India’s Winding Road to ‘#EndTB’

Introduction

Tuberculosis (TB) remains one of India’s most significant public health challenges. Despite decades of efforts, the disease continues to affect millions of lives, creating economic, social, and health-related challenges. The World Health Organization (WHO) has set the ambitious target of ending TB globally by 2030 under the Sustainable Development Goals (SDGs). India, however, has set an even earlier target to eliminate TB by 2025, underscoring its commitment to the cause through its National Strategic Plan for TB Elimination (2017–2025).

This eBook provides an in-depth analysis of India’s journey to achieve the ‘#EndTB’ goal, detailing its successes, challenges, and the way forward. It is particularly relevant for UPSC aspirants studying topics related to health, governance, and social development.

TB in India: Current Status

Prevalence:

India accounts for nearly one-fourth of the global TB burden.
In 2022, approximately 2.2 million new TB cases were reported in India, according to WHO estimates.

Mortality:

TB remains one of the top 10 causes of death in India, with nearly 500,000 deaths annually attributed to the disease.

Economic Impact:

The economic cost of TB is substantial, with affected individuals often losing income due to prolonged treatment and stigma.
It is estimated that TB costs the Indian economy nearly $32 billion annually in lost productivity.

Vulnerable Populations:

TB disproportionately affects marginalized communities, including those living in poverty, malnourished individuals, and people with HIV/AIDS.

Government Initiatives to Tackle TB

National Tuberculosis Elimination Program (NTEP):
- Formerly known as the Revised National Tuberculosis Control Program (RNTCP).
- Focuses on early detection, free treatment, and prevention of TB.
- Promotes a universal drug-susceptibility testing approach to combat drug-resistant TB (DR-TB).
Nikshay Poshan Yojana:
- Provides Rs. 500 per month as nutritional support to TB patients during their treatment.
- Aims to address malnutrition, which exacerbates TB.
Active Case Finding (ACF):
- Identifies cases in high-risk populations through community-based screening.
National Strategic Plan for TB Elimination (2017–2025):
- Aims to achieve a TB-free India by focusing on universal access to TB care and prevention.
- Incorporates strategies like patient-centric care, surveillance, and public-private partnerships.
Ayushman Bharat:
- Supports TB patients by providing financial assistance and ensuring access to healthcare services.

Achievements in the Fight Against TB

Increased Notification Rates:
- The government’s efforts have resulted in a significant rise in TB case notifications.
- From 1.7 million cases in 2018 to over 2.2 million cases in 2022.
Improved Diagnostics:
- Introduction of advanced diagnostic tools like CBNAAT (Cartridge-Based Nucleic Acid Amplification Test) and TrueNat for quicker and more accurate TB detection.
Expanded Drug-Resistant TB Treatment:
- Comprehensive treatment programs for multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB).
Public-Private Partnerships:
- Collaboration with private healthcare providers to ensure universal TB care.
Community Engagement:
- Initiatives like Nikshay Mitra, where individuals and organizations adopt TB patients to provide nutritional and social support.

Challenges in Achieving the #EndTB Goal

Drug Resistance:
- The emergence of MDR-TB and XDR-TB poses a severe challenge due to the higher cost and longer duration of treatment.
Underreporting:
- Despite progress, a significant number of TB cases go unreported, particularly in rural and marginalized communities.
Social Stigma:
- Stigma associated with TB often leads to delays in diagnosis and treatment, worsening outcomes.
Healthcare Infrastructure:
- Inadequate healthcare facilities and workforce, particularly in remote areas, hinder TB elimination efforts.
Funding Constraints:
- While India has increased funding for TB programs, the resources are still insufficient to meet the ambitious 2025 target.
Comorbidities:
- High prevalence of diabetes and HIV/AIDS complicates TB management.

The Way Forward

Strengthening Surveillance and Detection:

Enhance Active Case Finding programs to detect cases early, particularly in high-risk populations.
Leverage technology for real-time data collection and monitoring.

Focus on Drug-Resistant TB:

Scale up access to second-line drugs and newer regimens like Bedaquiline and Delamanid.
Establish more drug-resistance testing labs.

Public Awareness Campaigns:

Launch campaigns to reduce stigma and promote early diagnosis and treatment.
Involve community leaders and NGOs in awareness drives.

Addressing Social Determinants:

Improve nutrition, housing, and living conditions to address the root causes of TB.
Expand social welfare programs like the Nikshay Poshan Yojana.

Strengthening Healthcare Infrastructure:

Invest in capacity building of healthcare workers, especially in rural and underserved areas.
Upgrade health facilities to improve accessibility and quality of TB care.

Private Sector Collaboration:

Strengthen public-private partnerships to integrate private healthcare providers into the national TB program.
Incentivize private practitioners to report TB cases and follow treatment protocols.

International Collaboration:

Learn from best practices of other countries like China and South Africa.
Collaborate with global organizations for technical and financial support.

Relevance for UPSC Aspirants

General Studies Paper II (Governance):

Analyze government initiatives, policy implementation, and challenges in tackling TB.

General Studies Paper III (Health):

Focus on the public health aspects of TB, including its economic and social impact.

Essay Paper:

Topics like “Health is Wealth: Combating Tuberculosis in India” or “The Role of Public Health Initiatives in Nation-Building.”

Ethics Paper:

Ethical considerations in addressing health inequalities and providing equitable healthcare access.

Prelims:

Be familiar with schemes like NTEP, Nikshay Poshan Yojana, and technical terms like MDR-TB and XDR-TB.

Conclusion

India’s fight against TB represents a critical test of its public health system’s efficiency, equity, and resilience. Achieving the ambitious goal of ending TB by 2025 will require sustained political will, community participation, and innovative solutions. While the road to ‘#EndTB’ is winding and fraught with challenges, it also offers a unique opportunity for India to showcase its commitment to health equity and global health leadership.

For UPSC aspirants, understanding this issue provides key insights into health governance, the interplay between development and public health, and the ethical dimensions of combating a preventable yet deadly disease. By drawing lessons from India’s journey, aspirants can develop nuanced perspectives on public policy and governance in health.

Maximize the benefits of mock tests for IAS and KAS preparation with guidance from Amoghavarsha IAS Academy . For more details, visit https://amoghavarshaiaskas.in/.

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Current Affairs ( Prelims )

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India’s Winding Road to ‘#EndTB’

Introduction

TB in India: Current Status

Government Initiatives to Tackle TB

Achievements in the Fight Against TB

Challenges in Achieving the #EndTB Goal

The Way Forward

Relevance for UPSC Aspirants

Conclusion

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