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​India has made progress in detecting, treating, and preventing TB, however, universal health coverage demands addressing inequitable healthcare access.

Advancements in TB diagnosis in India

Tuberculosis (caused by Mycobacterium tuberculosis) remains one of the most significant public health challenges despite significant progress in detection, treatment, and prevention.

The country accounts for nearly 25% of the global TB burden, with millions of cases reported annually.

Challenges

• Unequal access to healthcare services, particularly for marginalized communities.
• High out-of-pocket expenditure (OOPE)
• Insufficient integration of TB care into general healthcare systems.
• Social stigma and misinformation hinder early diagnosis and treatment.

TB Diagnosis 

Conventional methods like sputum smear microscopy delayed detection and missed cases due to lower sensitivity. Molecular testing platforms such as CBNAAT (Cartridge-Based Nucleic Acid Amplification Test) and TrueNat detect TB within hours and also identify drug-resistant strains.

BPaLM treatment

India introduced the BPaLM regimen (Bedaquiline, Pretomanid, Linezolid, Moxifloxacin) to treat multidrug-resistant TB (MDR-TB)

Unlike older treatments that lasted 18–24 months and included painful injectable drugs causing severe side effects like hearing loss, BPaLM reduces treatment duration to just six months. This improves patient compliance, lowers dropout rates, and minimizes the development of further drug resistance. 

Ni-kshay Poshan Yojana (NPY)

It provides direct cash transfers to patients’ bank accounts, to reduce financial stress and ensure access to nutritious food.

Government recently increased the monthly cash entitlement under NPY from ₹500 to ₹1,000 per patient.

Ayushman Bharat

Ayushman Bharat integrates TB services into general healthcare, decentralizing care and making it more accessible.

Patients diagnosed at tertiary hospitals can now access treatment at local health centers, which reduces travel costs and dropout rates.

Community health officers monitor early-stage TB patients, and ensure timely hospitalization for severe cases.

Steps needed to achieve equitable TB care

The Union Government needs to adopt initiatives like Kasanoi Erappila Thittam (TN-KET) in Tamil Nadu to focus on identifying and admitting high-risk TB patients.

Factors like gender, socio-economic status, and disability influence healthcare access. While the NTEP’s gender-responsive framework is a step forward, further efforts are needed to address intersectional vulnerabilities affecting TB outcomes.

Many TB patients actively suffer from coexisting conditions like COPD or depression. Implementing AI-enabled chest X-rays for TB and COPD screening, along with routine tests for non-communicable diseases, actively improves overall patient health.

Indirect costs like wage loss during treatment strain patients. Expanding social protection measures, such as wage-loss compensation and livelihood programs for TB survivors, mitigates these economic challenges.

Misinformation about TB hinders early diagnosis and treatment adherence. Large-scale public health campaigns, similar to those during the COVID-19 pandemic, combat stigma and drive awareness.

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Source:

THEHINDU

https://t.me/+hJqMV1O0se03Njk9