India faces challenges in meeting its "End TB" targets by 2025, despite being the global leader in TB cases. The country faces challenges in tackling the disease, including disruption of the drug supply chain, shortage of trained healthcare workers, and expensive molecular tests. Despite record high case notifications and a 24% decline in TB-related deaths since 2015, India needs to modify its TB control frameworks, including international best practices, and integrate TB services into primary healthcare.
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India struggles to meet its "End TB" targets by 2025.
It is a communicable bacterial infection caused by the bacterium "Mycobacterium tuberculosis" which spreads through the air when an infected person coughs, sneezes, or spits.
Two forms of TB:
It mainly affects the lungs, but can also affect other organs like the brain, kidneys, and spine.
Most cases are treated with antibiotics, However, drug-resistant TB may require different medications and longer treatment.
TB is preventable and curable. People with weakened immune systems are at higher risk of developing TB.
Extrapulmonary TB (EP-TB) affects organs other than the lungs, such as lymph nodes, kidneys, brain, and bones. While it accounts for 24% of all TB cases, EP-TB is often difficult to diagnose.
The symptoms are vague, mimicking other diseases, and are frequently missed or delayed in diagnosis, which results in advanced disease, highlighting the need for better-trained healthcare professionals and more accessible diagnostic tools.
In 2023, the World Health Organization (WHO) reported that about 8.2 million people were newly diagnosed with TB, marking the highest number recorded since WHO began monitoring in 1995.
In 2023, the TB incidence rate in India decreased to 195 per 100,000 population, down from 237 per 100,000 in 2015. TB-related deaths also reduced from 28 per lakh population in 2015 to 22 per lakh in 2023.
According to the World Health Organization’s Global Tuberculosis Report 2024 "India continues to be the leader in the global TB burden, accounting for 26% of the world’s TB cases".
Despite ambitious national initiatives like "End TB by 2025", the gap between policy and ground realities continues, highlighting the challenges in effectively tackling the disease.
Disruption of the drug supply chain pushes many patients and their families to purchase medicines from the open market, which increases overall health costs. Shortages also risked the development of drug-resistant TB, making treatment even more complicated.
One of the main challenges for the National Tuberculosis Elimination Programme (NTEP) is the shortage of trained human resources at district levels slowing down the diagnosis and treatment process.Expensive molecular tests and delays in lab results exacerbate the issue, making it difficult for patients to receive timely treatment.
Case notifications have reached record highs, and TB-related deaths have declined by 24% since 2015, outperforming the global decline. An achievement has been the treatment initiation in over 95% of notified TB cases. However, a more comprehensive approach involving multisectoral action, better training for healthcare workers, and addressing gaps in drug supply is still needed.
India needs to modify its TB control frameworks, by including international best practices like active case finding, more focus on high-risk groups, better integration of TB services into primary healthcare, and improving diagnostic capabilities. With Continuous effort and adaptation to local challenges, India can achieve the goal of ending TB.
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PRACTICE QUESTION Q. Discuss the burden of tuberculosis (TB) in India and its socio-economic impact on vulnerable populations. 150 words |
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