Detect and report to wipe out TB

India accounts for the largest number of tuberculosis deaths reported from all over the world. A WHO report has estimated that the country saw more than one-third of the 1.5 million TB-related deaths in 2014. Even with a large population, this is a high number, especially when TB is a preventable and curable disease. The disease is a major killer worldwide, and is more prevalent among poorer countries. Among 9.6 million new TB cases detected last year, 58 per cent were in Asian and western Pacific regions. India, Indonesia and China accounted for the largest number, with India leading the table with 23 per cent of the cases. The report also says that reporting of TB has improved globally, and this is mainly because there is better reporting from India. Detection and reporting are the first requirements for successful implementation of any programme to treat and eradicate the disease.

Most of the deaths caused by tuberculosis could have been prevented. It was once considered an incurable disease but effective treatment is available now. The high number of cases and deaths show that the government-sponsored anti-tuberculosis programmes have not either reached all the targeted groups and individuals or failed to successfully treat all patients. The success rate in treatment improved from 25 per cent in 1995 to 88 per cent in 2013. However, for a completely curable disease this is a low success rate. It is over 95 per cent in China. One major problem is that many patients stop their treatment while still on its course. It is necessary to complete the course for total cure but many patients discontinue due to loss of income during the treatment or for other reasons. Most of those who contract the disease are from poor backgrounds and many are not literate enough to understand the need to complete the course of treatment. A break can be dangerous too because there are chances of multi-resistant strains of the disease developing. This will make the fight against TB even more difficult. All this underlines the need for effective detection and intervention programmes and continuous monitoring of cases. Since there is a social and economic context for the disease, improvement of nutrition, life styles and living environment is also important.

Better communication and awareness campaigns are needed. The Revised National Tuberculosis Control Programme should take these factors into consideration. The report also calls for creation of more laboratory services. This is especially relevant to India as the services available in the country are considered to be inadequate.