The Growing Effort to Address Tuberculosis in India

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NEW DELHI — While it has been effectively eliminated from developed nations, tuberculosis still remains a present epidemic. The World Health Organization (WHO) has estimated that there were over 10.4 million new cases of tuberculosis around the world in 2016. Tuberculosis in India has been the biggest threat to the country over the past decade, with 25 percent of the 10.4 million new cases that arose last year stemming from the nation-state.

Tuberculosis 

According to WHO, tuberculosis is the ninth global leading cause of death. Charles P. Davis defines tuberculosis as “a multi-systemic infectious disease caused by Mycobacterium tuberculosis,” and it is transmitted from person to person by being very contagious.

Due to its large-scale prevalence, tuberculosis in India has been combatted with fervent efforts. Starting in 1997, the government of India implemented the Revised National Tuberculosis Control Program (RNTCP); by 2006, the entire nation was covered by this program.

RNTCP uses the Directly Observed Treatment Short Course (DOTS) strategy recommended by WHO, which is how it’s currently able to reach over 1 billion people in 632 districts throughout India.

The main goal of the program was initially to be able to have a tuberculosis treatment success rate of about 85 percent among new sputum positive (NSP) patients, and this goal entails a laboratory test on a patient’s phlegm to find out if there is a mycrobacterial infection. NSP patients are those that have never received treatment for tuberculosis before or they have only been taking drugs as treatment for less than a month.

Developments Against Tuberculosis 

Along the way in 2012 through 2017, there also grew the National Strategic Plan which uses the resources provided through RNTCP that aimed to achieve universal access to provide quality diagnosis and treatment for tuberculosis. This biggest challenge prior to this program was that tuberculosis itself developed multi-drug resistant (MDR) strains which prior medication and treatment efforts would not work on. Due to this occurrence, scientists and doctors have to continuously identify new strains and develop new treatment plans so that the infection doesn’t spread even more. A total of 93,000 people with MDR tuberculosis were diagnosed and given treatment by 2015.

In 2017, the government announced their goal to have tuberculosis in India completely eliminated by 2025. However, in order to accomplish this mission, there has to be a review of the previous plan with new policies and resources provided. The biggest issues identified by the Joint TB Monitoring Mission (JMM) for the 2012-2017 plan was a lack of funding and a lack of cooperation in the private sector. Many individuals with tuberculosis are unable to afford diagnosis and treatment. The government will thus have to permit increased funding for the program to ensure that all patients receive standard care for tuberculosis in the country.

The private sector is run by private individuals or groups that are not controlled by the state. Arguably, practices run in this sector don’t have to follow government guidelines for state-implemented programs. However, in order to have correct data on tuberculosis cases, early diagnoses and the necessary treatment regimens, private practices need to be in sync with the government operations.

Enforcement of Health Policies 

A government order in May 2012 made it compulsory for health care providers to notify every tuberculosis case diagnosed; this effort hasn’t been as set in stone as it should be. In fact, there has been a lack of action taken by the government to enforce the order on those not following it.

With the amount of cases, the task of eliminating tuberculosis in India seems like an overwhelming process. However, tuberculosis is treatable, and the government of India has been very ambitious about tackling this epidemic.

Many groups are teaming up in order to close the gap in detection and treatment against current and potentially increasing strains of tuberculosis. If they can follow the recommendations provided by the JMM, fully fund the necessary budget and provide quality health care resources, then perhaps tuberculosis in India can become nothing more than a passing thought.

– Caysi Simpson

Photo: Flickr

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