National TB Workshop calls for knowledge-sharing for better TB management

The workshop aimed to strengthen and bring forth existing and emerging partnerships in the public and private sector and other players involved in comprehensive TB care and treatment in India.

The Central TB Division, Ministry of Health and Family Welfare and CARE India organized a national workshop, “India Towards Comprehensive TB Care; Building Partnerships and Integrating TB Control Response” today. The workshop aimed to strengthen and bring forth existing and emerging partnerships in the public and private sector and other players involved in comprehensive TB care and treatment in India. The panel discussions in the workshop focused on developing a workable strategy and roadmap based on best practice models and recommendations for an effective TB response in India along with ways to contribute to the Revised National TB Control Programme (RNTCP) of the GoI.

The workshop also marked the release of key learnings report, “Improving Treatment Adherence for TB: Learnings from MDR-TB Project from West Bengal”- a project of CARE India executed with support from Eli Lilly. The report was released by Mr C K Mishra, Secretary, Ministry of Health and Family Welfare, GOI. The release was followed by the screening of a film which showcased highlights from the project.

Shri C K Mishra gave the key note address at the workshop, sharing that, “there is an urgent need to reposition and reshape TB care and treatment by focusing on access, addressing treatment and adherence issues, and fostering multi-stakeholder collaboration. We have to involve the private sector to become our DOTS provider, engage with more civil society partners, optimize resource management to get maximum return on investment, and change public perception. There is also a need to initiate new research on the disease, and improve systems to enable patients with correct diagnosis for complete cure. Today’s deliberations will greatly help in addressing current concerns and prepare a workable roadmap to reduce TB-related morbidities in India.” Read more on how to prevent TB.
Mr Rajan Bahadur, MD and CEO, CARE India shared in his welcome address that, “TB continues to be a serious public health challenge in India, especially with increasing cases of MDR-TB and HIV-induced TB cases in India. While the National Strategy Plan for TB is being finalized, this workshop is an effort to get experts from multiple sectors, discuss lessons learnt, share best practice models, offer recommendations and encourage multi-sectoral partnerships and inter-ministerial coordination for TB control. It will pave the way for increased public-private engagement, develop an integrated TB response plan to overcome present challenges around adherence and treatment.”

Dr. Sunil Khaparde, DDG, Central Tuberculosis Division, Ministry of Health and Family Welfare, placed emphasis on the fact that, “TB is not only a medical problem but also a social health issue. Lack of access to the social determinants impacts and aggravates the medical aspects of the disease. The Government of India is the enabler of healthcare services and highly committed towards eradicating the disease, but it urgently needs the support of the private sector. Communication for social mobilisation, diagnosis and treatment of the disease and its co-morbidities, and programme management are core areas where the private sector partners can play a significant role. We need to integrate our overall strategic approach to reach every TB patient, treat them with high-quality drugs and prevent new cases among susceptible populations.” (Read: 10 facts about tuberculosis (TB) you should know)

The event saw two panel discussions focused on strengthening the TB narrative. The eminent panel for the first discussion, chaired by Mr. AK Jha, Economic Advisor, Ministry of Health and Family Welfare, deliberated upon building partnerships on inter-sectoral response for TB Control, the learnings and way forward. The discussion focused at how the TB outreach needs to be modelled on the HIV outreach as it has been a successful exercise under public health with a national decline rate of 67% as against the world decline rate of 41% for HIV cases. We can also utilize existing platforms such as the NRLM under the Ministry of Rural Development, for upscaling of information and messages to build awareness. The second panel, chaired by Dr. A Venkataraman, Faculty of Management Studies, University of Delhi & National PPM Committee Member, focused the discussion on the emerging TB challenge in India and ways to strengthen public private partnerships. The deliberation brought about important facets of how there is an imminent need to increase awareness around the disease, build capacities of the field workers and also the need to position TB as a disease that needs immediate response from both the government and the private sector.

(Read: Real success rate of TB treatment in India is much lower than that stated by the government)

The burden of TB in India, according to the Global TB report 2015, is 2.2 million new TB cases annually with 167 cases per 100,000 population. The current prevalence rate is 2.5 million cases with 195 cases per 100,000 population. About 2,20, 000 deaths occur each year with 17 deaths per 100,000 population and about 5% of TB patients are estimated to be HIV positive. Although the prevalence and mortality rates have declined in recent years, but an estimated 1 million cases a year still go undetected and/or unreported and delays in the diagnosis and treatment of TB continue to be widespread. Improvements in public sector service delivery alone will not be sufficient to achieve the GoI goals of a 95% reduction in TB deaths and a 90% reduction in TB incidence rates by 2025. There needs to be more scalable and sustainable PPM models that will be a critical contributor in achieving the goals.