovery, to 6.4 million.
National TB Elimination Program
The goal of NTEP program is to eliminate TB in India by 2025 and the following strategies are being implemented:
- Improved case finding with UDST decentralised management
- Patient centric care.
- Customised treatment supervision.
- Improved quality of MDR TB centres.
The path ahead
In order to achieve the target, we need to identify and fill the gaps undertaking the following measures:
- Infrastructure improvement to a further level.
- Adequate budgetary allocation required.
- Quality and quantity of medical facilities which has been improved with the program needs to be uplifted.
- There should be flexibility in the management and individualised approach for programmatic management of TB needs to be highlighted.
- We need to address issues like malnutrition and over-crowding that contribute to infection spread.
- Contact tracing and diagnosis and treatment of latent TB needs more focus.
