TB Elimination Challenges       

The Ministry of Health and Family Welfare informed Rajya Sabha on Tuesday last that the incidence of Tuberculosis in India has reduced by 18% from 256/lakh population in 2015 to 210/lakh population in 2021. This was largely due to the implementation of the National Strategic Plan for Tuberculosis Elimination (2017-25), it said. As the numbers show, the challenge is still huge amid reduction of less than a quarter in the incidences.

There are some key challenges faced by the Government in the implementation of the programme, in fight against the elimination of tuberculosis, predominantly caused by Mycobacterium TB and remains as one of the oldest known communicable diseases.

The challenges enumerated by the government includes latent TB infection in the community (31% of the population as per National TB Prevalence Survey), social determinants of Tuberculosis beyond health and health seeking behaviour of the population due to lack of awareness and prevailing myths  and misconceptions in the community

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.

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.

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, 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. The challenges enumerated by the government must be confronted and among others awareness places a key role.

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