Context

• World TB Day was observed on 24th March with the theme of ‘Yes! We can end TB’.
• This article urges the Indian government to act in a still better way to eradicate TB or to fight with TB which claims 4,00,000 Indian lives annually.

Issues associated with TB management

• Most Indians believe that TB is unlikely to happen to them as a result of critical failure in addressing information gaps that exist around TB. 
• Most Indians still do not know the symptoms of TB, most doctors rarely order enough TB tests, and a staggering one million cases remain unreported in India.
• Reliable and affordable diagnostics for both drug-sensitive and drug-resistant TB remain inaccessible to most.
• Gaps in implementation and inadequate financial support of the Nikshay Poshan Yojana (NPY). (500rs now)
  • NPY aims to support every TB Patient by providing a Direct Benefit Transfer (DBT) per month for nutritional needs.
• TB is highly stigmatized within communities, families, and patients routinely face discrimination within the health system. 
• The largest number of TB cases are diagnosed and treated in India’s unmonitored private sector where the quality of care is unreliable, and diagnosis and treatment are expensive and often inaccurate. 

Way forward

• • Normalizing and destigmatising TB testing:  By organizing large-scale socially relevant campaigns targeted both the population and India’s healthcare providers.
    • TB survivors can play a critical role in helping design such communication and community support strategies that actually work.
  • Ensuring accessible and affordable diagnostics: India needs to urgently invest in diagnostics, focusing on the scale-up of new diagnostic tests and offering universal drug-susceptibility testing (DST) to all TB patients and also ensure every Indian seeking care can easily access accurate TB tests for free.
  • Implementing best available treatment: The universal implementation of the shortest and best available TB regimens for TB prevention, drug-sensitive TB and drug-resistant TB is needed. If cost is an obstacle, options such as compulsory licensing has to be considered.

• Addressing implementation gaps in NPY: The amount for NPY needs to be increased to at least Rs 2,500 for the TB-affected.

• Adequate provision for treatment: Providing both patient and family counseling, information and support to help mitigate mental health impact and reduce stigma is needed.

• Stigma reduction measures: India needs to launch a national campaign for stigma reduction and provide counseling and mental health support to TB-affected individuals particularly women, trans individuals and the LGBTQIA++ community. 

• Public private partnerships: An innovative and well-thought-out people-centred private sector engagement strategy is needed  for which successful examples of public-private partnerships can be considered and incorporated into our national plans.

• Invest in research: India needs to rapidly invest in TB-related research.

Conclusion

• Innovation, rethinking current strategies and putting people at the center of our efforts can help achieve India’s target of eradicating TB by 2025.