India among Asian nations that may account for 7 mn additional TB cases

India and other nations in the WHO South East Asia region may account for seven million additional tuberculosis cases and 1.5 million TB deaths between 2022-2026, the World Health Organisation warned on Thursday.

The alert comes on the eve of Prime Minister Narendra Modi’s announcement of a pan-India roll out of a shorter TB preventive treatment for vulnerable individuals and a few other schemes that are meant to accelerate India’s TB elimination goal.

“The overall impact of the crisis (pandemic) could lead to over 7 million additional TB cases and 1.5 million additional TB deaths between 2022 and 2026,” the WHO South East Asia region said in a statement, ahead of the World Tuberculosis Day. India, with the world’s largest TB burden, is the region’s biggest nation.

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The WHO South-East Asia region bears the world's highest TB burden. In 2021, the region accounted for more than 45 per cent of global TB incidence and more than half of global TB deaths. In 2020, the region notified 2.6 million new and relapse TB cases, a 24 per cent reduction from 2019.

The Covid-19 crisis has exacerbated key social and economic determinants of TB such as poverty and under-nutrition, pushing tens of millions people in South East Asia into extreme poverty.

Even before the pandemic, an estimated 30-80% of TB patients in the region faced catastrophic costs due to TB, and around one million new TB cases annually - more than one in five - were attributable to under-nutrition.

While the Union Health Ministry has launched programmes to boost nutritional standards of TB patients, the Prime Minister will launch other schemes to fast track India’s target of TB reduction by 2025, five years ahead of the UN deadline even though there are question marks on the target.

At Varanasi, Modi will launch the TB-Mukt Panchayat initiative; roll out a pan-India scheme to provide shorter TB preventive treatment (TPT); introduce a family-centric care model for TB and release India’s Annual TB Report 2023.

One of the key WHO recommended interventions as a part of its End-TB strategy, the TPT is for treating those without the disease but in close contact with TB patients with a single medicine (isoniazid) for six months.

Family members of TB and HIV patients; people living with HIV, people who will start anti-TNF treatment, who will receive dialysis, or who are preparing for organ or haematological transplantation besides prisoners, health-workers and immigrants from high TB burden countries are eligible for TPT.

In 2021, the South East Asia region achieved a partial recovery, reporting 3 million new and relapsed cases, but it is still 12 per cent fewer than in 2019.

Globally, the Covid-19 pandemic has not just stalled but reversed years of progress towards the End TB milestones. In 2021, the estimated burden of new and relapse TB cases globally was 10.6 million, an increase of half a million compared to 2020. Mortality from TB and TB-HIV co-infection stood at 1.6 million, an increase of around 200,000 from pre-pandemic levels.