Urgent, unprecedented action needed to end TB in India in next 32 months: Expert

India is looking to eradicate TB by 2025, five years ahead of the global target for the same

Urgent and unprecedented science-backed actions are crucial for bringing an end to tuberculosis in India in the next 32 months, with Prime Minister Narendra Modi setting a target to end TB in the country by 2025, five years ahead of the global goal to eradicate the public health threat by 2030.

During India’s Presidency year of G20, a Global TB Summit is also being held in Varanasi to mark this year’s World TB Day on March 24.

“With domestic capacity to produce and supply the best of TB medicines and diagnostics, and robust TB R&D, India has demonstrated leadership in scaling up access to TB prevention, diagnostics, treatment and care as no other country globally. Despite these important successes, we need much stronger actions with a sense of urgency and purpose if we are to end TB by 2025 in India,” said Mumbai-based Dr Ishwar Gilada, Consultant in HIV and Infectious Diseases, and Secretary General of People’s Health Organization (PHO).

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“TB rates need to decline many times more steeply than the current rate of annual TB decline. Likewise, TB deaths too need to be reduced quickly. We need to remember that TB is a preventable and curable disease, and even one death is a death too many. Every new case of TB infection is a grim reminder of what we could have averted if infection control measures were more effective – including treating latent TB infection,” said Dr Gilada.

Several recent initiatives of the National TB Elimination Programme of the Government of India have begun to yield fruit. For example, the Public Private Partnership (PPP) model of the government-run programme is very effective and needs to be emulated by other programmes such as National AIDS Control Programme (NACP). In South Mumbai, for instance, Unison Medicare and Research Centre is the only private sector entity recognized by the government-run programme where patients can access the latest medicines like Bedaquiline (supplied by the government within hours of due requisition). However, more private sector healthcare services need to be approved so that they can effectively contribute towards TB eradication. Unfortunately, stigma against TB and more so against MDR-TB is much higher among doctors.

According to Dr Gilada, we also need to focus more on children and young people as almost one out of every ten persons in India who got TB was under the age of 14. Also, in India, one in five people who were estimated to have an active TB infection in 2021 was over 55 years of age (over 619,000 people). One third of these older persons could not get access to TB treatment (or were not notified to the government-run National TB Elimination Programme).

“In 2021, India had 119,000 new cases of multidrug-resistant TB (MDR-TB) out of which less than half were put on treatment. This has to change rapidly so that every person with drug- resistant strains has access to a regimen with medicines that work on the person,” he said.