Tuberculosis takes hundred thousand Indian lives every year and the cost associated with the Indian economy was approximated to be above 300 billion US dollars. Tuberculosis has been registered as a public health epidemic with India bearing an unfair share of tuberculosis mortality rates. Of 2011 statistic, India reported a whooping 2.6 million cases on an incidence of 9.6 million cases worldwide. The new category of a TDR-TB or Totally Drug Resistant Tuberculosis gave the epidemic a turn for the worse. As of today, the country has been awarded the status of being the TB capital of the world by the world health organisation.
To eradicate this epidemic, the Government of India has advanced the goal to eliminate TB to 2015, 5 years ahead of it’s global contemporaries fighting against this disease. The target comes with it’s own set of debates on attainment as every one out of four TB patients is an India as stated by Stop Tb. Even though the incidence of TB saw a drop from 289 to 217 in a span of 15 years (2000 to 2015), the necessary elimination of Tuberculosis would require the count of victims to drop below one person out of 10,00,000 people. Unsurprisingly, ambitious target seems far-fetched and dramatic to a lot of experts.
The healthcare industry talks of the aforementioned eradication as more of a social problem with homelessness and pollution, both of which is an abundant occurrence in the country, being the leading causes of people contracting the disease. The bacterium Mycobacterium Tuberculosis is airborne. It can be communicated by coughing, sneezing or simply talking with an affected individual. The bacterium often finds home in the tissues where it remains dormant for days, years even, only to come out when the immune system weakens. No wonder, every third AIDS patient in India die of tuberculosis. Other risk factors include smoking tobacco, whether active or passive, malnutrition, use of unclean fuels and improper diagnosis. It is a standing problem across the country where tuberculosis is treated unsuccessfully due to improper diagnosis of it’s drug resistance.
Professor Madhukar Pai, Associate Director of McGill International TB Centre, Canada, points out to explicitly to a magazine that the global TB community is still undecided on ways to hold the leaders accountable for their big declarations and commitments. He adds that the world is audience to India’s way of execution of the TB free Campaign by 2025. With 6 years remaining, the sand is swiftly falling through the hourglass.
On the contrary there are optimistic health experts who believe that the right systems, partnerships and political willingness are the driving forces of India’s progress in the fight against TB. The END TB summit that was recently held in New Delhi was a platform to strategise appropriate measures to end the dreaded disease. These are a part of the implementation along with the National Strategic Plan (NSP) 2017-2025 for TB Elimination in India.
Dr Suvanand Sahu, Deputy Director of Stop TB Partnership points out that India has been fighting TB for quite some years now. However the recent shift in paradigm with bold commitments and strong strategies might lead the fight to a turn for the better. The path to actualising the commitments need an elevation in innovations, policies, research and resources followed by a massive scale of implementation. The budget for TB has gone up and strong policies are being enacted upon notification. The challenge in a diverse country like India is to find the uniformity in the implementation of policies.
Dr. Henk Bekedam, the WHO Representative to India informs that from the National Health Policy 2017 and the Ayushman Bharat-National Health Protection Mission, it is evident that health is accorded the top-most priority. He also adds that the current initiatives cover all bases and could prove transformational in India’s fight against TB. The identification of TB as a major public health problem and the strong political commitment to end TB by 2025, five years ahead of global Sustainable Development Goals (SDG) target of 2030, outlines bold policies undertaken.
Detect, treat, prevent and build constitute the pillars on which TB elimination strategy rests. While finding, testing and treating remains the main focus, the NSP also aims to empower communities and create awareness to fight the epidemic at the grass-root level.