End stigma and discrimination to end TB

Prelims level : Health / Biotech Mains level : GS – IIIScience and Technology- developments and their applications
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The years 2018 and 2019 have been landmark years in the fight against TB

  • In the two years since, the team at REACH, an organisation working on TB since 1998, has witnessed similar scenes play out at other workshops around the country.
  • Over 300 TB survivors from across India all of whom attended trainings to help them become powerful TB champions and advocates described stigma as an impenetrable barrier in accessing TB services.

Each TB survivor brought his/her own personal experience to the discussion the difficulties in getting a clear diagnosis, doctor-shopping, the lack of information on what the treatment involved, having to deal with side-effects, the loss of income, to name a few.
While TB had impacted each of their lives differently, they were all unanimous in identifying one cross-cutting barrier stigma and its assiduous companion, discrimination.

Landmark years

  • The years 2018 and 2019 have been landmark years in the fight against TB, globally and in India, with the first ever High Level Meeting on TB held at the United Nations last year.
  • In India, there is high political will and commitment to end TB, budgets are slowly increasing, new social support schemes have been announced and TB survivors are speaking up.
  • There is a lot of talk of ‘ending TB’ and the ambitious phrase — TB elimination — has entered our lexicon.

India and TB

  • TB is second only to HIV/AIDS as the greatest infectious killer disease worldwide
  • India has the highest TB burden in the world, accounting for almost 25 per cent of global TB cases.
  • According to the Global TB Report 2017 released by World Health Organisation (WHO), India has topped list of seven countries, accounting for 64% of the over 10 million new tuberculosis (TB) cases worldwide in year 2016.
  • India’s domestic budget for fighting tuberculosis showed a dramatic jump from about ₹700 crore in 2015 to ₹2,500 crore last year.
  • According to World Health Statistics 2018 released by World Health Organisation (WHO), India saw estimated 211 cases of tuberculosis (TB) per 1,00,000 people in 2016.
  • India has pledged to eradicate tuberculosis by 2025, five years ahead of global target set by WHO.

Basics about TB:

Tuberculosis is an infectious, airborne disease caused by the bacterium Mycobacterium tuberculosis. It mainly affects the lungs. It can be transmitted from person to person through the air when people with TB cough, sneeze, laugh or speak, spit, propelling the germs into the atmosphere.

Why TB is an issue?

  • With proper diagnosis and treatment, TB can be cured.
  • However, too many people with TB don’t seek care for early symptoms and get properly diagnosed. Of those in whom the disease is detected, many do not complete their treatment.
  • Despite global efforts to combat TB, which saved an estimated 53 million lives since 2000 and reduced TB mortality rate by 37%, the disease is still top infectious killer in 2016. The disease also has been reported to be main cause of deaths related to antimicrobial resistance and the leading killer of people with HIV.
  • The biggest challenge was underreporting and underdiagnosis of TB cases, especially in countries with weak health systems and large unregulated private sectors.

‘90-90-90 target’ by 2035:

  • The government has committed to achieve a ‘90-90-90 target’ by 2035 (90% reductions in incidence, mortality and catastrophic health expenditures due to TB).
  • This is premised on improved diagnostics, shorter treatment courses, a better vaccine and comprehensive preventive strategies.

Moscow Declaration:

  • The declaration calls for eliminating additional deaths from HIV co-infection by 2020 and achieving synergy in coordinated action against Tuberculosis
  • and non-communicable diseases (NCDs). India is among signatories to the declaration. Moscow declaration emphasis need for fixing multi sectoral responsibility towards ending TB by 2035, the global target.

Steps Taken by Govt.:

  • Indo-US partnership to free India of TB (see Indo-US relation).
  • India has signed WTO’s call to end TB by 2030.
  • USAID-India End TB Alliance.
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