Tuberculosis, predominantly caused by Mycobacterium TB, is one of the oldest known communicable diseases. In India, “National Tuberculosis Control programme (NTCP)” was launched in 1962. However no appreciable change in the epidemiological situation of TB in India has been observed to overpower the disease declared as a Global emergency in 1993 by WHO. India TB Report 2022 has concluded that the prevalence rate of TB in the country is 312 cases per 100,000 people. Even though the numbers have reduced marginally from 320 in 2015 to the current figure between 2019-2020, it is still far higher than the target set by the 2017 National Strategic Plan for TB Elimination: 170 by 2020, 90 by 2023, and 65 by 2025. But even these worrying figures do not reveal the entire picture.
In 1993 “Revised National TB Control Programme (RNTCP)” was launched as a Pilot Project in five States adopting Directly Observed Treatment Short course Strategy (DOTS) which was further extended in a phased manner in the whole country.
DOTS is a systematic strategy to control TB disease which has the following five components:Political & Administrative commitment; Good Quality diagnosis, primarily by Sputum Smear Microscopy; Un- interrupted supply of quality drugs; Directly Observed Treatment and Systematic Monitoring & Accountability.
RNTCP is now introducing the Daily Treatment Regimen replacing the old intermittent DOTS regimen where in the Anti-TB drugs shall be given on daily basis to TB patients.
Last week, on the eve of World Tuberculosis Day, Anantnag, Kupwara and Pulwama for showing progress of 60-80% reduction in TB cases claimed Gold medal while Baramulla district for about 20% progress secured the Bronze category along with 55 other districts in India. The numbers for other 16 districts have not been so impressive on the TB front.
Some experts say that the shortage of funds, poor public awareness, delay in diagnosis and initiation of treatment are some of the chief reasons for the slow progress in the reduction of TB.
There needs to be a multi-pronged approach to removing the barriers to equitable TB care. There is a need to increase occupational screening, nutritional interventions for the malnourished and a gender-responsive approach to TB. These measures are crucial in addressing the gaps to control the disease.
Also, unfortunately society has attached a social stigma with TB. Awareness among people is to be spread to eradicate this attitude and create a conducive environment so TB patients do not face any inconvenience.