India can't slack in its fight against TB

We have the highest TB burden in the world

The India TB report, released last week, presents a positive picture of the country’s fight against the disease, but areas of concern remain. The report shows that India has achieved its 2023 target of initiating treatment for 95% of all patients diagnosed with the infection. One major problem in tackling the disease has been the underreporting of cases. Missing patients who are untreated endanger themselves and expose others to infection. The narrowing gap between the estimated and the actual number of cases is a sign of progress. The private sector’s participation and improved performance by states such as Uttar Pradesh and Bihar mainly contributed to this. It is now possible to treat more patients, and that helps reduce mortality, check spread, and prevent the evolution of more virile forms of the pathogen.

India has set a target to eliminate the disease by 2025. Though the anti-TB programme has shown good results in recent years, India is unlikely to achieve the target because the multi-drug resistant (MDR) version of the disease is a serious challenge. The report has shown progress in identifying this severe version. About 60% of those diagnosed were tested to check whether their infection was resistant to first-line drugs. The scope of the tests will be expanded to cover more patients, and that is expected to help ascertain the number of those who need treatment with second-line drugs. The aim is to identify all MDR cases through better testing and investigations. MDR TB was declining in India before the Covid-19 pandemic, but recorded cases have increased since then.

MDR TB is difficult to treat because many drugs are not effective against it. A majority of the patients offered second-line treatment did not complete the course. Meanwhile, a short-duration last-resort drug has been found useful. With the decision not to renew the patent for this drug for an MNC drug, cheaper generic versions may be available soon. It is also necessary to pay more attention to non-lung TB which is more prevalent among women. The report has said that India achieved a 16% decline in new TB cases and an 18% reduction in mortality since 2015. But it is also a fact that India has the highest TB burden among all countries and contributes 27 per cent of all cases. The fight against TB has a special significance because the disease is more prevalent in the lower socio-economic strata of society.