With current pandemic testing our resilience of undeterred efforts towards our vision of TB free India, the country is driving for its mission amidst all challenges through systematic efforts. Dr Vandana Dabla, Voluntary Health Services, Accelerating Sustainability of Public Health Systems in India to Prevent, Detect, and Respond to Infectious Disease Outbreaks and Other Public Health Emergencies Project and Dr K S Sachdeva, Deputy Director General and Head, Central TB Division, Ministry of Health & Family Welfare share some insights on the relentless efforts and strategies to realise TB free vision of India, when the country accounts for a quarter of global TB case burden and faced with an unavoidable health challenge of global pandemic
In India, tuberculosis is more than a disease! The country accounts for a quarter of global TB case burden, with its 2.64 million population affected by this disease and documenting 16 per cent mortality. While the country also shares the highest international burden of Drug-resistant TB (DR-TB) cases (27 per cent); it remains as a public health threat with only one-third infected patients get enrolled for DR-TB treatment.
Nonetheless, the current pandemic is also testing our resilience of undeterred efforts, eliminating this disease is equally challenging as eliminating its stigma. With social stigma and its common risk factors like immunocompromised population, undernourishment, alcoholism, diabetes etc., has made the eradication more of a fighting task. However, recalling TB management timelines, India is undoubtedly driving for its mission amidst all challenges. Penetrating services to the smallest districts, a well implemented state level planning and strategically designed national policies are giving every hope to achieve our ambitious aim to eradicate it from the country by 2025.
India, with its progressive approach, invested its efforts in a systematic national strategic plan. It finalised and released the operational guidelines for TB services across Health & Wellness centers; implemented “Single Window Services” for all co-infected patients of TB and HIV infection; and launched TB Preventive Therapy among vulnerable population, in addition to inclusion of private sector engagement to avoid missing any links in successful management of disease. Moreover, to address the gender-specific challenges in accessing the TB services, a proactive approach is adopted in 2019 for gender-specific interventions in TB prevention, diagnosis and treatment. Further, the research is being promoted among the species and phytochemical extraction from medicinal plants for anti-TB drug development.
The pandemic, inciting the national lockdown certainly challenged the continuity of efforts, however the immediate action plan was put into force to continue the treatment services. Efforts have been made to deliver uninterrupted services to already Notified TB patients. Systematic monitoring of service delivery cascade from early case detection to treatment; and strengthening the online monitoring through NIKSHAY/ Nikshay Aushadhi.
The innovative service delivery models were outlined and applied to district and sub-district levels, with the collaborative efforts from community organisations, development partners and stakeholders. Home delivery of anti-tuberculosis treatment (ATT) drugs from Primary Health institutions were arranged, with focused attention to uninterrupted ATT Quarantined / Isolated TB patients. Special facilities were drawn towards collection and transportation of priority samples from TB patients. A regular counselling schedule was drafted and followed for the on-treatment TB patients to ensure adherence and monitoring. The efforts ensured minimum 72 per cent TB treatment coverage with 84 per cent treatment success rate.
India has come a long way in its approach towards tuberculosis management. It’s assuming an enormous amount of strategic inter-sectoral collaborative attempts, consistently. Its coherent endeavour supports the country’s enthusiasm to mirror the United Nations Sustainable Development Goals for healthcare. Although challenging in the dynamic phase of public health threat, the country is putting its best efforts possible to attain its TB elimination goal with defined strategies, integrated efforts of parallel health services and community and stakeholder’s participation.