Integrate TB services with primary health system: Lancet
21, Mar 2019
Of the 10 million new tuberculosis (TB) cases reported globally in 2017 by the World Health Organisation, 2.74 million were from India, showing a marginal reduction from 2.79 million in 2016. Despite TB incidence in the country being 204 cases per 1,00,000 in 2017, the government has set a highly ambitious target of “eliminating TB by 2025”, five years ahead of the Sustainable Development Goals (SDGs) target.
The Lacent Data:
- According to The Lancet Global Health article based on modelling for three high-burden countries, including India, compared with 2015 data, 57% reduction in incidence and 72% reduction in mortality will been seen only by 2035.
- Strengthening the care cascade could reduce cumulative TB incidence by 38% in the case of India, it notes. India has to adopt measures to prevent TB on a population level to eliminate the disease in the coming decades.
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.
- 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 WTOs call to end TB by 2030.
- USAID-India End TB Alliance