Fighting TB: Challenges and Way Forward

Posted By Dr Rita Prasad on Tuesday 28-Mar-2017 in HEALTH
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Tuberculosis can affect any age, caste or class and it is one of the top 10 causes of death across the globe, ranking above HIV and malaria. To generate awareness, 24 March is observed as World TB Day. According to the World Health Organization (WHO), in 2015, there were 10.4 million new cases of TB worldwide. Six countries account for 60% of the total TB deaths, with India leading the count, followed by Indonesia, China, Nigeria, Pakistan and South Africa. As per WHO, each year about 2.2 million people develop TB in India and an estimated 220,000 die from the disease.

Challenges with regard to this illness in India include poor primary health-care and infrastructure in rural areas; unregulated private health care; HIV induced TB cases; lack of hygiene facilities and widespread malnourishment and poverty. The main variables that help understand tuberculosis transmission are  rapid unplanned urbanization, overcrowding, poor airborne infection control, poor nutrition, HIV, diabetes and tobacco use. Marginalized sections are at the highest risk because of inadequate healthcare systems and lack of access to tuberculosis treatment centers in remote, unreached areas.

In India, the Directly Observed Treatment-Short course programme is widely prevalent intervention and imperative for its treatment. This is one of the largest programmes in the world considering the number of patients it covers. However despite this, there is a need for greater co-ordination and collaboration between the private sector and public sector, the varied skill sets in practice, expertise and the resources allocated. The nodal agencies have to work in synchronization with one another, complementing each other to ease adherence and access.

Focus should be on understanding the key determinants like poverty, under- nutrition and tobacco smoking. This is so that prevention is the approach and not cure. In addition to this the gaps in the public healthcare system must be addressed as this is the main medium through which millions of Indians seek treatment. Although the Revised National Tuberculosis Control Program has worked toward improving the diagnosis of patients with free tests, free TB drugs, extended adherence support to increase rates of TB treatment, completion and involvement of private healthcare providers, there is more that can be done.

The Government of India aims to eradicate tuberculosis in India by 2025 by involving the private sector, NGOs and caregivers to improve earlydiagnosis, treatment adherence and outcomes for TB patients, and intersectional collaboration between different platforms that promote access to healthcare with regard to tuberculosis.

CARE India recently released its report, “Improving Treatment Adherence for TB: Learnings from MDR-TB Project from West Bengal”-based on its project executed with support from Eli Lilly. The findings of this report highlights that improved treatment outcomes are possible through counselling of patients to ensure compliance, capacity building of health providers, sensitization of community pharmacists and innovative patient support systems in West Bengal.The battle against TB is only half-won over 4 000 people lose their lives each day to this leading infectious disease even today. WHO is calling upon countries and partners to "Unite to End Tuberculosis" this year as ending TB by 2030 is a target of the Sustainable Development Goals.

Tuberculosis can affect any age, caste or class and it is one of the top 10 causes of death across the globe, ranking above HIV and malaria. To generate awareness, 24 March is observed as World TB Day. According to the World Health Organization (WHO), in 2015, there were 10.4 million new cases of TB worldwide. Six countries account for 60% of the total TB deaths, with India leading the count, followed by Indonesia, China, Nigeria, Pakistan and South Africa. As per WHO, each year about 2.2 million people develop TB in India and an estimated 220,000 die from the disease.

Challenges with regard to this illness in India include poor primary health-care and infrastructure in rural areas; unregulated private health care; HIV induced TB cases; lack of hygiene facilities and widespread malnourishment and poverty. The main variables that help understand tuberculosis transmission are  rapid unplanned urbanization, overcrowding, poor airborne infection control, poor nutrition, HIV, diabetes and tobacco use. Marginalized sections are at the highest risk because of inadequate healthcare systems and lack of access to tuberculosis treatment centers in remote, unreached areas.

In India, the Directly Observed Treatment-Short course programme is widely prevalent intervention and imperative for its treatment. This is one of the largest programmes in the world considering the number of patients it covers. However despite this, there is a need for greater co-ordination and collaboration between the private sector and public sector, the varied skill sets in practice, expertise and the resources allocated. The nodal agencies have to work in synchronization with one another, complementing each other to easeadherence and access.

Focus should be on understanding the key determinants like poverty, under- nutrition and tobacco smoking. This is so that prevention is the approach and not cure. In addition to this the gaps in the public healthcare system must be addressed as this is the main medium through which millions of Indians seek treatment. Although the Revised National Tuberculosis Control Program has worked toward improving the diagnosis of patients with free tests, free TB drugs, extended adherence support to increase rates of TB treatment, completion and involvement of private healthcare providers, there is more that can be done.

The Government of India aims to eradicate tuberculosis in India by 2025 by involving the private sector, NGOs and caregivers to improve earlydiagnosis, treatment adherence and outcomes for TB patients, and intersectional collaboration between different platforms that promote access to healthcare with regard to tuberculosis.

CARE India recently released its report, “Improving Treatment Adherence for TB: Learnings from MDR-TB Project from West Bengal”-based on its project executed with support from Eli Lilly. The findings of this report highlights that improved treatment outcomes are possible through counselling of patients to ensure compliance, capacity building of health providers, sensitization of community pharmacists and innovative patient support systems in West Bengal.The battle against TB is only half-won over 4 000 people lose their lives each day to this leading infectious disease even today. WHO is calling upon countries and partners to "Unite to End Tuberculosis" this year as ending TB by 2030 is a target of the Sustainable Development Goals.