India Leading the Global TB Elimination Response: WHO Report
Jan 05,2024
The recently released World Health Organization’s Global TB Report 2023 affirms significant victories for India . The report noted that since 2015, India has seen a 16% decline in TB incidence, almost twice the rate of global decline, and a reduction in mortality due to TB by 18%. These impressive gains have been made by decentralizing TB care to the remotest parts of the country, saturating every Panchayat, block, and district with quality and patient-centric TB care. With the government’s ongoing flagship programme, Viksit Bharat Sankalp Yatra, we aimed to further “reach the unreached” and ensure all patients, irrespective of where they seek care, receive a quality diagnosis, treatment, and social support and entitlements.
The drive towards TB elimination gained momentum with a resounding political commitment of the Hon'ble Prime Minister when he pledged to eliminate TB from India by 2025, five years ahead of the global goals. This commitment finds reinforcement in strategic policies embedded in the National Strategic Plan (2017-2025), designed to reach the last mile. To that end, several novel and patient-centric interventions were rolled out to improve case detection. The private sector was motivated through sustainable engagement models and incentive structures, upgradation of the program’s diagnostic capacity and strengthening of community engagement approaches. These measures have brought about a paradigm shift in the management of TB and transformed the country’s TB elimination response.
Our framework and comprehensive strategy to engage with the private health care sector, in particular, has drawn praise from across the world. Since 2014, notifications from the private sector have surged sevenfold, reaching nearly 763,000 cases in 2023 (constituting over 32% of total notifications in the year). Policies and programmatic interventions such as the mandatory notification policy, collaborations with professional medical associations, and the roll out of innovative engagement programs called Patient Provider Support Agency (PPSA) programs across 200 districts, have shown tremendous success and hold lessons for countries across the globe, especially those from the Global South.
Alongside, the TB program’s steadfast efforts to strengthen our diagnostic capacity have improved case detection and reduced delays in diagnosis – since 2017, India has scaled up the WHO-recommended molecular tests from 651 molecular diagnostic machines in 2017 to 5,090 in 2022. The commitment to advancing diagnostic methodologies is evident as certain States, including Goa and Lakshadweep, have entirely phased out microscopy tests, transitioning to a 100% adoption of molecular tests. Similarly, Andhra Pradesh has significantly reduced its reliance on microscopy. This shift underscores a concerted effort to embrace more effective diagnostic technologies in the fight against TB.
Furthermore, flagship initiatives, such as Ayushman Arogya Mandirs have expanded the scope of care for TB patients. Community Health Officers (CHO) in over 1.6 lac Ayushman Arogya Mandirs actively screen potential TB patients and refer cases to diagnostic centers. Recognizing the link between nutrition and TB, the Ni-Kshaya Poshan Yojana, launched in 2018, provides crucial monthly nutrition support of Rs 500 to TB patients. As of now, approximately Rs 2,613 crore has been transferred to the bank accounts of around 95 lakh TB patients.
Source: Healthworld